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Mutisya LM, Sserwanja Q, Kamara K, Mazzi M, Olal E. Anaemia and associated factors among children aged 6-59 months during the post-ebola period in Sierra Leone: a national cross-sectional survey- 2019. Arch Public Health 2024; 82:156. [PMID: 39277757 PMCID: PMC11401428 DOI: 10.1186/s13690-024-01290-9] [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: 07/09/2022] [Accepted: 04/15/2024] [Indexed: 09/17/2024] Open
Abstract
BACKGROUND Anaemia is a global public health problem associated with early childhood adverse effects on mental, physical, and social development. Sierra Leone had made progress in reducing the prevalence of anaemia pre-Ebola period however this was affected by the Ebola epidemic which further strained an already struggling health system. Therefore, this study aimed to assess the prevalence and factors associated with anaemia during post-Ebola period among children aged 6-59 months in Sierra Leone. METHODS We analyzed data from the 2019 Sierra Leone demographic and health survey (SLDHS), a nationally representative cross-sectional study. We used data collected using a stratified two-stage cluster sampling design that resulted in the random selection of a representative sample of 13,872 households. A total sample of 3,459 children aged 6-59 months were included in the study. Multivariable logistic regression was used to calculate the adjusted odds ratios and corresponding 95% confidence intervals. RESULTS The prevalence of anaemia was 68.9%, that of mild anaemia was 35.8%, moderate anaemia was 30.3% and for severe anaemia was 2.8%. Children aged 6-36 months were 1.83 times more likely to have anaemia compared to those above 36 months, while boys 1.33 times more likely to be anaemic compared to girls. Children born in poor households, to mothers who had anaemia and had a history of fever had 65%, 85% and 38% increase in likelihood of childhood anaemia respectively. In addition, children living in rural areas and stunted were 1.55 and 1.38 times more likely to be anaemic respectively compared to those living in urban areas and not stunted. Children born to younger mothers (15-24 years) were 1.45 times more likely to be anaemic compared to older mother (35-49 years. CONCLUSION The current study demonstrated the predominant existence of anaemia among children aged 6-59 months in Sierra Leone. Owing to the adverse effects of anaemia on the development of children in the future, there is an urgent need for effective and efficient remedial public health interventions to prevent further complications.
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Affiliation(s)
| | - Quraish Sserwanja
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda.
| | - Kassim Kamara
- National Disease Surveillance Programme, Ministry of Health and Sanitation, Free town, Sierra Leone
| | - Micheal Mazzi
- Programmes Department, Partners in Health, Freetown, Sierra Leone
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Tesfaye SH, Seboka BT, Sisay D. Application of machine learning methods for predicting childhood anaemia: Analysis of Ethiopian Demographic Health Survey of 2016. PLoS One 2024; 19:e0300172. [PMID: 38603735 PMCID: PMC11008879 DOI: 10.1371/journal.pone.0300172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/22/2024] [Indexed: 04/13/2024] Open
Abstract
Childhood anaemia is a public health problem in Ethiopia. Machine learning (ML) is a growing in medicine field to predict diseases. Diagnosis of childhood anaemia is resource intensive. The aim of this study is to apply machine learning (ML) algorithm to predict childhood anaemia using socio-demographic, economic, and maternal and child related variables. The study used data from 2016 Ethiopian demographic health survey (EDHS). We used Python software version 3.11 to apply and test ML algorithms through logistic regression, Random Forest (RF), Decision Tree, and K-Nearest Neighbours (KNN). We evaluated the performance of each of the ML algorithms using discrimination and calibration parameters. The predictive performance of the algorithms was between 60% and 66%. The logistic regression model was the best predictive model of ML with accuracy (66%), sensitivity (82%), specificity (42%), and AUC (69%), followed by RF with accuracy (64%), sensitivity (79%), specificity (42%), and AUC (63%). The logistic regression and the RF models of ML showed poorest family, child age category between 6 and 23 months, uneducated mother, unemployed mother, and stunting as high importance predictors of childhood anaemia. Applying logistic regression and RF models of ML can detect combinations of predictors of childhood anaemia that can be used in primary health care professionals.
