Prevalence and detecting spatial clustering of anaemia among children 6–59 months in the districts of India

Prevalence of and factors associated with childhood anaemia in remote villages of the Peruvian Amazon: a cross-sectional study and geospatial analysis

BACKGROUND

Anaemia is a public health problem in Peru. In the Loreto region of the Amazon, ≥50% of children may be anaemic, although insufficient information exists for rural villages.

METHODS

To generate more data about childhood anaemia in the Peruvian Amazon, haemoglobin was measured as part of a trachoma survey in 21 randomly selected villages. All children 1-9 y of age from 30 randomly selected households per village were recruited. Anaemia was classified according to the World Health Organization guidelines and a socio-economic status (SES) index was created for each household using principal component analysis. Spatial autocorrelation was determined using Moran's I and Ripley's K function.

RESULTS

Of 678 children with complete haemoglobin data, 25.4% (95% confidence interval [CI] 21.2 to 30.1) had mild-or-worse anaemia and 22.1% (95% CI 15.6 to 30.3) had moderate-or-worse anaemia. Mild-or-worse anaemia was more common among children whose primary source of drinking water was surface water (prevalence ratio [PR] 1.26 [95% CI 1.14 to 1.40], p<0.001) and who were in the lowest SES tercile (PR 1.16 [95% CI 1.02 to 1.32], p=0.021). Moderate-or-worse anaemia was more common among boys (PR 1.32 [95% CI 1.09 to 1.60], p=0.005). No evidence of geospatial clustering was found.

CONCLUSIONS

Remote villages of the Amazon would benefit from interventions for childhood anaemia and the poorest households would have the most to gain. Integrating anaemia screening into neglected tropical diseases surveys is an opportunity to use public health resources more efficiently.

Determinants and transition of anaemia among under-five children from different social groups in India from 2005-06 to 2015-16

Anaemia among under-five children is a global health problem and a major cause of child morbidity and mortality, especially in Lower-Middle-Income countries including India. Despite a significant decrease over the last decade, nearly 58% of children in India suffered from anaemia in 2015-16. This national average hides the inequality in the prevalence of anaemia among indigenous people and other social groups. Therefore, the study focuses on identifying time-dependent significant determinants of the prevalence of anaemia from 2005-06 to 2015-16 among children belonging to Scheduled Tribe (ST), Scheduled Caste (SC), Other Backward Class (OBC) and Other or General social groups. Besides, it also identified social group-wise transition of anaemia among under-five children belonging to different socio-demographic, economic, residential and regional backgrounds in India. Time-dependent and independent logistic regression models were used to identify significant determinants of child anaemia and the mean probability of anaemia across different categories of explanatory backgrounds. Though the probability of anaemia has decreased more among marginalized children during the last decade, it remains relatively higher among them. The study has outlined the significant effects of child age, birth order, maternal anaemia, education level and geographic regions on the prevalence of anaemia among ST, SC, OBC and General social groups in India over the past decade. The effect of economic status on the prevalence of anaemia among ST and SC children was insignificant. Four subpopulations demonstrated a relatively greater magnitude of decadal anaemia risk reduction among children of early age groups, living with teenage, non-anaemic, less educated mothers and living in northeast India. The study suggests the arrangement of region-specific, social-group based strategies for reducing the prevalence of anaemia among under-five children in India. In this way, the nation can achieve "health and well-being for all" (SDG 03) by eliminating the geographical, and social inequality in the prevalence of child anaemia within the country (SDG 10).