Micronutrient Status and Other Correlates of Hemoglobin among Children with Stunting: A Cross-Sectional Study in Uganda

Rolland Mutumba, Joseph Mbabazi, Hannah Pesu, Eva Greibe, Mette F. Olsen, André Briend, Christian Mølgaard, Christian Ritz, Ezekiel Mupere, Suzanne Filteau, Henrik Friis, Benedikte Grenov

Research output: Contribution to journalArticleScientificpeer-review


In low-income countries, undernutrition and infections play a major role in childhood anemia. Stunted children may be at particular risk of anemia. In a cross-sectional study nested in a nutrition trial among 12–59-month-old stunted children in eastern Uganda, we measured hemoglobin (Hb) and markers of iron, cobalamin, folate and vitamin A status. We assessed low micronutrient status, socio-demography, stunting severity, inflammation and malaria as correlates of Hb and anemia using linear and logistic regression analyses, respectively. Of 750 stunted children, the mean ± SD age was 32.0 ± 11.7 months and 55% (n = 412) were male. The mean Hb was 104 ± 15 g/L and 65% had anemia, Hb < 110 g/L. In a multivariable model with age, sex and inflammation, the following were associated with lower Hb: serum ferritin < 12 µg/L (−5.6 g/L, 95% CI: −8.6; −2.6), transferrin receptors > 8.3 mg/L (−6.2 g/L, 95% CI: −8.4; −4.0), plasma folate <20 nmol/L (−4.6 g/L, 95% CI: −8.1;−1.1), cobalamin < 222 pmol/L (−3.0 g/L, 95% CI: −5.4; −0.7) and serum retinol-binding protein < 0.7 µmol/L (−2.0 g/L, 95% CI: −4.1; 0.2). In addition, severe stunting, inflammation and malaria were negative correlates. Anemia is common among stunted children in eastern Uganda; micronutrient deficiencies, inflammation and malaria are associated with low Hb.

Original languageEnglish
Article number3785
Issue number17
Publication statusPublished - Aug 2023
Publication typeA1 Journal article-refereed


  • anemia
  • hemoglobin
  • inflammation
  • malaria
  • micronutrients
  • stunting

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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