Anemia in children residing in Chechersk district of Belarus

INTRODUCTION:  The accident at the Chernobyl nuclear power plant in Ukraine (April 26, 1986) has contaminated not only neighboring countries but the whole Europe. However, the most contaminated regions were in southern Belarus, northern Ukraine and the Bryansk and Kaluga regions of Russia by radionuclides such as Cs, Srand other trans-uranium elements. According to some publications the children (including in utero) of the Chechersk district of the Gomel region and the Mtsensk and Bolhov districts of the Orel region had various levels of exposure. Previous studies found anemia in 11.5% among 1926 surveyed children during 1986-1998.

METHODS: A total of 2,395 children aged 3 - 15 years old at the baseline checkup (2005) in Chechersk district were investigated for anemia prevalence. Data on the following plausible predictors were recorded: age, sex, living conditions, type of residency, food consumption, zone of residency, level of internal contamination. Anemia diagnosis was based on the hemoglobin level, hematocrit, number of erythrocytes and serum iron. Cut off criteria (140g/l) for children set up in Belarus was compared to WHO cut off criteria (120g/l) to look for the differences in the prevalence of anemia in the checkup periods during the years 2005, 2007 and 2009. The two criteria of anemia were compared using two statistical methods: NcNemar's test for marginal homogeneity and the Kappa statistic to measure agreement. The prevalence of anemia by predictor variables was determined using descriptive statistics. The statistical analysis was performed using SAS for Windows (version 9.3). Multivariate logistic regression modeling was used to estimate the relative risk and 95% confidence intervals of anemic children compared with non-anemic. 

RESULTS: Anemia was correlated with hemoglobin level, serum iron, height, globular value, erythrocytes, unsatisfactory social life, and zone of residence 5 compared to other residence zone (Pr < 0.05 for all). Nutrition variables were not consistent across the exams. OR =3.7 for anemia if the person does not have potatoes in the diet. The OR is slightly less than 1 if they have dairy in the diet.

CONCLUSIONS: Prevalence of anemia in children was correlated with hemoglobin level, serum iron, height, globular value, erythrocytes, unsatisfactory social life, and zone of residence.