Prácticas alimentarias para la prevención y tratamiento de anemia ferropénica en niños menores de 5 años: Una revisión sistemática
DOI:
https://doi.org/10.61347/ei.v5i1.243Palabras clave:
Anemia ferropénica, hemoglobina, micronutrientes, niños, suplementaciónResumen
La anemia ferropénica persiste como la patología hematológica más frecuente en la primera infancia y constituye un problema prioritario de salud pública, especialmente en países de ingresos bajos y medios, donde factores dietéticos y socioeconómicos exacerban su incidencia. Esta afección alcanza a más del 40% de la población infantil según la OMS y sus secuelas incluyen deterioro cognitivo y vulnerabilidad inmunológica. El objetivo de esta investigación fue determinar las intervenciones nutricionales efectivas para su prevención mediante una revisión sistemática de la literatura reciente. Siguiendo el protocolo PRISMA, se realizó una búsqueda exhaustiva en PubMed, Scopus y Web of Science hasta mayo de 2024, y se seleccionaron 18 ensayos clínicos aleatorizados publicados en inglés y español entre 2019 y 2024. Se evaluó la calidad de la evidencia mediante GRADE, incluyendo estudios de naciones como Pakistán, Bangladesh y Perú. Los resultados indicaron que las intervenciones con suplementos lipídicos (como Wawa Mum y Plumpy'Doz) y micronutrientes en polvo (MNP) generaron reducciones significativas en la prevalencia de anemia y aumentos en los niveles de hemoglobina y ferritina. Sin embargo, la efectividad de otras medidas varió según el tipo de suplemento y la fidelidad al tratamiento. Se concluye que las intervenciones nutricionales logran reducir la anemia de manera eficaz, sobre todo al combinar la suplementación directa con educación alimentaria para los cuidadores. La evidencia sugiere que, para asegurar resultados sostenibles, es imperativo diseñar estrategias multicomponentes que fomenten la adherencia y estén rigurosamente contextualizadas a la realidad sociocultural de la población objetivo.
Descargas
Citas
Albelbeisi, A., Shariff, Z., Mun, C., Rahman, H., & Abed, Y. (2020). Multiple micronutrient supplementation improves growth and reduces the risk of anemia among infants in Gaza Strip, Palestine: a prospective randomized community trial. Nutrition Journal, 19(1), 133. https://doi.org/10.1186/S12937-020-00652-7
Alcalá, M., García Ramírez, K., & Ponce, J. (2023). Programa de intervención farmacéutica periférica para la prevención de anemia ferropénica en niños. Horizonte Médico (Lima), 23(2), e2194. https://doi.org/10.24265/horizmed.2023.v23n2.06
Alfonso, V., Ogunlusi, A., Wright, C., & Garcia, A. (2021). Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink. Maternal & Child Nutrition, 18(1), e13256. https://doi.org/10.1111/MCN.13256
Alves, M., Paiva, M., Machado, R., Sucasas, P., Guedes, A., & Costa, M. (2021). Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial. Nutrients, 13(7), 2160. https://doi.org/10.3390/NU13072160
Amri, M., Filart, J., Yang, J., Manga, J., Barrett, K., & Bump, J. (2025). Decolonizing global health: a scoping review of its key components, proposed actions, and contributors. Global Health Research and Policy, 10(1). https://doi.org/10.1186/s41256-025-00436-8
Awasthi, S., Reddy, N. Mitra, M., Singh, S., Ganguly, S., Jankovic, I., Grathwohl, D., Cercamondi, C., & Ghosh, A. (2020). Micronutrient-fortified infant cereal improves Hb status and reduces iron-deficiency anaemia in Indian infants: an effectiveness study. The British Journal of Nutrition, 123(7), 780. https://doi.org/10.1017/S0007114519003386
