Elevated Pediatric Anemia Through Non-Serological Assessments at High Altitude: A Failure of Iron Supplementation?

Virto-Farfan H.; Virto C. · Gaceta Medica Boliviana (2026) · DOI: 10.47993/gmb.v49i1.1199

Resumen

Objective: To analyze the demographic and hematological characteristics of an Andean pediatric population, with emphasis on the prevalence and classification of anemia according to different altitude-adjustment criteria. Materials and Methods: A descriptive, cross-sectional, and analytical study was conducted in 178 children aged 3 to 12 years in San Jerónimo, Cusco, Peru, located at 3,390 meters above sea level. Hemoglobin concentration was measured using the Rad-67® Pulse CO-Oximeter® and adjusted according to Peruvian technical regulations. Sex, weight, height, and body mass index (BMI) were obtained from clinical records. Between-group differences were assessed using nonparametric statistical tests. Results: Three diagnostic scenarios were compared: unadjusted hemoglobin, hemoglobin adjusted according to the 2017 Peruvian regulation, and hemoglobin adjusted according to the 2024 Peruvian regulation. Without altitude correction, 90.45% of children were classified as non-anemic, 7.87% as having mild anemia, and 1.69% as having moderate anemia. After applying the 2024 correction, the proportion of non-anemic children decreased to 19.10%, with predominance of moderate anemia (58.43%) and mild anemia (22.47%). The 2017 correction yielded an even higher proportion of moderate anemia (68.54%). Significant differences were observed in hemoglobin concentration (p < 0.01) and BMI (p = 0.015) between sexes, with lower values among girls. Conclusions: The epidemiological estimation of anemia varied substantially according to the altitude-adjustment criterion applied. Longitudinal studies with complementary laboratory validation are required to clarify the clinical and programmatic implications of these differences.

Instituciones: Universidad Andina del Cusco