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The Increase in Hemoglobin Concentration With Altitude Differs Between World Regions and Is Less in Children Than in Adults.

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dc.contributor.author Mairbäurl, Heimo
dc.contributor.author Kilian, Samuel
dc.contributor.author Seide, Svenja
dc.contributor.author Muckenthaler, Martina U.
dc.contributor.author Gassmann Mendez, Max
dc.contributor.author Benedict, Rukundo K.
dc.coverage.spatial Guatemala
dc.coverage.spatial Honduras
dc.coverage.spatial Perú
dc.coverage.spatial Bolivia
dc.coverage.spatial Angola
dc.coverage.spatial Chad
dc.coverage.spatial Camerún
dc.coverage.spatial Guinea
dc.coverage.spatial Lesotho
dc.coverage.spatial Namibia
dc.coverage.spatial Esuatini
dc.coverage.spatial Sudáfrica
dc.coverage.spatial Burundi
dc.coverage.spatial Etiopia
dc.coverage.spatial Kenia
dc.coverage.spatial Madagascar
dc.coverage.spatial Malawi
dc.coverage.spatial Mozambique
dc.coverage.spatial Ruanda
dc.coverage.spatial Tanzania
dc.coverage.spatial Uganda
dc.coverage.spatial Zimbabwe
dc.coverage.spatial Jordania
dc.coverage.spatial Yemen
dc.coverage.spatial Armenia
dc.coverage.spatial Azerbaiyán
dc.coverage.spatial Kirguistán
dc.coverage.spatial Tajikistán
dc.coverage.spatial India
dc.coverage.spatial Birmania
dc.coverage.spatial Nepal
dc.coverage.spatial Timor Oriental
dc.date.accessioned 2023-04-16T04:38:16Z
dc.date.available 2023-04-16T04:38:16Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13413
dc.description.abstract To compensate for decreased oxygen partial pressure, high-altitude residents increase hemoglobin concentrations [Hb]. The elevation varies between world regions, posing problems in defining cutoff values for anemia or polycythemia. The currently used altitude adjustments (World Health Organization [WHO]), however, do not account for regional differences. Data from The Demographic and Health Survey (DHS) Program were analyzed from 32 countries harboring >4% of residents at altitudes above 1000 m. [Hb]-increase, (ΔHb/km altitude) was calculated by linear regression analysis. Tables show 95% reference intervals (RIs) for different altitude ranges, world regions, and age groups. The prevalence of anemia and polycythemia was calculated using regressions in comparison to WHO adjustments. The most pronounced Δ[Hb]/km was found in East Africans and South Americans while [Hb] increased least in South/South-East Asia. In African regions and Middle East, [Hb] was decreased in some altitude regions showing inconsistent changes in different age groups. Of note, in all regions, the Δ[Hb]/km was lower in children than in adults, and in the Middle East, it was even negative. Overall, the Δ[Hb]/km from our analysis differed from the region-independent adjustments currently suggested by the WHO resulting in a lower anemia prevalence at very high altitudes. The distinct patterns of Δ[Hb] with altitude in residents from different world regions imply that one single, region-independent correction factor for altitude is not be applicable for diagnosing abnormal [Hb]. Therefore, we provide regression coefficients and reference-tables that are specific for world regions and altitude ranges to improve diagnosing abnormal [Hb]. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries HemaSphere
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Hemoglobin Concentration en_US
dc.subject Altitude en_US
dc.subject World Regions en_US
dc.subject Children en_US
dc.subject Adults en_US
dc.title The Increase in Hemoglobin Concentration With Altitude Differs Between World Regions and Is Less in Children Than in Adults. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/HS9.0000000000000854
dc.relation.issn 2572-9241


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