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Azmeraw M, Kassaw A, Habtegiorgis SD, Tigabu A, Amare AT, Mekuria K, Temesgen D, Zemariam AB, Kerebeh G, Bantie B, Alemnew D, Abate BB. Prevalence of anemia and its associated factors among children aged 6-23 months, in Ethiopia: a systematic review and meta analysis. BMC Public Health 2023; 23:2398. [PMID: 38042804 PMCID: PMC10693156 DOI: 10.1186/s12889-023-17330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023] Open
Abstract
INTRODUCTION Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term health issues were reported in children who have history of anemia including decreased work productivity in adult hood period. Although analyzing data on burden and risk factors of anemia are the recommended action areas of World Health Organization framework for accelerating anemia reduction, the aggregated national burden and contributors of anemia in Ethiopia has not been determined so far. There for, this systematic and meta-analysis study is aimed to assess the pooled prevalence and associated factors of anemia among children aged 6-23 months in Ethiopia. METHODS The electronic databases including PubMed, Scopus, EMBASE, Web of Science, Science Direct, Google scholar and institutional repositories were searched using search terms. The studies that reported the prevalence and/or risk factors of anemia in children 6-23 months of age were included. The JBI quality assessment tool was used to evaluate the quality of each study. The data was extracted with Microsoft Excel, 2019 and analyzed with STATA 17.0 statistical software. A random effect model was used to estimate the pooled prevalence of anemia and its associated factors. The Cochrane Q-test statistics and I2 test were used to measure heterogeneity between the included studies. Furthermore, publication bias was examined using the funnel plot graph and statistical tests (Egger's and begg tests). Outliers also visualized using Galbraith plot. When necessary, sensitivity analysis was also employed to detect small study effect. RESULT Ten studies with a total population of 14, 733 were included for analysis. The pooled prevalence of anemia among children aged 6-23 months of age in Ethiopia was found to be 57.76% (95%CI; 51.61-63.91; I2 = 97.192%; p < 0.001). Having history of diarrhea AOR = 2.44 (95%CI: 1.03-3.85), being stunted AOR = 2.00 (95%CI: 1.38-2.61), living in food insecure house hold AOR = 2.08 (95%CI: 1.10-3.07), consuming less diversified food AOR = 2.73 (95%CI: 2.06-3.39) and being 6-11 months of age AOR = 1.59 (95%CI: 1.23-1.95) were associated with anemia. CONCLUSION AND RECOMMENDATION The prevalence of anemia is in the range of severe public health problem among children aged 6-23 months in Ethiopia. Diarrhea, stunting, house hold food insecurity, dietary diversity, and age were the predictors of anemia. Further, prospective cohort and random controlled trial studies are recommended. Further, random controlled trial especially effectiveness of nutritional education interventions trial is important. To reduce prevalence of anemia, strengthening diarrhea reduction program, securing household food insecurity, preventing stunting, giving special attention for infants age 6-11 months and encouraging food diversification are important.
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Affiliation(s)
- Molla Azmeraw
- Department of Nursing, College of Health Science, Woldia University, P.O. Box: 400, Weldiya, Ethiopia.
| | - Amare Kassaw
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia
| | - Samuel Derbie Habtegiorgis
- Department of Epidemiology, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Agimasie Tigabu
- Department of Comprehensive Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia
| | - Abraham Tsedalu Amare
- Department of Comprehensive Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia
| | - Kindie Mekuria
- Department of Nursing, College of Health Science, Woldia University, P.O. Box: 400, Weldiya, Ethiopia
| | - Dessie Temesgen
- Department of Nursing, College of Health Science, Woldia University, P.O. Box: 400, Weldiya, Ethiopia
| | | | - Gashaw Kerebeh
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia
| | - Dessie Alemnew
- Department of Nursing, Faculty of Health Science, Debark University, Debark, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Science, Woldia University, P.O. Box: 400, Weldiya, Ethiopia
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Nkurunziza JC, Nabukeera-Barungi N, Kalyango JN, Niyongabo A, Mwanja MM, Mupere E, Nankabirwa JI. Prevalence and factors associated with anaemia in children aged 6–24 months living a high malaria transmission setting in Burundi. PLoS One 2022; 17:e0273651. [PMID: 36054118 PMCID: PMC9439186 DOI: 10.1371/journal.pone.0273651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background In very young children, anaemia has been linked to increased morbidity, mortality and poor cognitive development. Although Burundi has a high burden of anaemia, which may be worsened by the high burden of malaria, little is known about the extent of the problem in very young children who are most at risk of severe disease. We estimated the prevalence, and assessed the factors associated with anaemia in children aged 6–24 months using baseline data collected as part of an on-going study