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Affiliation(s)
| | - Binyam Tariku Seboka
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Daniel Sisay
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
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Nyarko SH, Boateng ENK, Dickson KS, Adzrago D, Addo IY, Acquah E, Ayebeng C. Geospatial disparities and predictors of anaemia among pregnant women in Sub-Saharan Africa. BMC Pregnancy Childbirth 2023; 23:743. [PMID: 37864203 PMCID: PMC10588187 DOI: 10.1186/s12884-023-06008-3] [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: 06/22/2023] [Accepted: 09/19/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Anaemia has become a major public health concern among women in Sub-Saharan Africa (SSA). However, little is known about the spatial disparities in anaemia prevalence and their associated factors among pregnant women in the region. This study analysed the spatial disparities in anaemia and their associated factors among pregnant women in rural and urban settings in SSA. METHODS This is a secondary analysis of the most recent demographic and health surveys of 26 countries in SSA. Spatial autocorrelation and hotspot assessment were conducted, while a multivariate logistic regression model was used to identify demographic factors associated with anaemia. RESULTS Anaemia was reported among ~50% of pregnant women in urban and rural areas of SSA. The hotspot analysis identified the West African sub-region as having a higher concentration of anaemia cases in rural settings. In urban areas, the odds of anaemia were significantly higher among pregnant women in their second trimester (Adjusted OR = 2.39, CI = 1.99, 2.76). On the other hand, pregnant women in their third trimester (Adjusted OR = 1.98, CI = 1.77, 2.22) and those who had taken intestinal parasite drugs (Adjusted OR = 1.12 CI = 1.02, 1.23) had a higher likelihood of having anaemia in rural areas. Pregnant women aged 35-39 years (Adjusted OR = 0.52, CI = 0.33, 0.81) and those aged 40-44 years (Adjusted OR = 0.69, CI = 0.50, 0.95) had a lesser likelihood of having anaemia compared to women aged 15-19 years in urban and rural areas respectively. Compared to Congo DR, Benin (OR = 2.22, CI = 1.51, 3.28) and Mali (OR = 3.71, CI = 2.73, 5.05) had higher odds of anaemia in urban and rural areas respectively. CONCLUSIONS Spatial disparities in anaemia persist among pregnant women in rural and urban settings in SSA. Prevailing spatial variations in anaemia may be addressed by specialised interventions considering the contextual residential settings and socio-economic factors highlighted in this study.
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Affiliation(s)
- Samuel H Nyarko
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Ebenezer N K Boateng
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Kwamena S Dickson
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - David Adzrago
- Center for Health Promotion and Prevention Research (CHPPR), School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Isaac Y Addo
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Evelyn Acquah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health, and Allied Sciences, Ho, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
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Chang R, Li C, Qi H, Zhang Y, Zhang J. Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:810150. [PMID: 35911841 PMCID: PMC9326113 DOI: 10.3389/fped.2022.810150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children. Methods Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models. Results Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11-1.44)], poor physical health [OR 1.34 (95% CI 1.11-1.61)], mental disorder [OR 1.24 (95% CI 1.00-1.52)], and death [OR 1.11 (95% CI 1.01-1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87-0.97)]. The difference of substance use risk was not found between the two groups. Conclusion Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations. Systematic Review Registration https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42021214115.
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Affiliation(s)
| | | | | | | | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ferreira HDS, Santos LGMDL, Ferreira CMX, Kassar SB, dos Santos TR, Vasconcelos NBR, de Assunção ML, Cardoso MA. Factors associated with childhood anaemia in Afro-descendant communities in Alagoas, Brazil. Public Health Nutr 2021; 24:4888-4898. [PMID: 33210585 PMCID: PMC11094382 DOI: 10.1017/s1368980020004711] [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: 06/28/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate factors associated with anaemia in preschool children. DESIGN A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson's regression with robust variance and hierarchical selection of independent variables. SETTING Afro-descendants communities living in the state of Alagoas, northeast Brazil. PARTICIPANTS Children aged 6-59 months and their mothers (n 428 pairs). RESULTS The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d. CONCLUSIONS The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.