Azmeraw, M., Kassaw, A., Habtegiorgis, S., Tigabu, A., Amare, A., Mekuria, K., Temesgen, D., Zemariam, A., Kerebeh, G., Bantie, B., Alemnew, D., & Abate, B. (2023). Prevalence of anemia and its associated factors among children aged 6–23 months, in Ethiopia: a systematic review and meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-17330-y
Barffour, M., Hinnouho, G., Kounnavong, S., Wessells, K., Ratsavong, K., Bounheuang, B., Chanhthavong, B., Sitthideth, D., Sengnam, K., Arnold, C., Brown, K., & Hess, S. (2019). Effects of Daily Zinc, Daily Multiple Micronutrient Powder, or Therapeutic Zinc Supplementation for Diarrhea Prevention on Physical Growth, Anemia, and Micronutrient Status in Rural Laotian Children: A Randomized Controlled Trial. The Journal of Pediatrics, 207, 80. https://doi.org/10.1016/J.JPEDS.2018.11.022
Black, M., Fernandez-Rao, S., Nair, K., Balakrishna, N., Tilton, N., Radhakrishna, K., Ravinder, P., Harding, K., Reinhart, G., Yimgang, D., & Hurley, K. (2021). A Randomized Multiple Micronutrient Powder Point-of-Use Fortification Trial Implemented in Indian Preschools Increases Expressive Language and Reduces Anemia and Iron Deficiency. The Journal of Nutrition, 151(7), 2029. https://doi.org/10.1093/JN/NXAB066
Campbell, R., Shaikh, S., Schulze, K., Arguello, M., Ali, H., Wu, L., West, K., & Christian, P. (2020). Micronutrient and Inflammation Status Following One Year of Complementary Food Supplementation in 18-Month-Old Rural Bangladeshi Children: A Randomized Controlled Trial. Nutrients, 12(5), 1452. https://doi.org/10.3390/NU12051452
Chouraqui, J. (2022). Dietary Approaches to Iron Deficiency Prevention in Childhood—A Critical Public Health Issue. Nutrients, 14(8), 1604. https://doi.org/10.3390/nu14081604
Choudhury, D., Krishnapillai, M., Nagalla, B., Kankipati, R., Ghosh, S., Buwade, J., & Fernandez-Rao, S. (2021). Guava with an institutional supplementary meal improves iron status of preschoolers: a cluster-randomized controlled trial. Annals of the New York Academy of Sciences, 1492(1), 82-95. https://doi.org/10.1111/nyas.14556
Ferrari, B., & Peyvandi, F. (2020). How I treat thrombotic thrombocytopenic purpura in pregnancy. Blood, 136(19), 2125-2132. https://doi.org/10.1182/BLOOD.2019000962
Fink, G., Locks, L., Lauer, J., Chembe, M., Henderson, S., Sikazwe, D., Billima-Mulenga, T., Parkerson, D., & Rockers, P. (2024). The impact of home-installed growth charts and small-quantity lipid-based nutrient supplements (SQ-LNS) on child growth in Zambia: a four-arm parallel open-label cluster randomised controlled trial. BMJ Global Health, 9(8), e015438. https://doi.org/10.1136/BMJGH-2024-015438
Jembere, M., Kabthymer, R., & Deribew, A. (2020). Determinants of Anemia Among Children Aged 6 to 59 Months in Dilla Town, Southern Ethiopia: A Facility Based Case Control Study. Global Pediatric Health, 7. https://doi.org/10.1177/2333794X20974232
Khan, A., Ul-Haq, Z., Fatima, S., Ahmed, J., Alobaid, H., Fazid, S., Muhammad, N., Garzon, C., Ihtesham, Y., Habib, I., Tanimoune, M., Iqbal, K., Arshad, M., & Safi, S. (2023). Long-Term Impact of Multiple Micronutrient Supplementation on Micronutrient Status, Hemoglobin Level, and Growth in Children 24 to 59 Months of Age: A Non-Randomized Community-Based Trial from Pakistan. Nutrients, 15(7), 1690. https://doi.org/10.3390/NU15071690
Khan, G., Kureishy, S., Ariff, S., Rizvi, A., Sajid, M., Garzon, C., Khan, A., de Pee, S., Soofi, S., & Bhutta, Z. (2020). Effect of lipid-based nutrient supplement—Medium quantity on reduction of stunting in children 6-23 months of age in Sindh, Pakistan: A cluster randomized controlled trial. PLoS ONE, 15(8), e0237210. https://doi.org/10.1371/JOURNAL.PONE.0237210
