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S T PK, Lahiri B. Conditional selection of multifactor evidence for the levels of anaemia among women of reproductive age group. EVALUATION AND PROGRAM PLANNING 2023; 100:102344. [PMID: 37437494 DOI: 10.1016/j.evalprogplan.2023.102344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023]
Abstract
The study aims at ascertaining the conditional selection of key indicators affecting severe, moderate, mild, and no anaemia levels for women of reproductive age in India. The secondary data for levels of anaemia and personal records of individuals collected for India from the 7th phase of District Health Survey program of the United States Agency for International Development data depository. The data was cleaned and summarised using frequency and percentages. Then the variables were tested for association with levels of anaemia using the Chi-square (χ2) test. The multinomial logistic regression model was employed to ascertain the key indicators through a conditional selection of reference categories. Results suggest that severe anaemia was significantly prevalent among women in the reproductive stage, especially among the 15-29 age groups. Secondary and higher education had a negative effect on the severity of severe, moderate, and mild anaemia. The poorest wealth index stratum had higher and more significant severe anaemia, and households with two adults of the opposite sex had a significant negative effect (β = -0.116, OR = 0.89, p < 0.001) on severe anaemia level while having a significant positive effect on moderate and mild anaemia. Rural households were associated negatively and significantly with moderate and mild anaemia, and nuclear household structures had a higher prevalence of severe anaemia. Therefore, these indicators across different levels of anaemia should be considered for a faster rate of reduction at the national level. Despite several initiatives by the public sector, the anaemia level has remained elevated among women of reproductive age. Education, wealth index, age, pregnancy, relationship structure, household structure, and place of residence were found to be key indicators for the level of anaemia. The significant variables will act as a crucial input to formulate cost-effective public interventions and finally encourage the faster reduction of anaemia levels.
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Affiliation(s)
- Pavan Kumar S T
- College of Community Science, Central Agricultural University, Tura, Meghalaya 794005, India.
| | - Biswajit Lahiri
- College of Fisheries, Central Agricultural University, Lembucherra, Tripura, India
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Odo DB, Yang IA, Dey S, Hammer MS, van Donkelaar A, Martin RV, Dong GH, Yang BY, Hystad P, Knibbs LD. A cross-sectional analysis of ambient fine particulate matter (PM 2.5) exposure and haemoglobin levels in children aged under 5 years living in 36 countries. ENVIRONMENTAL RESEARCH 2023; 227:115734. [PMID: 36963710 DOI: 10.1016/j.envres.2023.115734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/23/2023] [Accepted: 03/20/2023] [Indexed: 05/08/2023]
Abstract
Low haemoglobin (Hb) concentrations and anaemia in children have adverse effects on development and functioning, some of which may have consequences in later life. Exposure to ambient air pollution is reported to be associated with anaemia, but there is little evidence specific to low- and middle-income countries (LMICs), where childhood anaemia prevalence is greatest. We aimed to determine if long-term ambient fine particulate matter (≤2.5 μm in aerodynamic diameter [PM2.5]) exposure was associated with Hb levels and the prevalence of anaemia in children aged <5 years living in 36 LMICs. We used Demographic and Health Survey data, collected between 2010 and 2019, which included blood Hb measurements. Satellite-derived estimates of annual average PM2.5 was the main exposure variable, which was linked to children's area of residence. Anaemia was defined according to standard World Health Organization guidelines (Hb < 11 g/dL). The association of PM2.5 with Hb levels and anaemia prevalence was examined using multivariable linear and logistic regression models, respectively. We examined whether the effects of ambient PM2.5 were modified by a child's sex and age, household wealth index, and urban/rural place of residence. Models were adjusted for relevant covariates, including other outdoor pollutants and household cooking fuel. The study included 154,443 children, of which 89,904 (58.2%) were anaemic. The country-level prevalence of anaemia ranged from 15.8% to 87.9%. Mean PM2.5 exposure was 33.0 (±21.6) μg/m3. The adjusted model showed that a 10 μg/m3 increase in annual PM2.5 concentration was associated with greater odds of anaemia (OR = 1.098 95% CI: 1.087, 1.109). The same increase in PM2.5 was associated with a decrease in average Hb levels of 0.075 g/dL (95% CI: 0.081, 0.068). There was evidence of effect modification by household wealth index and place of residence, with greater adverse effects in children from lower wealth quintiles and children in rural areas. Exposure to annual PM2.5 was cross-sectionally associated with decreased blood Hb levels, and greater risk of anaemia, in children aged <5 years living in 36 LMICs.
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Affiliation(s)
- Daniel B Odo
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; College of Health Sciences, Arsi University, Asela, Ethiopia.
| | - Ian A Yang
- Thoracic Program, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia; UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sagnik Dey
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, New Delhi, India; Arun Duggal Centre of Excellence for Research in Climate Change and Air Pollution, Indian Institute of Technology Delhi, New Delhi, India
| | - Melanie S Hammer
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Aaron van Donkelaar
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Randall V Martin
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, USA
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW, 2050, Australia
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Anemia among Syrian Refugee Children Aged 6 to 23 Months Living in Greater Beirut, Lebanon, including the Voices of Mothers' and Local Healthcare Staff: A Mixed-Methods Study. Nutrients 2023; 15:nu15030700. [PMID: 36771406 PMCID: PMC9920708 DOI: 10.3390/nu15030700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
Globally, the prevalence of anemia among children during the period of complementary feeding is high. A cross-sectional, mixed-methods study was conducted to examine the main determinants of anemia among Syrian refugee children aged 6 to 23 months (n = 215) and to illuminate the knowledge, attitudes and perceptions of their mothers and Lebanese healthcare staff on its causes and available treatment options. 42% of the children and 20% of their mothers were anemic. Determinants of child anemia were the mother having anemia or not knowing that fish/seafood is a source of iron; the child having been acutely ill the last two weeks or receiving cow's milk, but not consuming iron-rich infant formula, added fats/oils, or fruits in the previous 24 hours. Several Syrian mothers knew some causes of anemia and named dizziness as a leading symptom but did not mention flesh foods as a key source of heme iron. They reported financial constraints in accessing iron-rich foods and supplements. Lebanese doctors largely gave appropriate dietary advice and prescribed iron supplements as treatment. Multisectoral interventions are needed that combine medical and financial support with nutrition counseling for mothers to reduce the high burden of anemia among young children living in a multiple crises situation.
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Bayesian spatio-temporal modelling of child anemia in Ethiopia using conditional autoregressive model. Sci Rep 2022; 12:20297. [PMID: 36434074 PMCID: PMC9700834 DOI: 10.1038/s41598-022-24475-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
Anemia is a common health problem for women and under five children in low income countries. According to the WHO, anemia is considered a serious public health problem when the prevalence is greater than 40%. The prevalence of anemia among children under five in Ethiopia changes over time, and is spatially correlated because it is influenced by environmental, socio-economic and other related factors. However, to our knowledge, there is no small area level estimates of anemia among children under five in Ethiopia. Therefore, this study aimed to assess zonal level estimates of anemia using a Bayesian spatio-temporal conditional autoregressive modeling approach. The data for the study was extracted from the Ethiopian Demographic and Health Surveys (EDHS) from 2005 to 2016. A sample of 18,939 children aged 6-59 months were considered for this study. A Bayesian spatio-temporal conditional autoregressive model was implemented to identify the risk of child anemia. Smoothed relative risks along with the 95% credible interval were reported. The queen's adjacency matrix method was used in spatial smoothing and in estimating the relative risk. The prevalence of anemia among children aged 6-59 months in Ethiopia was 54% in 2005, 44% in 2011 and 57% in 2016. This study showed that low maternal education, low socio-economic status of women, and maternal anemia at zone level were strongly associated with child anemia in Ethiopia. Therefore, enhancing education for women, improving women's socioeconomic status, and mitigating maternal anemia are crucial to reduce the prevalence of childhood anemia in Ethiopia.
