Indicators of anemia and physical growth in schoolchildren from the Ouest and Sud-Est Departments of Haiti: A cross-sectional study

Background: The identification and correction of malnutrition in children remains a critical public health issue in many developing countries. In this study, the rate of anemia and standardized indicators of physical growth were investigated in schoolchildren from Haiti. Methods: Hemoglobin concentrations, height, and weight were collected from schoolchildren (n = 615) and evaluated by World Health Organization (WHO) standardized classifications for anemia and child growth. Data on glucose-6-dehydrogenase (G6PD) deficiency and current or previous malaria infection available for all students; a subset of anemia and non-anemic males (n = 43) were tested for serum ferritin. School A (n = 504) had a school-based supplemental nutrition program, while School B (n = 111) did not. Results: Anemia was identified in 48.3% of students (95% CI: 44.3, 52.3), and not associated with BMI Z scores (P = 0.28) or serum ferritin concentrations (P = 0.17). The average Z scores for body mass index (BMI) of students at School A was within the normal range, while Z scores for BMI at School B were below average. Compared to school A, students at School B had significantly higher (P <0.001) rates of anemia (44.4% vs 65.8%) and were significantly (P <0.001) more likely to be underweight (16.5% vs 43.2%). Conclusions: The high prevalence of anemia in children with and without normal BMIs represents a major public health concern that warrants further investigation with more comprehensive methods. This study may also highlight some potential benefits of in-school nutritional supplementation programs in achieving lower rates of anemia and reaching WHO standards for child growth.