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Assessment of Iron, Folate and Vitamin B12 Status in Severe Acute Malnutrition



To assess iron, folate and vitamin B12 status in hospitalized children aged between 6 mo to 5 y with severe acute malnutrition and its correlation with their clinico-epidemiological profile.


The study was conducted on 50 children with severe acute malnutrition. Anthropometric measurements were taken to determine their nutritional status. The demographic profile and relevant information of individual patient were collected by using structured proforma and an informed consent was taken for enrolling the children into the study. Serum ferritin, folate and vitamin B12 was estimated using electrochemiluminiscence (ECL) method.


Seventy eight percent patients had weight/height (WT/HT) Z score < −3 standard deviation (3SD), 72 % with mid upper arm circumference (MUAC) <11.5 cm and 22 % of them had edematous malnutrition. Anemia was prevalent in 47(94 %) and there was significant correlation between WT/HT < −3SD and vitamin B 12 deficiency (p = 0.015). Significantly higher number of these patients had vitamin B12 deficiency as compared to folate and iron deficiency (p = 0.0006 each).


Vitamin B12 deficiency was more common than iron and folate deficiencies in these patients with severe acute malnutrition.

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  1. Report on the IAEA technical meeting on ‘severe acute and moderate malnutrition in South East Asia’ (jointly with IMTF), 27–29 May 2013, Bangkok, Thailand, p. 1.

  2. National Family Health Survey 3, 2005–2006. Mumbai India: International Institute of Population Science; 2006. p. 269.

  3. Kumar R, Singh J, Joshi K, Singh HP, Bijesh S. Co-morbidities in hospitalized children with severe acute malnutrition in Rewa district. Indian Pediatr. 2014;51:125–7.

  4. Nutritional status of children and prevalence of anemia among children, adolescent girls and pregnant women. District level household survey on reproductive and child health 2002–04. p. 27.

  5. Ejaz MS, Latif N. Stunting and micronutrient deficiencies in malnourished children. J Pak Med Assoc. 2010;60:543–7.

    PubMed  Google Scholar 

  6. WHO-country office for India, NRHM. Facility based care of severe acute malnutrition. March 2011.

  7. WHO/UNICEF/UNU. Iron deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva, Switzerland: World Health Organization; 2001.

  8. WHO; CDC. Assessing the iron status of populations: including literature reviews: report of a Joint World Health Organization/Centers for Disease Control and Prevention Technical Consultation on the Assessment of Iron Status at the Population Level. 2nd ed. Geneva, Switzerland: World Health Organization & Centers for Disease Control and Prevention; 2004.

  9. De Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008;29:S238–44.

    PubMed  Google Scholar 

  10. page 3.

  11. page 1.

  12. Alderman H, Shekar M. Nelson textbook of paediatrics. 19th ed. Chapter 43, Nutrition, food security, and health. p. 172.

  13. Thakur N, Chandra J, Pemde H, Singh V. Anemia in severe acute malnutrition. Nutrition. 2014;30:440–2.

    Article  CAS  PubMed  Google Scholar 

  14. Allen LH. Vitamin B12 metabolism and status during pregnancy, lactation and infancy. Adv Exp Med Biol. 1994;352:173–86.

    Article  CAS  PubMed  Google Scholar 

  15. Allen LH. Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. 2005;81:1206S–12S.

    CAS  PubMed  Google Scholar 

  16. Menon KC, Skeaff SA, Thomson CD, Gray AR, Ferguson EL, Zodpey S, et al. Concurrent micronutrient deficiencies are prevalent in nonpregnant rural and tribal women from central India. Nutrition. 2011;27:496–502.

    Article  CAS  PubMed  Google Scholar 

  17. Pasricha SR, Shet AS, Black JF, Sudarshan H, Prashanth NS, Biggs BA. Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition. Am J Clin Nutr. 2011;94:1358–70.

    Article  CAS  PubMed  Google Scholar 

  18. Mackey AD, Picciano MF. Maternal folate status during extended lactation and the effect of supplemental folic acid. Am J Clin Nutr. 1999;69:285–92.

    CAS  PubMed  Google Scholar 

  19. Allen LH. B vitamins: proposed fortification levels for complementary foods for young children. J Nutr. 2003;133:3000S–7S.

    PubMed  Google Scholar 

  20. Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008;29:S126–31.

    PubMed Central  PubMed  Google Scholar 

  21. Taneja S, Bhandari N, Strand TA, Sommerfelt H, Refsum H, Ueland PM, et al. Cobalamin and folate status in infants and young children in a low-to-middle income community in India. Am J Clin Nutr. 2007;86:1302–9.

    CAS  PubMed  Google Scholar 

  22. Gomber S, Kumar S, Rusia U, Gupta P, Agarwal KN, Sharma S. Prevalence & etiology of nutritional anaemias in early childhood in an urban slum. Indian J Med Res. 1998;107:269–73.

    CAS  PubMed  Google Scholar 

  23. Hanumante NM, Wadia RS, Deshpande SS, Sanwalka NJ, Vaidya MV, Khadilkar AV. Vitamin B12 and homocysteine status in asymptomatic Indian toddlers. Indian J Pediatr. 2008;75:751–3.

    Article  CAS  PubMed  Google Scholar 

  24. Chandra J, Jain V, Narayan S, Sharma S, Singh V, Kapoor AK, et al. Folate and cobalamin deficiency in megaloblastic anemia in children. Indian Pediatr. 2002;39:453–7.

    PubMed  Google Scholar 

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The authors acknowledge the kind help from the HOD, department of Biochemistry.

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Correspondence to Taorem Yaikhomba.

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Yaikhomba, T., Poswal, L. & Goyal, S. Assessment of Iron, Folate and Vitamin B12 Status in Severe Acute Malnutrition. Indian J Pediatr 82, 511–514 (2015).

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  • Severe acute malnutrition
  • Ferritin
  • Folate
  • Vitamin B12