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Randrianarisoa MM, Rakotondrainipiana M, Randriamparany R, Andriantsalama PV, Randrianarijaona A, Habib A, Robinson A, Raharimalala L, Hunald FA, Etienne A, Collard JM, Randrianirina F, Barouki R, Pontoizeau C, Nestoret A, Kapel N, Sansonetti P, Vonaesch P, Randremanana RV. Factors associated with anaemia among preschool- age children in underprivileged neighbourhoods in Antananarivo, Madagascar. BMC Public Health 2022; 22:1320. [PMID: 35810292 PMCID: PMC9271242 DOI: 10.1186/s12889-022-13716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia occurs in children when the haemoglobin level in the blood is less than the normal (11 g/dL), the consequence is the decrease of oxygen quantity in the tissues. It is a prevalent public health problem in many low-income countries, including Madagascar, and data on risk factors are lacking. We used existing data collected within the pathophysiology of environmental enteric dysfunction (EED) in Madagascar and the Central African Republic project (AFRIBIOTA project) conducted in underprivileged neighbourhoods of Antananarivo to investigate the factors associated with anaemia in children 24 to 59 months of age. METHODS Children included in the AFRIBIOTA project in Antananarivo for whom data on haemoglobin and ferritin concentrations were available were included in the study. Logistic regression modelling was performed to identify factors associated with anaemia. RESULTS Of the 414 children included in this data analysis, 24.4% were found to suffer from anaemia. We found that older children (adjusted OR: 0.95; 95% CI: 0.93-0.98) were less likely to have anaemia. Those with iron deficiency (adjusted OR: 6.1; 95% CI: 3.4-11.1) and those with a high level of faecal calprotectin (adjusted OR: 2.5; 95% CI: 1.4-4.4) were more likely to have anaemia than controls. CONCLUSIONS To reduce anaemia in the children in this underprivileged area, more emphasis should be given to national strategies that improve children's dietary quality and micronutrient intake. Furthermore, existing measures should be broadened to include measures to reduce infectious disease burden.
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Affiliation(s)
- Mirella Malala Randrianarisoa
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Maheninasy Rakotondrainipiana
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Ravaka Randriamparany
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Prisca Vega Andriantsalama
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Anjasoa Randrianarijaona
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Azimdine Habib
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Annick Robinson
- Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, rue Patrice Lumumba, Rue Mabizo S, 101, Antananarivo, Madagascar
| | - Lisette Raharimalala
- Centre de Santé Maternelle et Infantile de Tsaralalana, Lalana Andriantsilavo, 101, Antananarivo, Madagascar
| | - Francis Allen Hunald
- Service de Chirurgie pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, BP 4150, Ampefiloha, 101, Antananarivo, Madagascar
| | - Aurélie Etienne
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Jean-Marc Collard
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar.,The Center for Microbes, Development and Health, Institut Pasteur of Shanghai/Chinese Academy of Sciences, Shanghai, China
| | - Frédérique Randrianirina
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Robert Barouki
- Laboratoire de Biochimie Métabolomique et Protéomique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Clement Pontoizeau
- Laboratoire de Biochimie Métabolomique et Protéomique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Alison Nestoret
- Service de Coprologie Fonctionnelle, Hôpital Salpétrière Paris, Paris, France
| | - Nathalie Kapel
- Service de Coprologie Fonctionnelle, Hôpital Salpétrière Paris, Paris, France
| | - Philippe Sansonetti
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France
| | - Pascale Vonaesch
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France.,Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015, Lausanne, Switzerland
| | - Rindra Vatosoa Randremanana
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar.
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Qasrawi R, Abu Al-Halawa D. Cluster Analysis and Classification Model of Nutritional Anemia Associated Risk Factors Among Palestinian Schoolchildren, 2014. Front Nutr 2022; 9:838937. [PMID: 35619964 PMCID: PMC9127973 DOI: 10.3389/fnut.2022.838937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Nutritional inadequacy has been a major health problem worldwide. One of the many health problems that result from it is anemia. Anemia is considered a health concern among all ages, particularly children, as it has been associated with cognitive and developmental delays. Researchers have investigated the association between nutritional deficiencies and anemia through various methods. As novel analytical methods are needed to ascertain the association and reveal indirect ones, we aimed to classify nutritional anemia using the cluster analysis approach. In this study, we included 4,762 students aged between 10 and 17 years attending public and UNRWA schools in the West Bank. Students' 24-h food recall and blood sample data were collected for nutrient intake and hemoglobin analysis. The K-means cluster analysis was used to cluster the hemoglobin levels into two groups. Vitamin B12, folate, and iron intakes were used as the indicators of nutrient intake associated with anemia and were classified as per the Recommended Dietary Allowance (RDA) values. We applied the Classification and Regression Tree (CRT) model for studying the association between hemoglobin clusters and vitamin B12, folate, and iron intakes, sociodemographic variables, and health-related risk factors, accounting for grade and age. Results indicated that 46.4% of the students were classified into the low hemoglobin cluster, and 60.7, 72.5, and 30.3% of vitamin B12, folate, and iron intakes, respectively, were below RDA. The CRT analysis indicated that vitamin B12, iron, and folate intakes are important factors related to anemia in girls associated with age, locality, food consumption patterns, and physical activity levels, while iron and folate intakes were significant factors related to anemia in boys associated with the place of residence and the educational level of their mothers. The deployment of clustering and classification techniques for identifying the association between anemia and nutritional factors might facilitate the development of nutritional anemia prevention and intervention programs that will improve the health and wellbeing of schoolchildren.
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Affiliation(s)
- Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine.,Department of Computer Engineering, Istinye University, Istanbul, Turkey
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D. Rajkumar, Dineshkumar J, Arunprasath TS. Anaemia in infants and young children- Risk factor analysis: Case control study. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i1.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Anaemia is a global problem with 42% prevalence. Analysis of risk factors of anaemia will be useful in formulating health programs. This case control study was done to analyse the risk factors for anaemia in infants and young children.
Materials and Methods: This study was done in hospitalised children in a University hospital. Children with anaemia in age group between 6 and 24 months. Age and sex matched children without anaemia were controls. Demographic details, maternal details and feeding practices were compared.
Results: 147 children were recruited in both groups. There was no significant difference in demographic factors. Exclusive breast feeding (EBF) more than four months (95.2% vs 70.1%, p value<0.001), vegetarian diet (53.7% vs 40.1%, p value=0.019), complimentary diet containing either cereals or pulses alone (83% vs 47.6%, p value< 0.001), cow’s milk intake more than 400 ml (36.1% vs 18.4%, p value=0.001) and birth order more than one (62.6% vs 32%, p value<0.001) were identified as risk factors.
Conclusion: Iron supplements are essential in infants, if EBF is practised beyond 4 months and additional vitamin b12 supplements if vegetarian diet is followed. Cow’s milk intake should be less than 400 ml, to protect against anaemia.