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Affiliation(s)
- Haroldo da Silva Ferreira
- Faculdade de Nutrição (FANUT), Universidade Federal de Alagoas (UFAL), Rua Constant Pacheco, 550, Cruz das Almas 57038-020, Maceió, AL, Brasil
- Programa de Pós-Graduação em Nutrição (mestrado), FANUT/UFAL, Maceió, AL, Brasil
- Programa de Pós-Graduação em Ciências da Saúde (doutorado), Instituto de Ciências Biológicas e da Saúde/UFAL, Maceió, AL, Brasil
| | | | | | | | - Tamara Rodrigues dos Santos
- Programa de Pós-Graduação em Ciências da Saúde (doutorado), Instituto de Ciências Biológicas e da Saúde/UFAL, Maceió, AL, Brasil
| | | | - Monica Lopes de Assunção
- Faculdade de Nutrição (FANUT), Universidade Federal de Alagoas (UFAL), Rua Constant Pacheco, 550, Cruz das Almas 57038-020, Maceió, AL, Brasil
- Programa de Pós-Graduação em Nutrição (mestrado), FANUT/UFAL, Maceió, AL, Brasil
| | - Marly Augusto Cardoso
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil
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Ali M, Amin MR, Jarl J, Chisholm N, Saha S. Maternal health status and household food security on determining childhood anemia in Bangladesh -a nationwide cross-sectional study. BMC Public Health 2021; 21:1581. [PMID: 34418981 PMCID: PMC8380337 DOI: 10.1186/s12889-021-11581-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/02/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the effect of household food security on childhood anemia in Bangladesh while controlling for socioeconomic and demographic factors. METHODS We used nationally representative Bangladesh Demographic Health Survey (BDHS) 2011 data for this study, the only existing survey including anemia information and household food security. The sample included 2171 children aged 6-59 months and their mothers. Differences between socioeconomic and demographic variables were analyzed using Chi-square test. Univariate and multivariate logistic regression analyses were performed to estimate the effects of different socioeconomic and demographic factors on childhood anemia. We also performed mediation analysis to examine the direct and indirect effect of household food security on childhood anemia. RESULTS In Bangladesh, 53% male (95% CI: 50-56) and 51% female (95% CI: 47-54) children aged 6-59 months were anemic in 2011. The food insecure households have 1.20 times odds (95% CI: 0.97-1.48) of having anemic children comparing to food secure households in the unadjusted model. On the other hand, anemic mothers have 2 times odds (95% CI: 1.67-2.44) of having anemic children comparing to non-anemic mothers. However, household food security is no longer significantly associated with childhood anemia in the adjusted model while mothers' anemia remained a significant factor (OR 1.87: 95% CI: 1.53-2.29). Age of children is the highest associated factor, and the odds are 4.89 (95% CI: 3.21-7.45) for 6-12 months old children comparing to 49-59 months in the adjusted model. Stunting and household wealth are also a significant factor for childhood anemia. Although food security has no significant direct effect on childhood anemia, maternal anemia and childhood stunting mediated that relationship. CONCLUSIONS Future public health policies need to focus on improving mothers' health with focusing on household food security to eliminate childhood anemia.