Koch, R., Pool, J., & Heymans, Y. (2025). Decolonisation of Health Sciences curricula as a vehicle for transformation in Higher Education: A scoping review. South African Journal of Higher Education, 39(1). https://doi.org/10.20853/39-1-6109
Larson, L., Feuerriegel, D., Hasan, M., Braat, S., Jin, J., Tipu, S., Shiraji, S., Tofail, F., Biggs, B., Hamadani, J., Johnson, K., Pasricha, S., & Bode, S. (2023). Supplementation With Iron Syrup or Iron-Containing Multiple Micronutrient Powders Alters Resting Brain Activity in Bangladeshi Children. The Journal of Nutrition, 153(1), 352-363. https://doi.org/10.1016/J.TJNUT.2022.12.026
Martínez-Torres, V., Torres, N., Davis, J., & Corrales-Medina, F. (2023). Anemia and Associated Risk Factors in Pediatric Patients. Pediatric Health, Medicine and Therapeutics, 14, 267-280. https://doi.org/10.2147/phmt.s389105
Mboya, I. B., Mamseri, R., Leyaro, B., George, J., Msuya, S., & Mgongo, M. (2020). Prevalence and factors associated with anemia among children under five years of age in Rombo district, Kilimanjaro region, Northern Tanzania. F1000Research, 9, 1102. https://doi.org/10.12688/f1000research.24707.1
Mehjabeen, D., Patel, K., & Jindal, R. (2025). Decolonizing global health: a scoping review. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-025-12890-8
Michaux, K., Hou, K., Karakochuk, C., Whitfield, K., Ly, S., Verbowski, V., Stormer, A., Porter, K., Li, K., Houghton, L., Lynd, L., Talukder, A., McLean, J., & Green, T. (2019). Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial. Maternal & Child Nutrition, 15(Suppl 3), e12757. https://doi.org/10.1111/MCN.12757
Mithra, P., Khatib, M., Sinha, A. P., Kumar, N., Holla, R., Unnikrishnan, B., Vijayamma, R., Nair, N. S., Gaidhane, A., & Quazi Zahiruddin, S. (2021). Interventions for Addressing Anemia Among Children and Adolescents: An Overview of Systematic Reviews. Frontiers in Pediatrics, 8. https://doi.org/10.3389/fped.2020.549549
Morón-Arce, A., Palomino-Zevallos, C., Peralta-Medina, A., Morales, R., & Vela-Ruiz, J. (2024). Systematic review of health sector and multisectoral interventions for the reduction of anemia in children under 5 years of age in Latin American countries. Archivos Latinoamericanos de Nutrición, 74(3), 206-221. https://doi.org/10.37527/2024.74.3.006
Moscheo, C., Licciardello, M., Samperi, P., La Spina, M., Di Cataldo, A., & Russo, G. (2022). New insights into iron deficiency anemia in children: A practical review. Metabolites, 12(4). https://doi.org/10.3390/metabo12040289
Page, M., McKenzie, J., Bossuyt, P., Boutron, I., Hoffmann, T., Mulrow, C., Shamseer, L., Tetzlaff, J., Akl, E., Brennan, S., Chou, R., Glanville, J., Grimshaw, J., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pant, I., Khosla, S., Lama, J., Shanker, V., AlKhaldi, M., El-Basuoni, A., Michel, B., Bitar, K., & Nsofor, I. (2022). Decolonising global health evaluation: Synthesis from a scoping review. PLOS Global Public Health, 2(11). https://doi.org/10.1371/journal.pgph.0000306
Parkin, P., Degroot, J., Maguire, J., Birken, C., & Zlotkin, S. (2016). Severe iron-deficiency anaemia and feeding practices in young children. Public Health Nutrition, 19(4), 716-722. https://doi.org/10.1017/S1368980015001639
Pasricha, S., Hasan, M., Braat, S., Larson, L., Tipu, S., Hossain, S., Shiraji, S., Baldi, A., Bhuiyan, M., Tofail, F., Fisher, J., Grantham-McGregor, S., Simpson, J., Hamadani, J., & Biggs, B. (2021). Benefits and Risks of Iron Interventions in Infants in Rural Bangladesh. New England Journal of Medicine, 385(11), 982-995. https://research.monash.edu/en/publications/benefits-and-risks-of-iron-interventions-in-infants-in-rural-bang/
