Abstract
Objective: To determine the frequency of iron deficiency anemia (IDA) in children presenting with acute lower respiratory tract infection (ALRTI) at a tertiary care hospital of Karachi, Pakistan.
Methodology: This cross-sectional study was performed at the department of pediatrics, Memon Medical Institute Hospital, Karachi, Pakistan, from August 2024 to January 2025. A total of 97 children of any gender, aged 6 to 60 months, and presenting with ALRTI, having a duration of illness being less than 30 days, were analyzed. Chi-square or fisher’s exact test was applied to compare categorical data concerning the frequency of IDA. Multivariate binary logistic regression model was applied to identify independent predictors of IDA, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI), and p<0.05 as significant.
Results: The IDA was diagnosed in 79 (81.4%) children. IDA was independently associated with lack of exclusive breastfeeding (aOR 5.26; 95% CI 1.41–20.0; p=0.014), rural residence (aOR 4.17; 95% CI 1.23–14.29; p=0.021), and age 6–12 months (aOR 4.76; 95% CI 1.09–25.0; p=0.039). Lower income also increased IDA risk as <35,000 PKR (aOR 8.33; 95% CI 1.05–41.67; p=0.032) and 35,000–70,000 PKR (aOR 3.57; 95% CI 1.03–12.50; p=0.045).
Conclusion: IDA is highly prevalent among children aged 6 to 60 months presenting with ALRTIs. IDA was significantly associated with younger age, rural residence, low family income, and absence of exclusive breastfeeding.

Key words: Anemia, exclusive breastfeeding, hemoglobin, lower respiratory tract infection, serum ferritin