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Endris BS, Dinant GJ, Gebreyesus SH, Spigt M. Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model. BMC Nutr 2022; 8:2. [PMID: 34996515 PMCID: PMC8740428 DOI: 10.1186/s40795-021-00495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The etiology and risk factors of anemia are multifactorial and varies across context. Due to the geospatial clustering of anemia, identifying risk factors for anemia should account for the geographic variability. Failure to adjust for spatial dependence whilst identifying risk factors of anemia could give spurious association. We aimed to identify risk factors of anemia using a Bayesian geo-statistical model. METHODS We analyzed the Ethiopian Demographic and Health Survey (EDHS) 2016 data. The sample was selected using a stratified, two- stage cluster sampling design. In this survey, 9268 children had undergone anemia testing. Hemoglobin level was measured using a HemoCue photometer and the results were recorded onsite. Based on the World Health Organization's cut-off points, a child was considered anaemic if their altitude adjusted haemoglobin (Hb) level was less than 11 g/dL. Risk factors for anemia were identified using a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data. Posterior means and 95% credible interval (BCI) were used to report our findings. We used a statistically significant level at 0.05. RESULT The 9267 children in our study were between 6 and 59 months old. Fifty two percent (52%) of children were males. Thirteen percent (13%) of children were from the highest wealth quintile whereas 23% from the lowest wealth quintile. Most of them lived in rural areas (90%). The overall prevalence of anemia among preschool children was 57% (95% CI: 54.4-59.4). We found that child stunting (OR = 1.26, 95% BCI (1.14-1.39), wasting (OR = 1.35, 95% BCI (1.15-1.57), maternal anemia (OR = 1.61, 95% BCI (1.44-1.79), mothers having two under five children (OR = 1.2, 95% BCI (1.08-1.33) were risk factors associated with anemia among preschool children. Children from wealthy households had lower risk of anemia (AOR = 0.73, 95% BCI (0.62-0.85). CONCLUSION Using the Bayesian geospatial statistical modeling, we were able to account for spatial dependent structure in the data, which minimize spurious association. Childhood Malnutrition, maternal anemia, increased fertility, and poor wealth status were risk factors of anemia among preschool children in Ethiopia. The existing anaemia control programs such as IFA supplementation during pregnancy should be strengthened to halt intergenerational effect of anaemia. Furthermore, routine childhood anaemia screening and intervention program should be part of the Primary health care in Ethiopia.
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Affiliation(s)
- Bilal Shikur Endris
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Geert-Jan Dinant
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Seifu H Gebreyesus
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mark Spigt
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
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Moyano Tamara L, Espitia P, Mora A. Anemia in Children from the Caribbean Region of Colombia: An Econometric Analysis. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.2001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lina Moyano Tamara
- Food Research Division, Observatorio del Caribe Colombiano, Getsemaní, Cartagena de Indias, Colombia
- ALZAK Foundation, Cartagena de Indias, Colombia
| | - Paula Espitia
- Nutrition and Dietetics School, Universidad del Atlántico, Puerto Colombia, Colombia
| | - Ana Mora
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición, IICAN, Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán, México
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Abstract
Background The geographical differences that cause anaemia can be partially explained by the variability in environmental factors, particularly nutrition and infections. The studies failed to explain the non-linear effect of the continuous covariates on childhood anaemia. The present paper aims to investigate the risk factors of childhood anaemia in India with focus on geographical spatial effect. Methods Geo-additive logistic regression models were fitted to the data to understand fixed as well as spatial effects of childhood anaemia. Logistic regression was fitted for the categorical variable with outcomes (anaemia (Hb < 11) and no anaemia (Hb ≥ 11)). Continuous covariates were modelled by the penalized spline and spatial effects were smoothed by the two-dimensional spline. Results At 95% posterior credible interval, the influence of unobserved factors on childhood anaemia is very strong in the Northern and Central part of India. However, most of the states in North Eastern part of India showed negative spatial effects. A U-shape non-linear relationship was observed between childhood anaemia and mother’s age. This indicates that mothers of young and old ages are more likely to have anaemic children; in particular mothers aged 15 years to about 25 years. Then the risk of childhood anaemia starts declining after the age of 25 years and it continues till the age of around 37 years, thereafter again starts increasing. Further, the non-linear effects of duration of breastfeeding on childhood anaemia show that the risk of childhood anaemia decreases till 29 months thereafter increases. Conclusion Strong evidence of residual spatial effect to childhood anaemia in India is observed. Government child health programme should gear up in treating childhood anaemia by focusing on known measurable factors such as mother’s education, mother’s anaemia status, family wealth status, child health (fever), stunting, underweight, and wasting which have been found to be significant in this study. Attention should also be given to effects of unknown or unmeasured factors to childhood anaemia at the community level. Special attention to unmeasurable factors should be focused in the states of central and northern India which have shown significant positive spatial effects.
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Ghosh K, Desai GS. Prevalence and detecting spatial clustering of anaemia among children 6–59 months in the districts of India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Hailegebreal S, Nigatu AM, Mekonnen ZA, Endehabtu BF. Spatio-temporal distribution and associated factors of anaemia among children aged 6-59 months in Ethiopia: a spatial and multilevel analysis based on the EDHS 2005-2016. BMJ Open 2021; 11:e045544. [PMID: 34404697 PMCID: PMC8372819 DOI: 10.1136/bmjopen-2020-045544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Anaemia is a global public health problem with major health and socioeconomic consequences. Though childhood anaemia is a major public health problem in Ethiopia, there is limited evidence on the spatio-temporal variability of childhood anaemia over time in the country. Therefore, this study aimed to assess the spatio-temporal distribution and associated factors of childhood anaemia using the Ethiopian Demographic and Health Survey (EDHS) data from 2005 to 2016. DESIGN Survey-based cross-sectional study design was employed for the EDHS. SETTING Data were collected in all nine regions and two city administrations of Ethiopia in 2005, 2011 and 2016. PARTICIPANTS The source population for this study was all children in Ethiopia aged 6-59 months. A total of 21 302 children aged 6-59 months were included in this study. OUTCOME MEASURE The outcome variable was child anaemia status. RESULTS The prevalence of anaemia declined from 53.9% in 2005 to 44.6% in 2011, but it showed an increase in 2016 to 57.6%. The spatial analysis revealed that the spatial distribution of anaemia varied across the regions. The spatial scan statistics analysis indicated a total of 22 clusters (relative risk (RR)=1.5, p<0.01) in 2005, 180 clusters (RR=1.4, p<0.01) in 2011 and 219 clusters (RR=1.4, p<0. 0.01) in 2016, significant primary clusters were identified. The child's age, mother's age, maternal anaemia status, wealth index, birth order, fever, stunting, wasting status and region were significant predictors of childhood anaemia. CONCLUSIONS In this study, childhood anaemia remains a public health problem. The spatial distribution of childhood anaemia varied significantly across the country. Individual-level and community-level factors were associated with childhood anaemia. Therefore, in regions with a high risk of childhood anaemia, individual-level and community-level factors should be intensified by allocating additional resources and providing appropriate and tailored strategies.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, Arba Minch University, Arba Minch, Southern Nations, Ethiopia
| | - Araya Mesfin Nigatu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | | | - Berhanu Fikadie Endehabtu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Assessment of aflatoxins exposure through urinary biomarker approach and the evaluation of the impacts of aflatoxins exposure on the selected health parameters of the children of Multan city of Pakistan. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.107863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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14
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Keokenchanh S, Kounnavong S, Midorikawa K, Ikeda W, Morita A, Kitajima T, Sokejima S. Prevalence of anemia and its associated factors among children aged 6-59 months in the Lao People's Democratic Republic: A multilevel analysis. PLoS One 2021; 16:e0248969. [PMID: 33765048 PMCID: PMC7993607 DOI: 10.1371/journal.pone.0248969] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/08/2021] [Indexed: 11/19/2022] Open
Abstract
Anemia is a major public health concern among children aged <5 years in the Lao People’s Democratic Republic. Thus far, no study has determined the factors associated with anemia among children aged <5 years in the Lao People’s Democratic Republic using a nationwide representative sample. Therefore, this study aimed to evaluate the prevalence of anemia and its associated factors with multilevel variations among children aged 6–59 months. This quantitative, cross-sectional study used a nationally representative sample from the Lao Social Indicator Survey II, 2017. Children aged 6–59 months tested for anemia were included in this study through multistage sampling approaches. Anemia was defined as a hemoglobin level of <11.0 g/dL. Multilevel binary logistic regression analyses were used to determine the adjusted effect of the factors associated with anemia. Among the 5,087 children included, the overall prevalence of anemia was 43.0%. Three factors were associated with higher odds of developing anemia—male sex (adjusted odds ratio, 1.16; 95% confidence interval, 1.01–1.34), underweight (adjusted odds ratio, 1.30; 95% confidence interval, 1.09–1.55), and residence in central provinces (adjusted odds ratio, 1.59; 95% confidence interval, 1.30–1.95) and southern provinces (adjusted odds ratio, 1.42; 95% confidence interval, 1.11–1.81). However, the other three factors—age, educational level of the household head, and Hmong-Mien ethnicity—were inversely associated with anemia. To resolve the problem regarding the severity of the anemia among children aged <5 years in the Lao People’s Democratic Republic. Our findings highlight the need for designing an effective approach to address each factor associated with childhood anemia. Interventions should focus on the prevention of childhood anemia, which is considered a major priority of public health intervention in the Lao People’s Democratic Republic.