Prasad, M. (2024). Introduction to the GRADE tool for rating certainty in evidence and recommendations. Clinical Epidemiology and Global Health, 25, 101484. https://doi.org/10.1016/j.cegh.2023.101484
Rodríguez, R., Leal, J., Vera, J., & Ávila, C. (2024). Factores de riesgo de anemia y estado nutricional en menores de 5 años atendidos en el Centro de Salud Rocafuerte, Manabí, Ecuador. QhaliKay Revista de Ciencias de la Salud ISSN 2588-0608, 8(1), 1-10. https://doi.org/10.33936/qkrcs.v8i1.6236
Safiri, S., Kolahi, A., Noori, M., Nejadghaderi, S., Karamzad, N., Bragazzi, N., Sullman, M., Abdollahi, M., Collins, G., Kaufman, J., & Grieger, J. (2021). Burden of anemia and its underlying causes in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019. Journal of Hematology and Oncology, 14(1). https://doi.org/10.1186/s13045-021-01202-2
Sallo, V., Trujillo, P., Zúñiga, L. & Mendoza, J. (2025). Manejo preventivo de la anemia infantil en Sudamérica: revisión sistemática de políticas, intervenciones y desafíos. Zenodo. https://doi.org/10.5281/zenodo.15420829
Sobrido, M., & Rumbo-Prieto, J. (2018). The systematic review: Plurality of approaches and methodologies. Enfermeria Clinica, 28(6), 387-393. https://doi.org/10.1016/j.enfcli.2018.08.008
Stewart, C., Fernald, L., Weber, A., Arnold, C., & Galasso, E. (2020). Lipid-Based Nutrient Supplementation Reduces Child Anemia and Increases Micronutrient Status in Madagascar: A Multiarm Cluster-Randomized Controlled Trial. The Journal of Nutrition, 150(4), 958. https://doi.org/10.1093/JN/NXZ320
Sunardi, D., Bardosono, S., Basrowi, R., Wasito, E., & Vandenplas, Y. (2021). Dietary determinants of anemia in children aged 6–36 months: A cross-sectional study in Indonesia. Nutrients, 13(7). https://doi.org/10.3390/nu13072397
Tuck, E., & Wayne, K. (2021). La descolonización no es una metáfora. Tabula Rasa, 38, 61-111. https://doi.org/10.25058/20112742.n38.04
Varea, A., Disalvo, L., Fasano, M., Sala, M., Avico, A., Azrack, M., Padula, G., & González, H. (2023). Efectividad de la administración de hierro en forma semanal y diaria para la prevención de anemia por deficiencia de hierro en lactantes. Archivos argentinos de pediatria, 121(4), e202202815. https://doi.org/10.5546/aap.2022-02815.eng
Vásquez-Guzmán, R., Solano-Ceh, A., Villarreal-Ríos, E., Aguilar-Ramírez, M., Vargas-Daza, E., Hernández-Vásquez, M., Galicia-Rodríguez, L., & Elizarrarás-Rivas, J. (2022). Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants. Boletín Médico del Hospital Infantil de Mexico, 79(6), 376-380. https://doi.org/10.24875/BMHIM.22000081
Viscarra, D. & Prieto, C. (2025). Factores asociados a la anemia ferropénica en niños de 0-16 años en Latinoamérica. Arandu UTIC, 12(2), 4105-4118. https://doi.org/10.69639/arandu.v12i2.1217
Yip, S., Wang, N., & Sugimura, R. (2023). Give them vasculature and immune cells: How to fill the gap of organoids. Cells Tissues Organs, 212(5), 369-382. https://doi.org/10.1159/000529431
Young, M., Mehta, R., Gosdin, L., Kekre, P., Verma, P., Larson, L., Girard, A., Ramakrishnan, U., Chaudhuri, I., Srikantiah, S., & Martorell, R. (2021). Home Fortification of Complementary Foods Reduces Anemia and Diarrhea among Children Aged 6–18 Months in Bihar, India: A Large-Scale Effectiveness Trial. The Journal of Nutrition, 151(7), 1983. https://doi.org/10.1093/JN/NXAB065
Zheng, J., Liu, J., & Yang, W. (2021). Association of iron-deficiency anemia and non-iron-deficiency anemia with neurobehavioral development in children aged 6–24 months. Nutrients, 13(10). https://doi.org/10.3390/nu13103423
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Andreina Morelia Núñez Barros, Lizbeth Geovanna Silva-Guayasamín
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
