Living High, Living Dangerously with Anemia

Pneumonia severity in anemic children at high altitudes is greater than at low altitudes

(RxWiki News) The higher you are in the world, the thinner the air is. Higher altitudes mean it's more difficult to breathe and gain the oxygen your body needs.

For children with anemia, the difficulty of getting enough oxygen in their blood could be even greater.

A recent study found that children with anemia living at higher altitudes have a harder time recovering from pneumonia than anemic children at lower altitudes.

Anemia means a person's body does not produce enough healthy red blood cells. Red blood cells carry oxygen throughout the body.

"Talk to your pediatrician about the risks of your child's anemia."

The study, led by Peter P. Moschovis, MD, MPH, of Massachusetts General Hospital and Harvard Medical School, looked at the risks for pneumonia among children with anemia at high altitudes.

The researchers used data from another study that had compared the use of antibiotics among children with severe pneumonia.

The study involved 958 children, aged 2 months to 5 years old, who lived at various elevations.

Their elevations were split according to those higher or lower than 2000 meters, or about 6,500 feet.

The researchers found that children with anemia who became sick with pneumonia at higher altitudes did more poorly and were less likely to respond to treatment.

Children with pneumonia and anemia who had been at higher altitudes had lower levels of oxygen saturation in their blood when they were diagnosed with pneumonia.

They also appeared more "blue" from having too little oxygen at the surface of their skin.

Those high altitude pneumonia children also had lower systolic (top number) blood pressure and higher levels of hemoglobin in their blood. Hemoglobin is the part of red blood cells that contains iron and carries oxygen throughout the body.

The researchers found that anemic children living at altitudes over 6,500 feet were four times less likely to have their pneumonia treatment work.

These findings remained even after taking into account other factors that might influence a child's response to treatment, including location, the child's nutrition and aspects of the child's medical history, such as immunizations.

Children living at higher altitudes also took longer to have normal levels of blood oxygen than children at lower altitudes.

"Children at high altitude [arrive] with more severe disease, and children with anemia at high altitude are at greater risk of poor outcome when being treated for severe pneumonia," the researchers concluded.

"Prevention and treatment of anemia should be a priority in children living at high altitude and could improve outcomes of pneumonia," they wrote.

The study was published October 7 in the journal Pediatrics.

The research was funded by the Department of Child and Adolescent Health and Development at the World Health Organization, the Center for International Health and Development at Boston University and the Johns Hopkins Bloomberg School of Public Health.

Additional support was provided by the Harvard Clinical and Translational Science Center and the National Institutes of Health. The authors declared no conflicts of interest.

Review Date: 
October 7, 2013