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Affiliation(s)
- Sengtavanh Keokenchanh
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu-shi, Mie, Japan
- Foreign Relation Division, Cabinet of the Ministry of Health, Sisattanack District, Vientiane Capital, Lao PDR
- * E-mail:
| | - Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Ministry of Health, Sisattanack district, Vientiane Capital, Lao PDR
| | - Kaoru Midorikawa
- Faculty of Child Education, Suzuka University, Suzuka, Mie, Japan
| | - Wakaha Ikeda
- Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu-shi, Mie, Japan
| | - Akemi Morita
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu-shi, Mie, Japan
| | - Takumi Kitajima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu-shi, Mie, Japan
| | - Shigeru Sokejima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu-shi, Mie, Japan
- Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu-shi, Mie, Japan
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15
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Liu J, Huo J, Liu Z, Sun J, Huang J. Prevalence and Temporal Trend (2016-2018) of Anaemia among 6-23-Month-Old Infants and Young Children in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042041. [PMID: 33669777 PMCID: PMC7922411 DOI: 10.3390/ijerph18042041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
Anaemia is a public health problem that can lead to various harmful effects on physical and neurodevelopment in infants and young children (IYC). This study aimed to investigate trends of anaemia and haemoglobin concentration among 6- to 23-month-old Chinese IYC from 2016 to 2018. We used data from the China Nutrition Improvement Project on Children in Poor Areas (CNIPCPA), conducted in 142 national-level poor counties of 20 provinces, autonomous regions, and municipalities from 2016 to 2018. Our study included 103,621 6- to 23-month-old IYC selected by a stratified multistage cluster sampling design. There were 26,303, 33,443, and 43,875 IYC in the survey in 2016, 2017, and 2018, respectively. The overall prevalence of anaemia was 27.0% in the three years. The prevalence of anaemia was 28.0%, 27.2%, and 26.2%, and the mean haemoglobin (Hb) was 11.82, 11.81, and 11.88 g/dL in 2016, 2017, and 2018, respectively. The prevalence of anaemia was highest in 6- to 11-month-olds, and declined with age. There was a gap in the education level between parents. However, the percentage of education improved in the rural areas of China. The prevalence of anaemia decreased significantly in the three years, which shows that prevention and control actions achieved the initial results.
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Affiliation(s)
- Jing Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
| | - Junsheng Huo
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
- Correspondence: ; Tel.: +86-135-0115-2782
| | - Zengyan Liu
- Fengtai District Center for Disease Control and Prevention, No.0 Kanyang Road, Beijing 100070, China;
| | - Jing Sun
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
| | - Jian Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
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16
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Silva DLF, Höfelmann DA, Taconeli CA, Lang RMF, Dallazen C, Tietzmann DC, Moreira JD, Silva SAD, Nilson EAF, Gonçalves VSS, Crispim SP. Individual and contextual predictors of children's hemoglobin levels from Southern Brazilian municipalities in social vulnerability. CAD SAUDE PUBLICA 2021; 36:e00166619. [PMID: 33440420 DOI: 10.1590/0102-311x00166619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 05/06/2020] [Indexed: 11/21/2022] Open
Abstract
Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children's hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals' data were collected using a structured questionnaire, and secondary and ecological data of children's municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.
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Affiliation(s)
| | | | | | | | - Camila Dallazen
- Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil
| | - Daniela Cardoso Tietzmann
- Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil
| | - Julia Dubois Moreira
- Departamento de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - Sara Araújo da Silva
- Coordenação Geral de Alimentação e Nutrição, Ministério da Saúde, Brasília, Brasil
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Getawa S, Getaneh Z, Melku M. Hematological Abnormalities and Associated Factors Among Undernourished Under-Five Children Attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia. J Blood Med 2020; 11:465-478. [PMID: 33376434 PMCID: PMC7755328 DOI: 10.2147/jbm.s284572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/05/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction The hematopoietic system is one of the systems which can be affected by malnutrition, leading to impaired production of all blood cell lines. Undernourished children with hematological abnormalities like anemia are at higher risk of mortality. Therefore, this study aimed at determining the magnitude and associated factors of hematological abnormalities among undernourished under-five children attending at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia. Methods and Materials An institution-based cross-sectional study was conducted on a total of 251 undernourished under-five children at University of Gondar Specialized Referral Hospital from January to May 2020. A convenient sampling technique was employed to select study participants. Data were collected using a pretested structured questionnaire. Blood samples were collected for complete blood count which were determined by Sysmex KX-21N analyzer. Stool sample was processed via direct wet mount. Thin and thick blood films were examined to assess malaria parasite. The data were entered to EpiData version 4.6.0.0 and analyzed using SPSS version 23 software. Bi-variable and multi-variable binary logistic regression model were fitted to identify factors associated with hematological abnormalities. A p-value <0.05 in the multivariable analysis was considered as statistically significant. Results The overall magnitude of anemia, leukocytosis, thrombocytosis, thrombocytopenia, and leukopenia was 53.4%, 26.7%, 23.9%, 8%, and 2.8%, respectively. Being male, age 6-23 months, high birth order, intestinal parasite infection, edema, not eating vegetables and fruits, and paternal occupation were found to be associated with anemia. Only the age of a child was associated with leukocytosis in undernourished children. Conclusion The current study demonstrated the predominant existence of anemia, leukocytosis, and thrombocytosis among undernourished under-five children. Therefore, early diagnosis, monitoring and setting intervention strategies for anemia especially among children under two years old are required to prevent further complication.
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Affiliation(s)
- Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Roberts DJ, Zewotir T. Copula geoadditive modelling of anaemia and malaria in young children in Kenya, Malawi, Tanzania and Uganda. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:8. [PMID: 33158460 PMCID: PMC7648409 DOI: 10.1186/s41043-020-00217-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Anaemia and malaria are the leading causes of sub-Saharan African childhood morbidity and mortality. This study aimed to explore the complex relationship between anaemia and malaria in young children across the districts or counties of four contiguous sub-Saharan African countries, namely Kenya, Malawi, Tanzania and Uganda, while accounting for the effects of socio-economic, demographic and environmental factors. Geospatial maps were constructed to visualise the relationship between the two responses across the districts of the countries. METHODS A joint bivariate copula regression model was used, which estimates the correlation between the two responses conditional on the linear, non-linear and spatial effects of the explanatory variables considered. The copula framework allows the dependency structure between the responses to be isolated from their marginal distributions. The association between the two responses was set to vary according to the district of residence across the four countries. RESULTS The study revealed a positive association between anaemia and malaria throughout the districts, the strength of which varied across the districts of the four countries. Due to this heterogeneous association between anaemia and malaria, we further considered the joint probability of each combination of outcome of anaemia and malaria to further reveal more about the relationship between the responses. A considerable number of districts had a high joint probability of a child being anaemic but not having malaria. This might suggest the existence of other significant drivers of childhood anaemia in these districts. CONCLUSIONS This study presents an alternative technique to joint modelling of anaemia and malaria in young children which assists in understanding more about their relationship compared to techniques of multivariate modelling. The approach used in this study can aid in visualising the relationship through mapping of their correlation and joint probabilities. These maps produced can then help policy makers target the correct set of interventions, or prevent the use of incorrect interventions, particularly for childhood anaemia, the causes of which are multiple and complex.
