Association of Zinc Deficiency with Anaemia in Under-five Children of Rural Bangladesh: An Observational Study

Author(s): Moniruzzaman Mollah MD*, Ashik Mosaddik, Asgor Hossain, Andrew Asim Roy, Parvez Hassan

Introduction: Anemia is a major public health challenge worldwide that occurs with a higher prevalence in under-five children who live in rural areas. Like other micronutrients, zinc deficiency may be a new determinant of anaemia.

Objectives: This study was designed to find out if there is any association between zinc deficiency and anaemia in preschool children.

Methods: This cross-sectional study was conducted in the rural Bangladesh from July 2018 to December 2019. Total 428 under-five children were enrolled, of them 61.45% (263) were anaemic. Etiological exploration was conducted among anaemia respondent (n=163) through essential blood tests (CBC, Hb electrophoresis, Ferritin, Vitamin B12 assay, and Folate assay) and of them 36% remained as undifferentiated. These subjects and who are willing to respond were enrolled for further Zinc assay as per study flowchart. Then serum zinc was estimated through the colorimetric method by a semi-automated biochemistry analyzer. Zinc status was defined as deficiency (<69 μg/d), normal (≥69 to <108 μg/dL) and high (≥109 μg/dL). Chi-square (χ2) tests were done to find out the significant factors. Ethical clearance was obtained from IBSc, Rajshahi University. The data were analyzed through SPSS 23 software and at a 95% confidence interval and p values < 0.05 were considered significant.

Results: The overall prevalence of anaemia was 61.45%. Etiologically, iron deficiency anemia (34%) was observed as the leading pattern followed by inherited hemoglobin disorder (32%) and zinc deficiency (24%). Zinc status (n = 67) revealed, nearly 72 % of anaemic children belonged to low zinc category, 22% had normal status and remaining 6% had high zinc level. Among low zinc category (72%), a proportionate 55% anaemic children independently associated with zinc deficiency alone, which was statistically significant (p < .001).

Conclusion: The study indicates nearly one fourth of anaemic population had low level zinc and of them nearly threefourth of the anaemia sufferer independently associated with zinc deficiency alone.