Sachith Mettananda
Duantida Songdej
Nirmani Yasara- 1Department of Paediatrics, University of Kelaniya, Ragama, Sri Lanka
- 2University Paediatrics Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka
- 3Hematology-Oncology Unit, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- 4Department of Biochemistry and Clinical Chemistry, University of Kelaniya, Ragama, Sri Lanka
Editorial on the Research Topic
Anemia in children: from nutritional deficits to genetic disorders
Anemia is one of the most common health problems among children globally (1). The prevalence of anemia among preschool children ranges between <10% in developed countries in Europe and North America to >50% in developing countries in sub-Saharan Africa (2, 3). The causes for anemia are numerous and include nutritional deficiencies, hemoglobinopathies, inherited red cell disorders, bone marrow failure, and chronic infections (4). The relative contribution of these etiologies to the burden of anemia among children varies from country to country.
This research topic aims to provide insight into many outstanding issues related to anemia in children. The seven manuscripts of this Research Topic examine different aspects related to various causes of anemia among children, ranging from nutritional problems to genetic diseases in different parts of the world.
A study done in Uganda by Komakech et al., published in this research article collection, reported the prevalence of anemia among children aged 6–59 months as 67%. The study highlighted malaria as a significant cofactor, with children who had a history of malaria showing a 20% higher risk of anemia. It also showed that children with older caregivers were more likely to be anemic, while children aged between 3 and 5 years had a lower risk. This emphasizes how local health conditions and family factors influence anemia risk.
The study by Akindutire et al., done in Gambia, uses structural equation modelling to identify sociodemographic determinants of childhood anemia. It identified parental educational attainment, housing location, type of restroom, gender, level of education, marital status, drinking water source, state, number of children, and income status as factors affecting anemia in children.
In addition to the above community-based research studies, the research topic collection published papers covering inherited genetic diseases causing anemia in children. These include sickle cell disease, thalassemia, hereditary spherocytosis, Diamond-Blackfan anemia, and bone marrow failure syndromes.
An observational study done in Senegal by Petigas et al. described how the introduction of neonatal screening impactfully changed the trajectory of sickle cell disease in the country. Infants diagnosed at birth through screening had fewer complications and needed fewer interventions than those who were diagnosed later, when symptoms had already developed. This demonstrates how early diagnosis can reduce suffering and improve long-term health outcomes of children with sickle cell disease.
The thalassemia study reported in this article collection reviews the mechanisms of cardiac injury due to iron overload in thalassemia. Regular blood transfusions are the leading cause of iron overload in children with transfusion-dependent thalassemia (5). The review by Fu and Yang showed that cardiac iron overload affects about a quarter of patients with beta-thalassemia major, contributing to heart failure and early death. The paper describes plausible mechanisms of injury, including oxidative stress and ferroptosis in the heart, and emphasizes the importance of early diagnosis and careful monitoring.
Another brief research report describes the clinical characteristics of a cohort of 64 patients with hereditary spherocytosis in China. The study by Cheng et al. presents the clinical features and correlates the clinical phenotype with genotypes of these patients. The study revealed that patients with genetic variants in ANK1 and SPTB genes have severe disease, whereas SPTA1 variants are associated with a milder disease.
Diamond-Blackfan anemia (DBA) is another genetic disease that causes anemia through pure red blood cell aplasia. The recent case report by Zhou et al., published under this research topic, described a 56-day-old infant with severe DBA presenting in shock due to an extremely low hemoglobin level of 1.8 g/dl; a rare presentation of the disease. The case report highlights the importance of establishing early genetic testing in patients with DBA before life-threatening complications arise.
The final paper in the collection presents a retrospective analysis of early clinical and laboratory features of 167 primary bone marrow failure syndromes in children in Shandong, China. The study by Leng et al. describes how clinical manifestations, peripheral blood counts, reticulocyte levels, red blood cell indices, and bone marrow examination findings help to differentiate aplastic anemia from refractory cytopenia and idiopathic cytopenia of undetermined significance.
Overall, the research topic has provided insight into the need for multifaceted responses in combating anemia in children. For genetic diseases like thalassemia and sickle cell disease, early diagnosis by genetic testing plays a pivotal role (6). Neonatal screening programs for sickle cell disease, thalassemia, and other inherited conditions can identify affected infants before complications arise. Genetic testing for infants presenting with unexplained severe anemia should be standard practice where resources permit (7).
From a public health viewpoint, improving overall social conditions would have a positive impact on reducing the burden of anemia, especially in underdeveloped countries. Nutrition interventions should be locally designed, including caregiver education on good dietary practices and discouraging harmful habits, like excessive tea consumption with meals (8, 9). Addressing infectious diseases, particularly malaria, remains crucial (10). Without these decisive actions, the combined burden of nutritional and genetic anemia will continue to affect growth, learning, and life opportunities for millions of children around the world.
Author contributions
SM: Validation, Conceptualization, Resources, Data curation, Formal analysis, Project administration, Investigation, Writing – review & editing, Methodology, Supervision, Writing – original draft. DS: Writing – review & editing, Methodology, Conceptualization, Validation, Data curation. NY: Writing – review & editing, Data curation, Project administration, Validation, Conceptualization, Methodology.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
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2. Tesema GA, Worku MG, Tessema ZT, Teshale AB, Alem AZ, Yeshaw Y, et al. Prevalence and determinants of severity levels of anemia among children aged 6–59 months in sub-Saharan Africa: a multilevel ordinal logistic regression analysis. PLoS One. (2021) 16(4):e0249978. doi: 10.1371/journal.pone.0249978
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Keywords: anemia, thalassemia, sickle cell anemia, hereditary spherocytosis, Diamond-Blackfan anemia (DBA)
Citation: Mettananda S, Songdej D and Yasara N (2025) Editorial: Anemia in children: from nutritional deficits to genetic disorders. Front. Pediatr. 13:1678056. doi: 10.3389/fped.2025.1678056
Received: 1 August 2025; Accepted: 13 August 2025;
Published: 22 August 2025.
Edited and Reviewed by: Birgit Knoechel, Dana–Farber Cancer Institute, United States
Copyright: © 2025 Mettananda, Songdej and Yasara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sachith Mettananda, c2FjaGl0aG1ldHRhQHlhaG9vLmNvbQ==