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Affiliation(s)
- Masum Ali
- Department of Food Business and Development, O’Rahilly Building, University College Cork, Cork, Ireland
| | - Md. Ruhul Amin
- Institute of Nutrition and Food Science (INFS), University of Dhaka, Dhaka, 1000 Bangladesh
| | - Johan Jarl
- Department of Clinical Science (Malmö), Health Economics Unit, Lund University, Medicon Village, Scheelevagen 2, SE-223 63 Lund, Sweden
| | - Nick Chisholm
- Department of Food Business and Development, O’Rahilly Building, University College Cork, Cork, Ireland
- Center for Global Development and Department of Food Business and Development, O’Rahilly Building, University College Cork, Cork, Ireland
| | - Sanjib Saha
- Department of Clinical Science (Malmö), Health Economics Unit, Lund University, Medicon Village, Scheelevagen 2, SE-223 63 Lund, Sweden
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Jugha VT, Anchang-Kimbi JK, Anchang JA, Mbeng KA, Kimbi HK. Dietary Diversity and Its Contribution in the Etiology of Maternal Anemia in Conflict Hit Mount Cameroon Area: A Cross-Sectional Study. Front Nutr 2021; 7:625178. [PMID: 33614694 PMCID: PMC7889504 DOI: 10.3389/fnut.2020.625178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background: In the Mount Cameroon area, maternal anemia remains a major public health concern. We hypothesized that nutrient inadequacy may account for the level of anemia in pregnancy. Thus, this study examined the relative effect of dietary diversity on maternal anemia in the study area. Methods: A total of 1,014 consenting pregnant women were enrolled in this cross-sectional study. Information on socio-demographic, antenatal characteristics, malaria and anemia control measures were documented. Dietary diversity (DD) was evaluated using the 24-h recall method and hemoglobin (Hb) levels (g/dl) measured using a portable Hb meter. Malaria parasitaemia was diagnosed by blood microscopy. Anemia status was trimester specific. Logistic regression analysis was used determine predictors of maternal anemia. Results: Among the pregnant women enrolled, the mean DD score was 3.5±0.8 SD and only 10.4% had adequate dietary diversity. Anemia prevalence was 40.9%. Majority of the women consumed starchy staples (99.3%) while least consumed foods were dairy (4.5%), eggs (8.3%), fruits and vegetable (vitamin A-rich) (8.6%). A significant lower prevalence of anemia was associated with intake of dairy (P < 0.001), animal protein (P = 0.006), vitamin A-rich fruits and vegetables (P < 0.001). Furthermore, mean Hb levels were higher (P < 0.001) among women with diverse diets (12.39 ± 1.34) than in those with less diverse diets (10.85 ± 1.33). Predictors of anemia were as follows: study setting [Odd Ratio (OR) = 1.4, 95% CI: 1.07-1.94], occupation (OR = 1.9, 95% CI: 1.16-3.43), number of clinic visits (OR = 1.9, 95% CI: 1.27-2.91), trimester of pregnancy (OR = 3.2, 95% CI: 1.45-7.38), malaria parasitaemia (OR = 1.8, 95% CI: 1.33-2.68), out of home eating (OR = 1.4, 95% CI: 1.03-2.13), and DD (OR = 9.8, 95% CI: 4.56-20.80). The attributable risk of anemia due to dietary diversity was 82.9%. Conclusion: In the study area, DD is a major risk factor for maternal anemia. This finding underscores the importance of content specific nutrition education during clinic visits to improve intake of protein and iron-rich food in anemia prevention.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | | | | | | | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Bamenda, Bamenda, Cameroon
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Prevalence of Anemia and Associated Factors among Infants and Young Children Aged 6-23 Months in Debre Berhan Town, North Shewa, Ethiopia. J Nutr Metab 2020; 2020:2956129. [PMID: 33414958 PMCID: PMC7768586 DOI: 10.1155/2020/2956129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/23/2020] [Accepted: 12/07/2020] [Indexed: 02/03/2023] Open
Abstract
Background Anemia is a problem of both the developed and developing world, which occurs in all age groups of the population. Half of the anemia cases are due to iron deficiency and affects physical growth and mental development. Nevertheless, there is a scarcity of information about anemia and associated factors among infants and young children aged 6 to 23 months in low-income countries like Ethiopia. Objective The aim of this study was to assess the prevalence of anemia and associated factors among infants and young children aged 6–23 months. Methods A community-based cross-sectional study design was used among 531 mothers/caregivers-children pairs in Debre Berhan Town, North Shewa, Ethiopia, from February 1 to March 2, 2018. The cluster sampling technique was used to select the study participants. Sociodemographic data were collected from mothers/caregivers using pretested structured questionnaires. Hemoglobin levels were measured using a HemoCue analyzer machine (HemoCue® Hb 301, Ängelholm, Sweden). All relevant data were described using descriptive statistics such as frequencies, proportions, mean, and standard deviation. Odds ratio and 95% CI were estimated using binary logistic regression to measure the strength of the association between anemia and explanatory variables. The level of statistical significance was declared at P < 0.05. Results The overall prevalence of anemia was 47.5% (95% CI: 43.1–51.4%) of which 18.3% were mildly anemic, 25% were moderately anemic, and 4.1% were severely anemic. In multivariable logistic regression analysis, household food insecurity (AOR = 2.7, 95% CI: 1.6–4.5), unmet minimum dietary diversity (AOR = 2.5, 95% CI: 1.4–4.3), stunting (AOR = 2.3, 95% CI: 1.2–4.3), and underweight (AOR = 2.7, 95% CI: 1.4–5.4) positively associated with anemia while having ≥4 antenatal care visits (AOR = 0.5, 95% CI: 0.3–0.9) and met minimum meal frequency (AOR = 0.25, 95% CI: 0.14–0.45) had a protective effect against anemia. Conclusion Generally, the study showed that anemia was a severe public health problem among infants and young children in the study setting. Antenatal care visit, meal frequency, dietary diversity, underweight, stunting, and food insecurity significantly associated with anemia. Therefore, efforts should be made to strengthen infant and young child feeding practices and antenatal care utilization and ensure household food security, thereby improving the nutritional status of children.
