Cobas e601 5 analyzer

For children under five years of age, length/height-for-age (stunting) and weight-for-length/height (wasting) indices were calculated using the WHO Anthro 2011 software (version 3.2.2, Geneva, Switzerland). Children with indices below -2 z-scores from the median reference values of the WHO growth standards were considered undernourished. In caregivers, a body mass index (BMI) below 18.5 and over/equal to 25 indicates underweight and overweight respectively [32 ].
Hemoglobin was tested using the fluorescence flow cytometry technology (model XT-1800i, Sysmex machine, (Norderstedt, Germany) while ferritin was analyzed using Cobas e601 5 Analyzer Roche Diagnostics, (Indianapolis, IN, USA). In regard to iron status, a hemoglobin level below 11 g/dL indicates anemia among children while a value below 12 µg/L highlights limited/no iron storage for ferritin [31 ]. Iron status among children was assessed by combining results of hemoglobin (<11 g/dL) and ferritin (12 µg/L) levels. As ferritin is elevated in the presence of inflammation, young children with an elevated CRP (>5 mg/L) were excluded from the analysis [5 ].
Child birth weight (BW) was classified in one of two categories namely (1) Low BW: if <2.5 kg and, (2) Adequate BW: if ≥2.5 kg.

For children under-five years of age, length-for-age (LAZ), and weight-for-length (WLZ) Z-scores were derived with the WHO Anthro 2011 software (version 3.2.2, Geneva, Switzerland). Children with indices below −2 Z-score from the median values of the standards were considered undernourished. In caregivers/mothers, a body mass index (BMI) below 18.5 and over/equal to 25 indicated underweight and overweight respectively [19 ]. Child-birth weight was assigned in one of two categories namely (1) a birth weight below 2.5 kg was considered inadequate and; and (2) a birth weight at or above 2.5 kg was considered adequate.
Hemoglobin was tested using the fluorescence flow cytometry technology (Sysmex machine, model XT-1800i) while ferritin was analyzed using Cobas e601 5 Analyzer (Roche Diagnostics, Risch-Rotkreuz, Switzerland). A hemoglobin level below 11 g/dL indicates anemia among children, while a value below 12 ug/L highlights limited/no iron storage for ferritin [20 ]. The C-reactive protein (CRP) was also tested using the immunoturbometric method (Bayer machine, model 7180) to assess the presence of inflammation. Children with a CRP value above 5 mg/L were excluded, given the potential impact on ferritin measurement [20 ].