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Affiliation(s)
- Danielle J. Roberts
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
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19
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Sundagumaran H, Seethapathy J. Outer hair cell functioning in infants with iron deficiency anemia. Int J Pediatr Otorhinolaryngol 2020; 138:110393. [PMID: 33152983 DOI: 10.1016/j.ijporl.2020.110393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Distortion product otoacoustic emissions (DPOAE) in infants with Iron Deficiency Anemia (IDA) helps in understanding the cochlear status especially the functioning of outer hair cells. OBJECTIVES To analyze the presence of DPOAE across frequencies and DP amplitude in infants with and without IDA. METHOD DPOAE were recorded on 40 infants with IDA and 40 infants without IDA in the age range of 6-24 months. Cubic DPOAEs (2f1-f2) were measured at six f2 frequencies (1500 Hz, 2000 Hz, 3000 Hz, 4500 Hz, 6000 Hz & 8000 Hz) with primary tone stimulus of intensity L1 equal to 65 dBSPL and L2 equal to 55 dBSPL. Immittance audiometry was performed using 226 Hz probe tone prior to DPOAE recording to ascertain normal middle ear functioning. RESULTS DPOAEs were present in all infants with and without IDA across frequencies tested. DP amplitude across the frequencies did not show any statistically significant difference (p < 0.05) between anemic and non-anemic groups. There was no statistically significant difference observed when both the groups were compared in terms of gender and age. CONCLUSION The study indicated that reduced iron levels does not have any influence on outer hair cell functioning as there were no changes observed in the DPOAE amplitude levels between infants with IDA and infants without IDA. Iron status does not seem to have a direct effect on outer hair cell functioning in infants. However, fine structure DPOAEs can reveal even more precise changes (if any) that are caused due to iron deficiency.
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Affiliation(s)
| | - Jayashree Seethapathy
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India, 600 116.
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20
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Dutta M, Bhise M, Prashad L, Chaurasia H, Debnath P. Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Abstract
Background Anaemia among under-5 children is a major public health issue worldwide. Some countries with a high prevalence of anaemia also have high prevalence of malaria. Even though Lesotho does not have a high prevalence of malaria, its prevalence rate of anaemia is as high. According to the 2014 Lesotho Demographic and Health Survey (DHS), the prevalence of anaemia among children under-5 was 51%. Other factors could be influencing the prevalence of anaemia in Lesotho. Objectives This study examined the household and individual risk factors of anaemia among children under-5 in Lesotho. Methods Data from the 2014 Lesotho DHS which included 924 children under-5 years were analysed. Descriptive statistics, chi-square cross-tabulations and ordered logistic regression models were run using Stata v15. Results Twenty-one percent (21%) of children under-5 had mild anaemia while 7% had severe-moderate anaemia. Children residing in households cooking with biogas (aOR=4.88, CI: 1.28–18.58) and those living in households that cook with biomass (aOR=4.22, CI: 1.40–12.67) had higher odds of severe-moderate anaemia. Conclusion Using solid fuels for cooking increases the vulnerability of children under-5 developing anaemia. Therefore, knowledge of renewable energy resources should be increased. This will help reduce levels of anaemia among under-5 children in Lesotho.
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Affiliation(s)
- Teboho Letuka
- Faculty of Humanities, Demography and Population Studies, Schools of Social Sciences and Public Health, University of the Witwatersrand, Private bag 3 Wits, 2050, Johannesburg, South Africa
| | - Sasha Frade
- Faculty of Humanities, Demography and Population Studies, Schools of Social Sciences and Public Health, University of the Witwatersrand, Private bag 3 Wits, 2050, Johannesburg, South Africa
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22
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Thomas MS, Demirchyan A, Khachadourian V. How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6-59 Months Old Children in India? Front Public Health 2020; 8:234. [PMID: 32733832 PMCID: PMC7359635 DOI: 10.3389/fpubh.2020.00234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/18/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives: The study sought to identify whether iron and folic acid supplementation of pregnant women and preschool children is associated with child's anemia status and the predictors of anemia among children in India. Design: Secondary data analysis was performed using the National Family Health Survey 4 data. Multivariable logistic regression was used to identify the adjusted associations between child's anemia status and iron supplementation, both during pregnancy and childhood. Also, a model of significant predictors of anemia among children was fitted. Setting: India. Participants: Youngest children (6-59 months) in families. Results: The adjusted association between supplementation during pregnancy and child's anemia status was significant (p = 0.010), whereas the adjusted association between supplementation during childhood and child's anemia status was insignificant (p = 0.16). The variables independently associated with anemia status of the child included younger age (95% CI 2.67–2.86), child's recent diarrhea (95% CI 1.02–1.14), low birth weight (95% CI 1.17–1.27), current underweight (95% CI 1.14–1.28), diet diversity score (95% CI 0.96–0.98), higher birth order (95% CI 1.01–1.05), mother's current anemia (95% CI 1.68–1.81), months of breastfeeding (95% CI 0.99–1.00), no/primary education (95% CI 1.23–1.35), family's low wealth index (95% CI 1.11–1.23), and backward caste (95% CI 1.04–1.14). Conclusions: The National Iron Plus Initiative strategy of child's iron supplementation should be evaluated to identify the reasons of its ineffectiveness in anemia reduction. In addition, vulnerable groups of children, i.e., children from poor and less educated families and those with low birth weight, higher birth order, and poor nutritional status, should be targeted first with anemia reduction interventions.
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Affiliation(s)
- Monica Steffi Thomas
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Anahit Demirchyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Vahe Khachadourian
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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23
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Shimanda PP, Amukugo HJ, Norström F. Socioeconomic factors associated with anemia among children aged 6-59 months in Namibia. J Public Health Afr 2020; 11:1131. [PMID: 33209233 PMCID: PMC7649727 DOI: 10.4081/jphia.2020.1131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 10/17/2019] [Indexed: 11/23/2022] Open
Abstract
Anemia remains a public health concern, and its prevalence varies between countries as well as between age, sex and levels of poverty. This study aims at examining the association between socio-demographic factors and anemia among children aged 6–59 months in Namibia. Data was extracted from the 2013 Namibian Demographic Health Survey. The association between anemia and other factors was examined with logistic regression. Results are reported in odds ratio (OR), with 95% confidence intervals (CI). In total, 1,383 children aged 6–59 months had complete data and included in the analyses. Our study shows that there is a statistically significantly increased risk of anemia among children from poorer households compared with the richest quintile. Also, there was a statistically significance supporting anemia being more common among boys than girls. There was also a statistically significant negative effect related to age. Our study shows that young children, boys and children in poorer households have an increased risk of anemia. Considering the adverse impact of anemia on child development, policies must prioritize factors exacerbating anemia risk.
