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© 2009 Olson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Olson CL, Acosta LP, Hochberg NS, Olveda RM, Jiz M, et al. (2009) Anemia of Inflammation Is Related to Cognitive Impairment among Children in Leyte, The Philippines. PLoS Negl Trop Dis 3(10): e533. doi:10.1371/journal.pntd.0000533

Abstract

Background

Many studies have addressed the relationship between iron deficiency anemia (IDA) and cognitive impairment, but none have evaluated the role of non-iron deficiency anemia (NIDA). One of the main causes of NIDA in developing countries is AI, largely due to infectious diseases, whereby iron is shunted away from bio-available forms to storage forms, making it less accessible for use by host tissues. The objective of this study was to determine the effect of NIDA, due largely to AI in this context, on cognitive function after adjustment for potential confounders.

Methodology

This cross-sectional study was conducted in Leyte, The Philippines among 322 children ages 7-18 years. Blood samples were collected and analyzed at the time of cognition testing. Three stool samples were collected and evaluated by the Kato Katz method for quantitative assessment for Schistosoma japonicum and geo-helminth infection. Socio-economic status (SES) was evaluated by survey. Linear regression models were used to quantify the adjusted relationship between performance in different cognitive domains and both IDA and NIDA.

Principal Findings

After adjusting for age, sex, SES and nutritional status, children in the NIDA had lower scores on the PNIT (P = <0.05) and the WRAML memory domain (P<0.05) compared to children in the non-anemic group. Children in the IDA had lower performance on the PNIT compared to the non-anemic group after controlling for potential confounders (P<0.05).

Conclusions

NIDA, predominantly due to AI in this context, was related to lower performance on two tests of cognitive function. This is likely due to decreased delivery of iron to host tissues in this context, including the CNS.

Details

Title
Anemia of Inflammation Is Related to Cognitive Impairment among Children in Leyte, The Philippines
Author
Olson, Courtney L; Acosta, Luz P; Hochberg, Natasha S; Olveda, Remigio M; Jiz, Mario; McGarvey, Stephen T; Kurtis, Jonathan D; Bellinger, David C; Friedman, Jennifer F
Pages
e533
Section
Research Article
Publication year
2009
Publication date
Oct 2009
Publisher
Public Library of Science
ISSN
19352727
e-ISSN
19352735
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
1288100358
Copyright
© 2009 Olson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Olson CL, Acosta LP, Hochberg NS, Olveda RM, Jiz M, et al. (2009) Anemia of Inflammation Is Related to Cognitive Impairment among Children in Leyte, The Philippines. PLoS Negl Trop Dis 3(10): e533. doi:10.1371/journal.pntd.0000533