Investigation of Pediatric Anemia in the Commonwealth of the Northern Mariana Islands
Objective To report on the prevalence and etiology of pediatric anemia in the Commonwealth of the Northern Mariana Islands (CNMI). Method A retrospective chart review was conducted that included patients up to 19 years of age who presented for well child care and whose hemoglobin or hematocrit was checked in the CNMI from 2014 to 2015. Lab values, diagnoses and treatment plans, patient reported ethnicity, and follow-up results were collected from eligible patients. Results The records for 1483 pediatric patients who had 1584 well child visits were reviewed. The prevalence of anemia amongst all eligible patients was 8.0% (5.4–10.7). This included 292 9 to 18 months old patients, which is estimated to be 40% of the total pediatric population of CNMI in that age group. Among the 9 to 18 months old patients, the prevalence of anemia is 5.5% (2.6–8.4). Etiology of anemia was investigated and of the patients treated with iron, 55.2% had a documented response. The majority of those without documentation of improvement with iron were patients who were lost to follow-up. In addition, a total of 10 patients were found to have an alpha or beta thalassemia variant discovered initially by anemia screening or sibling tracing. Discussion In this United States Commonwealth, prevalence of anemia appears lower than prevalence reported for other independent Pacific Island nations and closer to that of the US. Thalassemia is documented within this population. Limitations to this data were use of a convenient sample that may be hampered by lack of presentation to well-child care. This study will guide future public health studies on anemia prevalence and can guide public health intervention decisions to improve pediatric care in the CNMI.
KeywordsPediatric anemia CNMI Pacific Island Anemia prevalence
- Dela Cruz, R. (2015). Assessing maternal and infant health in the Commonwealth of the Northern Mariana Islands. MPH Thesis, UCLA Fielding School of Public Health.Google Scholar
- Lin, T. F., Huang, J. N., & Cash, H. L. (2017). Comprehensive review of preschool age anemia in the Pacific Island jurisdictions. Hawaii Journal of Medicine and Public Health, 76(12), 331–336.Google Scholar
- McDonagh, M., Blazina, I., Dana, T., et al. (2015) Routine iron supplementation and screening for iron deficiency anemia in children ages 6 to 24 months: A systematic review to update the U.S. Preventative Services Task Force recommendation. Evidence Syntheses, No. 122. Rockville, MD: Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK285660/.
- Origa, R., Moi, P., Galanello, R., et al. (2013). Alpha-thalassemia. In R. A. Pagon, M. P. Adam, H. H. Ardinger, et al. (Eds), GeneReviews ®. Seattle, WA: University of Washington, Seattle. Updated Nov 21, 2013. Retrieved April 27, 2016, from http://www.ncbi.nlm.nih.gov/books/NBK1435/.
- Snyder, R. E., Cunninghan, W., Nakazono, T. T., et al. (2016). Access to medical care reported by Asians and Pacific Islanders in a West Coast Physician Group Association. Medical Care Research and Review, 57, 195–215.Google Scholar
- US Department of Commerce. (2012). Northern Marianas Islands: 2010 Census summary report. Retrieved September 21, 2015, from http://commerce.gov.mp/wp-content/uploads/2012/12/2010-Census-Demographics-Profile-Summary-Saipan-Village-Tables.pdf.
- WHO. (2011). Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. WHO/NMH/NHD/MNM/11.1. Geneva: World Health Organization. Retrieved October 30, 2017, from http://www.who.int/vmnis/indicators/haemoglobin.pdf.
- Yip, R. (1998). Recommendations to prevent and control iron deficiency in the United States. MMWR, 47, 1–36.Google Scholar
- Yip, R., Walsh, K. M., Goldfarb, M. G., & Binkin, N. J. (1987). Declining prevalence of anemia in childhood in a middle-class setting: A pediatric success story? Pediatrics, 80, 330–334.Google Scholar