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Affiliation(s)
- Panduleni Penipawa Shimanda
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Clara Barton School of Nursing, Welwitchia Health Training Centre, Windhoek, Namibia
| | - Hans Justus Amukugo
- School of Nursing Science, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Mboya IB, Mamseri R, Leyaro BJ, George J, Msuya SE, Mgongo M. Prevalence and factors associated with anemia among children under five years of age in Rombo district, Kilimanjaro region, Northern Tanzania. F1000Res 2020; 9:1102. [PMID: 36819212 PMCID: PMC9936566.3 DOI: 10.12688/f1000research.24707.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 02/05/2023] Open
Abstract
Background: Anemia is a severe public health problem affecting more than half of children under five years of age in low-, middle- and high-income countries. The study aimed to determine the prevalence and factors associated with anemia among children under five years of age in northern Tanzania. Methods: This community-based cross-sectional study was conducted in Rombo district, Kilimanjaro region, northern Tanzania, in April 2016. Multistage sampling technique was used to select a total of 602 consenting mothers and their children aged 6-59 months and interviewed using a questionnaire. Data were analyzed using Stata version 15.1. We used generalized linear models (binomial family and logit link function) with a robust variance estimator to determine factors associated with anemia. Results: Prevalence of anemia was 37.9%, and it was significantly higher among children aged 6-23 months (48.3%) compared to those aged 24-59 months (28.5%). There were no significant differences in anemia prevalence by sex of the child. Adjusted for other factors, children aged 6-23 months had over two times higher odds of being anemic (OR=2.47, 95% CI 1.73, 3.53, p<0.001) compared to those aged 24-59 months. No significant association was found between maternal and nutritional characteristics with anemia among children in this study. Conclusion: Prevalence of anemia was lower than the national and regional estimates, and it still constitutes a significant public health problem, especially among children aged 6-23 months. The study recommends iron supplementation, food fortification, dietary diversification, and management of childhood illnesses interventions for mothers and children under two years.
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Affiliation(s)
- Innocent B Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania.,School of Mathematics, Statistics & Computer Science, University of Kwazulu-Natal, Pietermaritzburg, Kwazulu-Natal, Private Bag X01, Scottsville 3209, South Africa.,Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
| | - Redempta Mamseri
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
| | - Beatrice J Leyaro
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
| | - Johnston George
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
| | - Sia E Msuya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania.,Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
| | - Melina Mgongo
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, 255, Tanzania
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25
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Wang JY, Hu PJ, Luo DM, Dong B, Ma Y, Dai J, Song Y, Ma J, Lau PWC. Reducing Anemia Among School-Aged Children in China by Eliminating the Geographic Disparity and Ameliorating Stunting: Evidence From a National Survey. Front Pediatr 2020; 8:193. [PMID: 32478015 PMCID: PMC7235374 DOI: 10.3389/fped.2020.00193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background: The aim of this study was to assess the geographic disparity in anemia and whether stunting was associated with anemia in different geographic groups among school-aged children in China. Methods: 71,129 Han children aged 7, 9, 12, and 14 years old were extracted from the 2014 cycle of Chinese National Surveys on Children Constitution and Health. Anemia, anemia severity, and stunting were defined according to WHO definitions. Binary logistic regression models were used to estimate the association between anemia and stunting in different geographic groups. Results: The prevalence of anemia was significantly higher in girls (10.8%) than boys (7.0%). The highest anemia prevalence was in Group VII (lower class/rural, 12.0%). A moderate/severe prevalence of anemia was concentrated in Group VII and Group VIII (western/lower class/rural) for both sexes. The prevalence of anemia was higher in stunting boys than non-stunting boys in Group IV (lower class/city, χ2 = 12.78, P = 0.002) and Group VII (χ2 = 6.21, P = 0.018), while for girls, it was higher in stunting girls than their non-stunting peers only in Group II (upper class/large city, χ2 = 4.57, P = 0.046). Logistic regression showed that the stunting children have 30% higher risk of anemia than non-stunting children after adjustment for age, sex and school (OR = 1.30, 95% CI: 1.05-1.60). Conclusion: A significant geographic disparity and an association between anemia and stunting among specific groups of school-aged children in China was demonstrated. Consequently, eliminating the geographic disparity and ameliorating stunting might contribute to the improvement of Chinese children's anemia. Specific guidelines and interventions are needed, especially for adolescent girls and the groups with serious anemia burden.
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Affiliation(s)
- Jun-Yi Wang
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Pei-Jin Hu
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Dong-Mei Luo
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jie Dai
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Patrick W C Lau
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon Tong, China
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Kaplan O, Wainstock T, Sheiner E, Staretz-Chacham O, Walfisch A. Maternal anemia and offspring failure to thrive - results from a large population-based cohort. J Matern Fetal Neonatal Med 2019; 34:3889-3895. [PMID: 31847635 DOI: 10.1080/14767058.2019.1702018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: To evaluate whether an association exists between maternal anemia and offspring failure to thrive (FTT) during childhood.Methods: A population-based cohort analysis was performed, comparing the risk for FTT among children (up to 18 years old) based on maternal hemoglobin (Hb) levels, upon postpartum discharge. Maternal Hb levels were categorized into 3 levels: <9.0 (moderate-severe anemia), 9.0-11.0 (mild anemia), and ≥11.0 g/dL (no anemia). FTT diagnosis was based on hospital records. All singletons born between 1991 and 2014 and discharged alive without congenital malformations were included. A survival curve was constructed to compare the cumulative FTT incidence, and a Weibull parametric survival analysis to assess the independent association between maternal anemia and offspring FTT while controlling for confounders.Results: Of the 214,305 included deliveries, 22,071 parturients (10.3%) were discharged with Hb <9.00; 83,932 (39.2%) with Hb between 9.0-11.0; and 108,302 (50.5%) with Hb ≥11.0 g/dL. FTT rates were 1.3% (n = 287), 1.2% (n = 967), and 1.1% (n = 1141) in the same groups, respectively (p = .003). The survival curve demonstrated a significantly higher cumulative incidence of FTT diagnosis in the moderate-severe maternal anemia group (p < .001). In the Weibull analysis, constructed for newborns with appropriate birthweight, both groups of maternal anemia were found to be independently associated with FTT related hospitalizations (mild anemia aHR, 1.1; 95%CI 1.002-1.219; p = .045, moderate-severe anemia aHR, 1.321; 95%CI, 1.141-1.529; p < .001).Conclusion: Maternal anemia is independently associated with long-term FTT in offspring, with increasing FTT rates proportional to anemia severity.
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Affiliation(s)
- Omer Kaplan
- Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Orna Staretz-Chacham
- Department of Neonatology, Metabolic clinic, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Association of Socioeconomic Status With Childhood Anemia Among Infant, Toddler, and Preschool Children in Bangladesh. Value Health Reg Issues 2019; 21:141-148. [PMID: 31812112 DOI: 10.1016/j.vhri.2019.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/01/2019] [Accepted: 09/24/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aims to delineate the association between economic inequality, along with other confounders, and anemia among infants, toddlers, and preschool children. METHODS From the 2011 Bangladesh Demographic Health Survey, a cross-sectional population sample comprising 2068 children between ages 6 and 59 months were selected for this study. Analyses were performed with a proportional odds model and finally stratified with the child age groups. RESULTS Infants belonging to a low and medium socioeconomic status (SES) have approximately a 3-fold higher chance of being affected by mild, moderate, or severe anemia compared with infants of high SES (odds ratio [OR] 2.94; 95% CI 1.09-7.91; P=.03 and OR 2.76; 95% CI .87-8.82; P=.08, respectively). Preschool children from low and medium SES households are 2.73× (95% CI 1.20-6.18; P=.02) and 2.47× (95% CI .99-6.14; P=.04) more likely to be anemic compared with their counterparts from higher SES households. The place of residence and childhood stunting are associated with childhood anemia (urban vs rural: OR 1.27; 95% CI .21-.35; P = .04; and stunted vs normal: OR 1.34; 95% CI 1.11-1.63; P = .003). Besides, vitamin A supplementations appear to serve as protective agents against the occurrence of the childhood anemia (OR 1.18; 95% CI .99-1.41; P = .06). CONCLUSION Urgent preventive measures are needed to control the impending childhood anemia among infants and preschool children, especially in the low and medium SES households (ClinicalTrials.gov Identifier: NCT03126253).