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Chowdhury MRK, Khan MMH, Khan HTA, Rahman MS, Islam MR, Islam MM, Billah B. Prevalence and risk factors of childhood anemia in Nepal: A multilevel analysis. PLoS One 2020; 15:e0239409. [PMID: 33021981 PMCID: PMC7537867 DOI: 10.1371/journal.pone.0239409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/05/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Anemia is a common problem in children particularly in developing countries and taking steps to tackle it is one of the major public health challenges for Nepal. The objective of this study is to investigate the prevalence of individual, household and community level determinants of childhood anemia in Nepal. METHODS Data was taken from a nationally representative sample of 1,942 Nepalese children aged from 6-59 months. The Chi-square test was used to determine the bivariate relationship between the selected variables and childhood anemia and a multilevel logistic regression model with a random intercept at household and community level was used to identify important determinants of this kind of anemia. RESULTS The results showed that 52.6% (95% CI: 49.8%-55.4%) of the children were anemic while 26.6% (95% CI: 24.0%-29.3%) of them were moderate to severe. The prevalence of overall anemia was higher among children aged less than 11 months as well as in underweight children, children of underweight, anemic and uneducated mothers and those in the terrain ecological regions. Multivariable analysis showed that children aged less than 11 months, who were underweight and had anemic mothers were more likely to have moderate or severe anemia. Children in the hilly ecological region were less likely to have it compared to mountain and terrain ecological regions. Children in middle-class families and children of mothers who completed secondary education were more likely to have anemia. CONCLUSION Nepal is facing a serious public health problem due to the high prevalence of childhood anemia. This adverse situation occurs due to socio-demographic and geographical factors such as age, malnutrition status, mother's anemia status, socio-economic status and regional variations. Prevention of childhood anemia should be given top priority in Nepal and should be considered as a major public health intervention.
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Affiliation(s)
| | | | - Hafiz T. A. Khan
- College of Nursing, Midwifery and Healthcare, University of West London, London, United Kingdom
| | - Md. Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan
| | - Md Rashedul Islam
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Md Moinul Islam
- School of Business, Middlesex University, London, United Kingdom
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Jiang H, Liu L, Liu T, Zhu S, Hou L. Current status on the ability of the elderly in rural China: implications for future nursing and policy. Cardiovasc Diagn Ther 2020; 10:1216-1225. [PMID: 33224745 DOI: 10.21037/cdt-20-555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Aging is a global problem, and the ability assessment of the elderly plays an important role in the formulation of pension policies. It's necessary to evaluate the ability of the elderly in rural China to provide insights into future nursing care and policy making. Methods The elderly in 20 rural villages were selected by convenience sampling. We used "Elderly Ability Evaluation Form" issued by the Ministry of Civil Affairs of China as survey tool. The characteristics and score differences of the elderly of different ability level were compared and analyzed. And logistic regression analyses were conducted to identify the potential risk factors for disability in the elderly. Results A total of 2,878 elders were included, of which there were 1,916 elders with intact ability, 866 elders with mild disability, 42 elders with moderate disability, 54 elders with severe disability. The incidence of disability among respondents was 33.43%. There were significantly statistical differences in the dimensions of activities of daily living, mental state, perception and communication, and social participation among elders with intact ability, mild, moderate and severe disability (all P<0.05). The age, education level, marital status and living situations were all corrected to the scores on the activities of daily living, mental state, perception and communication, and social participation among elders (all P<0.05), and the elderly with age ≥75 years, illiteracy, unmarried and live alone had higher risk for disability (all P<0.05). Conclusions The current situation of the ability level of the elderly in rural China seems to be worrying, and it's necessary to establish a long-term nursing care system and aging policy to meet the needs of the elderly with regards to those potential influencing factors.
