Abstract
Background: Anemia and growth impairment are major health problems in children under 5 years in countries with ongoing crises. Aim: The aim of this study is to investigate the prevalence of anemia; low z scores for height for age, weight for age, and weight for height; and elevated plasma total homocysteine (tHcy) and low folate and vitamin B(12) concentrations in Syrian children aged 12-60 months. Methods: This cross-sectional study included 344 children of whom physical growth was measured. Blood count and circulating biomarkers of folate and B(12) and blood count were measured in a subgroup of the children. Data were collected on sociodemographic and contextual factors. Results: Anemia (age-specific cutoff values for hemoglobin according to the World Health Organization) was detected in 24.4% of the children. The height-for-age z score was < -2 in 32.0%, the weight-for-age z score was < -2 in 16.3%, and the weight-for height z sore< -2 in 1.5% of the children. The concentrations of tHcy, folate, and vitamin B(12) were (median and (10th, 90th percentiles)) 8.4 (5.6, 12.3) μmol/L, 24.0 (9.3, 34.7) nmol/L, and 198 (123, 367) pmol/L, respectively. Anemia and child anthropometric measures were not associated with elevated tHcy, low folate, or low B(12) concentrations. Conclusion: Anemia and low height- or weight-to-age z scores are highly prevalent among Syrian preschool children. Low folate or vitamin B(12) status was common, but they did not explain these conditions. Future studies may investigate whether early life multinutrient interventions may improve child growth and anemia.