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Charuvila S, Davidson SE, Thachil J, Lakhoo K. Surgical decision making around paediatric preoperative anaemia in low-income and middle-income countries. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:814-821. [PMID: 31447408 DOI: 10.1016/s2352-4642(19)30197-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 11/18/2022]
Abstract
Prevalence of anaemia is high among children in low-income and middle-income countries. Anaemia is an important factor to consider preoperatively as low haemoglobin concentrations can have a negative effect on surgical outcomes and can also lead to surgeries being cancelled or postponed, which can have adverse health implications and stretch already limited resources in these countries. Additionally, blood transfusions to correct anaemia exposes children to safety issues. Therefore, where anaemia is known to be prevalent and resources are scarce, a contextually appropriate and relatively safe minimum haemoglobin concentration for proceeding to surgery could substantially improve patient management and efficiency of the health system. In this Review, we consider why paediatric anaemia is a major public health issue in low-income and middle-income countries, the value of preoperative testing of anaemia, and methods of optimising haemoglobin concentrations in the context of paediatric surgeries taking place in resource-limited settings.
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Affiliation(s)
- Somy Charuvila
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
| | - Sarah E Davidson
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Jecko Thachil
- Department of Haematology Manchester University, Manchester, UK
| | - Kokila Lakhoo
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Cordero D, Aguilar AM, Casanovas C, Vargas E, Lutter CK. Anemia in Bolivian children: a comparative analysis among three regions of different altitudes. Ann N Y Acad Sci 2019; 1450:281-290. [PMID: 30883800 DOI: 10.1111/nyas.14038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 11/30/2022]
Abstract
Here, we analyzed four population-based demographic and health surveys conducted in Bolivia between 1998 and 2016 to understand trends in anemia in children from 6 to 59 months of age by selected sociodemographic characteristics and three categories of altitude: low, medium, and high. Over the 18-year period, the prevalence of anemia was virtually unchanged while that in children living at high altitude increased. Anemia in children living at all three altitude categories is more than 40% and a severe public health problem according to the World Health Organization. We did not identify a single consistent risk factor for anemia in children living at high altitude compared with those living at medium or low altitude. The most consistent characteristic associated with childhood anemia across the three altitude categories was diarrhea in the last 2 weeks. Low length/height for age, an adolescent or anemic mother, a mother with no or little education, and a mother who speaks Quechua or Aymara were also risk factors. We conclude that it is necessary to review anemia policies and programs and prioritize children who are at greatest risk of developing anemia, particularly those living at high altitude. As iron deficiency appears to explain only a small part of childhood anemia, there is also a need to better understand its other causes and develop appropriate interventions.
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Affiliation(s)
| | - Ana Maria Aguilar
- Instituto de Investigación en Salud y Desarrollo, Universidad Mayor de San Andres, La Paz, Bolivia
| | - Carmen Casanovas
- Facultad de Medicina, Universidad Mayor de San Andres, La Paz, Bolivia
| | | | - Chessa K Lutter
- Division of Food Security and Agriculture, RTI International, Washington DC.,University of Maryland School of Public Health, College Park, Maryland
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Meena K, Tayal DK, Gupta V, Fatima A. Using classification techniques for statistical analysis of Anemia. Artif Intell Med 2019; 94:138-152. [PMID: 30871679 DOI: 10.1016/j.artmed.2019.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 08/20/2018] [Accepted: 02/18/2019] [Indexed: 11/15/2022]
Abstract
Anemia in children is becoming a worldwide problem owing to the unawareness among people regarding the disease, its causes and preventive measures. This study develops a decision support system using data mining techniques that are applied to a database containing data about nutritional factors for children. The data set was taken from NFHS-4, a survey conducted by the Government of India in 2015-16. The work attempts to predict anemia among children and establish a relation between mother's health and diet during pregnancy and its effects on anemic status of her child. It aims to help parents and clinicians to understand the influence of an infant's feeding practices and diet on his/her health and provide guidelines regarding diet to prevent anemia. Earlier, systems were built on computer using medical experts' advicewhich was then translated into algorithms for use. However, this method was time consuming thus, artificial intelligence came into play utilizing knowledge discovery and data mining tools for predictive modeling. The two techniques, decision tree and association rule mining has been applied and compared to select more appropriate technique for this particular task and a model is proposed in the healthcare domain with the aim to reduce the risk of the blood-related disease anemia.
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Affiliation(s)
- Kanak Meena
- Computer Science and Engineering, India; Indira Gandhi Delhi Technical University for Women, India.
| | - Devendra K Tayal
- Computer Science and Engineering, India; Indira Gandhi Delhi Technical University for Women, India.
| | - Vaidehi Gupta
- Computer Science and Engineering, India; Indira Gandhi Delhi Technical University for Women, India.
| | - Aiman Fatima
- Computer Science and Engineering, India; Indira Gandhi Delhi Technical University for Women, India.
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Auditory brainstem response in infants with iron deficiency anemia. Int J Pediatr Otorhinolaryngol 2019; 117:78-81. [PMID: 30579094 DOI: 10.1016/j.ijporl.2018.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/23/2018] [Accepted: 11/12/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Auditory brainstem response (ABR) in infants with Iron Deficiency Anemia (IDA) helps in understanding the auditory aspects of central nervous system. OBJECTIVES To analyse and compare absolute and interpeak latencies of ABR in infants with and without IDA. METHODS ABR traces were obtained from 40 anemic ears and 40 non anemic ears, aged 6-24 months. ABR was recorded with 11.1/s clicks at different intensity levels. RESULTS Absolute latencies of all the peaks were prolonged in infants with IDA at 70, 50 and 30 dBnHL except for peak I. Amplitude of peaks I, III and V was not statistically different between the two groups at 70 and 50 dBnHL. Reduced peak amplitude was noted only at 30 dBnHL in infants with IDA which was statistically significant (P < 0.05). Interpeak interval showed no significant difference between anemic and non-anemic infants at 70 dBnHL. Prolonged interpeak latency of peak III-V and I-V was noted at 50 and 30dBnHL. CONCLUSION Functional development of auditory system seems to be affected due to iron deficiency. IDA has a long lasting effects on central auditory system when IDA is left untreated This will in turn lead to an alteration in the neuro-functional maturation.
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Prevalence of Anaemia and Iron Deficiency among Primary Schoolchildren in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112332. [PMID: 30360488 PMCID: PMC6266561 DOI: 10.3390/ijerph15112332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/22/2018] [Accepted: 09/25/2018] [Indexed: 12/12/2022]
Abstract
The present study aimed to report the prevalence of anaemia and iron deficiency (ID) and to explore the associations among socio-demographic characteristics, nutritional status and inflammation status in the occurrence of anaemia and ID in a nationally representative sample of Malaysian primary schoolchildren. Using data from the South East Asian Nutrition Surveys (SEANUTS), 544 Malaysian children aged 7 to 12 years were included in this secondary analysis. Blood samples were drawn for haemoglobin and serum ferritin analysis while C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) were measured to detect inflammation. Prevalence of anaemia and ID were 4.0% and 5.2%, respectively. There were significantly more anaemic indigenous bumiputra children (9.9%) than Chinese children (0.6%). Correction for inflammation did not change the prevalence of ID. More overweight/obese children than thin/normal weight children were found to have elevated acute phase protein (APP). Children with elevated inflammatory markers had significantly higher ferritin level than children without inflammation. Periodic health assessments of anaemia and ID at the population level to monitor and clarify the epidemiology of health problems are required to inform public health policies and strategies.