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Affiliation(s)
- Hua Jiang
- School of Medicine, Tongji University, Shanghai, China.,School of Medicine, Jinggangshan University, Ji'an, China
| | - Lanfang Liu
- Jiangxi Health Vocational College, Nanchang, China
| | - Tao Liu
- School of Medicine, Jinggangshan University, Ji'an, China
| | - Shuihua Zhu
- School of Medicine, Jinggangshan University, Ji'an, China
| | - Lili Hou
- Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Li H, Xiao J, Liao M, Huang G, Zheng J, Wang H, Huang Q, Wang A. Anemia prevalence, severity and associated factors among children aged 6-71 months in rural Hunan Province, China: a community-based cross-sectional study. BMC Public Health 2020; 20:989. [PMID: 32576157 PMCID: PMC7310416 DOI: 10.1186/s12889-020-09129-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022] Open
Abstract
Background In recent 10 years, with the rapid socioeconomic development and the extensive implementation of children nutrition improvement projects, the previous epidemiological data cannot reflect the actual level of anemia among children in China, especially in rural areas. Therefore, this study analyzed the prevalence, severity and associated factors of anemia among children aged 6–71 months in rural Hunan Province. Methods A community-based cross-sectional study was conducted. Through multistage stratified cluster sampling, 5229 children aged 6 to 71 months and their caregivers were randomly selected from 72 villages across 24 towns in 12 counties from rural Hunan. The demographic characteristics of children and their caregivers, feeding practice, nutritional status of children, caregivers’ anemia-related feeding knowledge, and gestational conditions of mothers were acquired by using a unified questionnaire. Peripheral blood from the left-hand middle fingertip was sampled from each child, and hemoglobin concentration was measured using a HemoCue301 portable hemoglobin analyzer (Sweden). Associated factors analyses involving overall anemia and anemia severities were conducted on multivariate logistic regression models. Results The overall anemia prevalence was 8.8%, and the prevalence of mild, moderate and severe anemia was 6.3, 2.5 and 0.1%, respectively. Children age groups of 6–11 months, 12–23 months and 36–47 months, exclusive breast-feeding within 6 months after birth, and maternal moderate/severe anemia were significantly associated with an increased risk of overall anemia in children. Children age groups of 6–11 months and 12–23 months were significantly associated with an increased risk of mild anemia in children. Children age groups of 6–11 months, 12–23 months and 36–47 months, low caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia were significantly associated with an increased risk of moderate/severe anemia in children. Children who underwent regular physical examination were less likely to have moderate/severe anemia. The common protective factor for overall, mild and moderate/severe anemia in children was high family income. Conclusions The anemia status of preschool children in rural Hunan Province was a mild public health problem and associated with children age group, feeding practice, regular physical examination, family income, caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia.
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Affiliation(s)
- Huixia Li
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China.,NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
| | - Juan Xiao
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China
| | - Minghui Liao
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China
| | - Guangwen Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China.
| | - Jianfei Zheng
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hua Wang
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China. .,Department of Maternal Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China.