evaluating the effect of Micronutrient supplementation on anaemia and cognition among children in high malaria transmission settings in Burundi. Methods Between February and March 2020, surveys were conducted in 498 households within the catchment area of Mukenke Health Center. One child aged 6–24 months was selected per household to participate in the survey. Following written informed consent, we administered a questionnaire to the child’s primary caregiver to capture information on child’s demographics, nutritional status, food intake, health (status, and morbidity and treatment-seeking practices), as well as the household markers of wealth. A physical exam was conducted, and a blood sample was collected to: 1) assess for presence of plasmodium infection using a rapid diagnosis test; 2) estimate the haemoglobin levels using a portable haemocue machine. A stool sample was also collected to examine for the presence of helminth infections. Results The prevalence of anaemia was 74.3% (95% confidence interval [CI] 61.5%-84.0%), with most of the anaemic study participants classified as having moderate anaemia (59.2%). A total of 62 (12.5%) participants had positive malaria rapid diagnosis tests. Factors significantly associated with higher odds of developing anaemia included not receiving deworming medication (adjusted Odd ratio [aOR] = 3.54, 95% CI 1.79–6.99, p<0.001), the child’s home location (Mukenke II: aOR = 2.22, 95% CI 1.89–2.62, p<0.001; Mukenke: aOR = 2.76, 95% CI 2.46–3.10, p<0.001 and Budahunga: aOR = 3.12, 95% CI 2. 94–3.31, p<0.001) and the child’s age group (Children aged 6–11 months: aOR = 2.27, 95% CI 1.32–3.91, p<0.001). Education level was inversely associated with less odds of anaemia: child’s primary care giver with a secondary (aOR = 0.67; 95% CI: 0.47–0.95, p = 0,024) and tertiary education level (aOR = 0.48; 95% CI: 0.38–0.61, p<0.001). Conclusion Anaemia is highly prevalent among young children in high malaria transmission setting. Anaemia is more prevalent among children who not dewormed and those with malaria. To prevent the long-term adverse outcomes of the anaemia in children, policy makers should focus on improving uptake of the deworming and malaria prevention programs, promote preventive interventions and improve the education of women especially in families with very young children.
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Affiliation(s)
- Jean Claude Nkurunziza
- Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Community Medicine, Kamenge University Hospital Center (CHUK), University of Burundi, Bujumbura, Burundi
- * E-mail:
| | - Nicolette Nabukeera-Barungi
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Joan Nakayaga Kalyango
- Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pharmacy, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aloys Niyongabo
- Department of Laboratory, Kamenge University Hospital Center (CHUK), University of Burundi, Bujumbura, Burundi
| | - Mercy Muwema Mwanja
- Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ezekiel Mupere
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Joaniter I. Nankabirwa
- Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
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Heinrichs H, Endris BS, Dejene T, Dinant GJ, Spigt M. Anaemia and its determinants among young children aged 6-23 months in Ethiopia (2005-2016). MATERNAL AND CHILD NUTRITION 2020; 17:e13082. [PMID: 32969162 PMCID: PMC7988878 DOI: 10.1111/mcn.13082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/18/2020] [Accepted: 09/03/2020] [Indexed: 11/26/2022]
Abstract
Anaemia in children remains a significant public health threat. Recent numbers from Ethiopia showed that more than two‐thirds of children under the age of 2 years were anaemic. This study aimed to investigate the determinants of anaemia throughout Ethiopia over 11 years, making use of the Ethiopian Demographic and Health Survey (EDHS) rounds 2005, 2011 and 2016. The EDHS made it possible to use data on blood tests and detailed questionnaires among infants and young children. Multivariable logistic regression was applied to assess the association of anaemia and different immediate and underlying determinants. A total of 7,324 children aged 6–23 months were included in the analysis, with prevalences of anaemia being 71% in 2005, 61% in 2011 and 72% in 2016. The following determinants were significantly associated with childhood anaemia throughout the entire period: children younger than 1 year, anaemic mothers and those growing up in pastoralist regions. Risk factors such as diet and infections were consistently not significantly associated with anaemia. Given the tremendous adverse health effects of anaemia in young children, urgent action is needed. Hence, this study recommends nationwide multisectoral interventions targeting pastoralist regions, maternal and child health, screening and treatment of risk groups that could reduce the prevalence of anaemia.
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Affiliation(s)
- Helen Heinrichs
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Tariku Dejene
- Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Geert-Jan Dinant
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - 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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