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Chueh HW, Choi YC, Shin JH, Yoo JH. Family History as a Risk Factor for Iron Deficiency Anemia among Korean Adolescents: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES). CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2018. [DOI: 10.15264/cpho.2018.25.1.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hee Won Chueh
- Department of Pediatrics, College of Medicine, Dong-A University, Busan, Korea
| | - Yun Chang Choi
- Department of Pediatrics, College of Medicine, Dong-A University, Busan, Korea
| | - Jung Hyun Shin
- Department of Pediatrics, Good Gangan Hospital, Busan, Korea
| | - Jae Ho Yoo
- Department of Pediatrics, College of Medicine, Dong-A University, Busan, Korea
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Prevalence and temporal trend (2005-2015) of anaemia among children in Northeast Brazil. Public Health Nutr 2017; 21:868-876. [PMID: 29183408 DOI: 10.1017/s1368980017003238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Anaemia is the main nutritional deficiency in Brazil, and a prevention and control programme (National Program for Iron Supplementation) has been developed since 2005. Studies on the temporal evolution of anaemia prevalence contribute to assessment of the effectiveness of the actions undertaken. The present study aimed to identify the prevalence and temporal trend of anaemia in children. DESIGN Study based on two cross-sectional household surveys carried out in 2005 and 2015. Anaemia was defined as Hb<11 g/dl (HemoCue®). Trend analysis was performed using the prevalence ratio (PR), calculated by Poisson regression with a robust adjustment of the variance. Differences were significant when P<0·05 in both crude analyses and those adjusted for possible confounding factors (e.g. socio-economic, demographic and health variables). SETTING Alagoas, Brazil. SUBJECTS In total, 666 and 782 children in the first and second Alagoas State Health and Nutrition Survey, respectively (probabilistic samples). RESULTS In 2005 and 2015, anaemia prevalence was 45·1 and 27·4 %, respectively (-39·1 %; PR=0·61; 95 % CI 0·52, 0·70). In both surveys, children aged ≤24 months were more affected (P24 months (67·2 v. 40·7 %; 27·0 v. 19·3 %, respectively). CONCLUSIONS The prevalence of anaemia reduced significantly in the evaluated period. Thus, it may no longer be a severe public health problem but can instead be considered a problem of moderate magnitude. It remains, however, above the level considered acceptable according to WHO criteria. These results justify the implementation of prevention and control actions.
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Accinelli RA, Leon-Abarca JA. Solid fuel use is associated with anemia in children. ENVIRONMENTAL RESEARCH 2017; 158:431-435. [PMID: 28689034 DOI: 10.1016/j.envres.2017.06.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/20/2017] [Accepted: 06/26/2017] [Indexed: 06/07/2023]
Abstract
Over 3 billion people use solid fuels as a means of energy and heating source, and ~ 50% of households burn them in inefficient, poorly ventilated stoves. In 2010, ~ 43% of the 640 million preschool children in 220 countries suffered from a certain degree of anemia, with iron deficiency as the main cause in developed countries whereas its causes remained multifactorial in the undeveloped group. In this study, we explore the relations of country-wide variables that might affect the people's health status (from socioeconomic status to more specific variables such as water access). We found independent relationship between solid fuel use and anemia in children under five years old (p < 0.0001), taking into account the prevalence of anemia in pregnant woman and the access to improved water sources. Countries in which the population uses solid fuel the most have over three times higher anemia rates in children than countries with the lowest prevalence of solid fuels use. There is still a complex relationship between solid fuels use and anemia, as reflected in its worldwide significance (p < 0.05) controlled for measles immunization, tobacco consumption, anemia in pregnant mothers, girl's primary education, life expectancy and improved water access but not (p > 0.05) when weighing for sanitation access or income per capita.
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Affiliation(s)
- Roberto A Accinelli
- Hospital Cayetano Heredia, Peru; Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Juan A Leon-Abarca
- Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
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ANDRÉ HP, VIEIRA SA, FRANCESCHINI SDCC, RIBEIRO AQ, HERMSDORFF HHM, PRIORE SE. Factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years. REV NUTR 2017. [DOI: 10.1590/1678-98652017000300007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To evaluate factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years in the city of Viçosa, Minas Gerais state, Brazil. Methods This is a cross-sectional study of 357 children aged 4-7 years who had been followed-up up for during their first six months of life by the Breastfeeding Support Program. Socioeconomic and demographic characteristics, feeding practices, nutritional status (height-for-age and body mass index-for-age), and serum ferritin and hemoglobin concentrations were evaluated. Multiple linear regression analysis was carried out to evaluate factors independently associated with iron nutritional status (hemoglobin and ferritin), considering α=0.05 as the significance level. Results The prevalence of anemia and iron deficiency was (34) 9.52% and (11) 11.00%, respectively. The factors independently associated with anemia were younger child age, low maternal education, low height-for-age Z-scores, and children of single and separated mothers or widows. Iron deficiency was associated with child younger age and consumption of chocolates and chocolate flavored milk. Conclusion The results obtained allow us to conclude that anemia among children 4-7 years of age is a public health problem in the city of Viçosa, Minas Gerais. Therefore, there is a need for intervention measures targeting children in this age group. These measures can be implemented through food and nutritional education by encouraging the consumption of iron-rich foods.
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Hviid MM, Skovlund CW, Mørch LS, Lidegaard Ø. Maternal age and child morbidity: A Danish national cohort study. PLoS One 2017; 12:e0174770. [PMID: 28380000 PMCID: PMC5381873 DOI: 10.1371/journal.pone.0174770] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/15/2017] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The mean age at delivery has increased over the latest half of a century. Women of advanced maternal age have increased obstetrical risks and increased risk of chromosomal abnormalities and some other specified diagnoses in the offspring. The aim of this study was to assess the association between maternal age and overall child morbidity according to main diagnosis groups. MATERIAL AND METHODS We conducted a national cohort study including 352 027 live firstborn singleton children. The children were born between Jan 1994 and Dec 2009 and followed to Dec 2012. Children were divided into groups according to maternal age: 15-24, 25-29, 30-34, and 35+ years. Poisson regression analyses calculated adjusted incidence rate ratios (IRR) of child morbidities according to main diagnoses groups A-Q of the International Classification of Disease 10 with adjustment for year of birth, body mass index, smoking, and mother's level of education. RESULTS Average follow-up time was 11 years. Compared to children born to women 25-29 years, firstborn children to mothers aged 35+ had higher child morbidity in 8 of 19 main diagnosis groups and firstborn children to mothers 15-24 years had higher child morbidity in 12 of 19 main diagnosis groups. Thus, for a majority of diseases a U-shaped correlation was found, with lowest rates in women 25-29 years. CONCLUSION Firstborn children to both older and younger mothers have higher overall morbidity as compared to children born by mothers 25-29 years.
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Affiliation(s)
| | | | - Lina Steinrud Mørch
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Øjvind Lidegaard
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Xin QQ, Chen BW, Yin DL, Xiao F, Li RL, Yin T, Yang HM, Zheng XG, Wang LH. Prevalence of Anemia and its Risk Factors among Children under 36 Months Old in China. J Trop Pediatr 2017; 63:36-42. [PMID: 27543970 DOI: 10.1093/tropej/fmw049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study aims to evaluate the prevalence and sociodemographic factors of anemia in children <36 months old in China. In this study, data of 24 235 children were investigated from 32 primary health care (PHC) facilities in 11 province-level regions. Pearson χ2-test and logistic regression model were used to estimate potential risk factors associated with anemia. The overall prevalence of anemia was 24.4%, and 32.8% children from rural areas were anemic, but no statistically significant difference was observed between male and female. Predictors of anemia are different regions of China, cesarean delivery, premature birth and neonatal asphyxia. We also found that education level and income of children's parents are important determinants of childhood anemia. In additional, feeding practice would affect anemia among children aged 6-12 months. Our results could provide some insights for prevention and control of childhood anemia in PHC facilities.
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Affiliation(s)
- Qian-Qian Xin
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Bo-Wen Chen
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - De-Lu Yin
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Feng Xiao
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Rui-Li Li
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Tao Yin
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Hui-Min Yang
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Xiao-Guo Zheng
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
| | - Li-Hong Wang
- Department of Child Health Development, Capital Institute of Pediatric, Beijing, China
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Muchie KF. Determinants of severity levels of anemia among children aged 6–59 months in Ethiopia: further analysis of the 2011 Ethiopian demographic and health survey. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0093-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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