| | - Qun Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, No.53, Xiangchun Road, Kaifu District, Changsha, 410008, Hunan Province, China
| | - Aihua Wang
- Department of Information Management, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
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Shi H, Zhang J, Du Y, Zhao C, Huang X, Wang X. The association between parental migration and early childhood nutrition of left-behind children in rural China. BMC Public Health 2020; 20:246. [PMID: 32070327 PMCID: PMC7029458 DOI: 10.1186/s12889-020-8350-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND More than one-third of children under 3 years old are left behind at home due to parental migration in rural China, and we know very little about early childhood nutrition of left-behind children (LBC) because of the dearth of research. This study examined the association between parental migration and early childhood nutrition of LBC in rural China. METHODS We used repeated cross-sectional data of rural children aged 6-35 months who participated in two surveys in six counties of northern and southern China in 2013 and 2016 respectively. The length, weight, and hemoglobin concentration were measured by trained health-care workers blinded to parental migration status. Stunting, underweight, wasting, and anemia were identified with the standards recommended by WHO. Generalized linear regressions and multivariate logistic regressions were employed to explore the association between parental migration and these nutritional outcomes at each time point. RESULTS Two thousand three hundred thirty-six and 2210 children aged 6-35 months were enrolled in 2013 and 2016, respectively. The results show a reduction of the risks of stunting, underweight, and wasting from 2013 (16.4, 8.5, and 3.5%, respectively) to 2016 (12.1, 4.0, and 1.5%, respectively) but highlight a constantly and alarmingly high risk of anemia among these children (44.8% in 2013 and 43.8% in 2016). Children with migrant fathers performed as well as or better than those with non-migrants on these indicators. Children with migrant parents performed slightly worse in 2013, but equal or slightly superior in 2016 on these indicators compared with children with non-migrants and migrant fathers. Children aged 6-17 months with migrant parents had a significantly lower risk of anemia than those living with their mothers or with both parents (43.1% vs. 63.6% and 61.5 in 2013, and 42.5 vs. 60.1 and 66.2% in 2016), even after controlling for children's sociodemographic characteristics. CONCLUSIONS Parental migration may be not detrimental and even beneficial to early childhood nutrition of LBC in rural China. Continued nutritional support is needed for all rural children, especially interventions for preventing micronutrient deficiency. Programs for LBC are recommended to continue to focus on nutrition but pay more attention to other important health issues.
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Affiliation(s)
- Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yufeng Du
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Chunxia Zhao
- Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China
| | - Xiaona Huang
- Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Fang L. The well-being of China's rural to urban migrant children: Dual impact of discriminatory abuse and poverty. CHILD ABUSE & NEGLECT 2020; 99:104265. [PMID: 31756636 DOI: 10.1016/j.chiabu.2019.104265] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/24/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Post-migration experiences of discriminatory abuse and poverty have been recognized as key risk factors for psychopathology and health problems among children. However, little research has explored these associations among children participating in the internal migration process. Building on the stress and coping framework (Lazarus & Folkman, 1984), this study investigated the influence of discriminatory abuse and poverty on depressive symptoms and health problems in a group of Chinese migrant children. It also examined how a culturally based meaning-focused coping, as measured by Chinese beliefs about adversity scale, moderates the stress-distress associations. PARTICIPANTS A cross-sectional study was conducted among 1714 migrant youth (Mean Age = 13; Range = 10-16; 45.6 % Female). METHODS The latent variable interaction structural equation modeling was conducted to explore the main and interaction effects among studied variables. RESULTS High prevalence of depressive symptoms (49.6 %) was found for this sample. More than 90% of respondents reported on an average of 0-2 days as being sick over the past 30 days. Migrant youth were found to experience moderate levels of discriminatory abuse (M = 1.29, SD = 0.51; Range = 1-4) and economic stress (M = 1.38, SD = 1.25; Range = 1-4). The findings further revealed that discriminatory abuse and economic stress possessed severe consequences on their mental and physical health. The meaning-focused coping strategy weakened the relationship between discriminatory abuse and depressive symptoms (β=-0.07, p<.001). Among migrant youth who encountered discriminatory abuse those who adhered more to meaning-focused coping reported less depressive symptoms. CONCLUSION Findings shed light on the protective role of cultural factors in stress management for young people from migrant backgrounds.
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Affiliation(s)
- Lue Fang
- Asia Research Institute, Office 7.39, National University of Singapore, 10 Kent Ridge Crescent, #07-01 AS8, 119260, Singapore.
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Melku M, Alene KA, Terefe B, Enawgaw B, Biadgo B, Abebe M, Muchie KF, Kebede A, Melak T, Melku T. Anemia severity among children aged 6-59 months in Gondar town, Ethiopia: a community-based cross-sectional study. Ital J Pediatr 2018; 44:107. [PMID: 30176919 PMCID: PMC6122612 DOI: 10.1186/s13052-018-0547-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/26/2018] [Indexed: 11/20/2022] Open
Abstract
Background Anemia is a public health problem affecting both developed and developing countries. Childhood anemia is associated with serious consequences including growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Hence, this study aimed at assessing the prevalence and factors associated with severity of anemia among children aged 6–59 months in Gondar town, northwest Ethiopia. Method A community-based cross-sectional study was conducted. A multi-stage sampling technique was employed to select study participants. Socio demographic and socioeconomic data were collected using a pre-tested structured questionnaire. Anthropometric measurements were taken as per WHO recommendation. Hemoglobin (Hb) concentration was measured using a portable HemoCue301 instrument (A Quest Diagnostic Company, Sweden). Mild anemia corresponds to a level of adjusted Hb of 10.0–10.9 g/dl; moderate anemia corresponds to a level of 7.0–9.9 g/dl, while severe anemia corresponds to a level less than 7.0 g/dl. Descriptive statistics were used to describe the study participants. Both bivariable and multivariable ordinal logistic regression were done, and proportional odds ratio (POR) with a 95% confidence interval (CI) was reported to show the strength of association. A p-value < 0.05 was considered statistically significant. Result Out of the total of 707 children included in this study, more than half (53.5%) of them were male. The median age of children was 30 months. Two hundred two (28.6%) of children were anemic: 124(17.5%) were mildly anemic, 73(10.3%) were moderately anemic, and 5 (0.7%) were severely anemic. The young age of the child, low frequency of child complementary feeding per day, primary maternal educational status, unmarried maternal marital status, and home delivery were factors associated with severity of childhood anemia. Conclusion Anemia among children aged 6–59 months in Gondar Town was a moderate public health problem. Improving access to education, providing regular health education about childcare and child feeding practices, strengthening the socioeconomic support for single-parent families and conducting regular community-based screening are recommended to reduce childhood anemia.
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Affiliation(s)
- Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Kefyalew Addis Alene
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Abebe
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindie Fentahun Muchie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asemarie Kebede
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Melak
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsedalu Melku
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Wang L, Sun Y, Liu B, Zheng L, Li M, Bai Y, Osborn A, Lee M, Rozelle S. Is Infant/Toddler Anemia a Problem across Rural China? A Mixed-Methods Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1825. [PMID: 30142959 PMCID: PMC6163290 DOI: 10.3390/ijerph15091825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 11/16/2022]
Abstract
In the past, iron-deficiency anemia in children has had a widespread presence in rural China. Given the recent economic growth in China, it is unclear if anemia among infants/toddlers remains a problem. The objective of this study is to measure the anemia rate in rural Chinese infants/toddlers across four major subpopulations and attempt to discover the sources of anemia. We use a mixed-methods approach combining quantitative data on 2909 rural Chinese infants/toddlers and their families with qualitative interviews with 84 caregivers of infants aged 6 to 30 months. Quantitative analysis indicates that the overall prevalence of anemia (43%) within sampled infants/toddlers was high, especially in comparison to the low rates of stunting (2⁻5%), being underweight (2%), and wasting (2⁻4%). These findings suggest that in rural China, anemia stems from the poor quality of the diets of infants/toddlers, rather than insufficient quantities of food being consumed. Qualitative analysis illustrates the factors that are contributing to anemia. Caregivers do not understand the causes of this condition, the symptoms that would lead one to recognize this condition, or the steps needed to treat their child with this condition. The findings offer a comprehensive understanding of the limited awareness of anemia among rural Chinese caregivers.
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Affiliation(s)
- Lei Wang
- International Business School, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Yonglei Sun
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Buyao Liu
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Lijuan Zheng
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Mengjie Li
- International Business School, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Yu Bai
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Annie Osborn
- Rural Education Action Project, Stanford University, Stanford 94305, CA, USA.
| | - Maggie Lee
- Rural Education Action Project, Stanford University, Stanford 94305, CA, USA.
| | - Scott Rozelle
- Rural Education Action Project, Stanford University, Stanford 94305, CA, USA.
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16
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Wang D, Li S, Hu M, Dong D, Tao S. Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal. Front Psychol 2017; 8:1312. [PMID: 28824495 PMCID: PMC5539078 DOI: 10.3389/fpsyg.2017.01312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/17/2017] [Indexed: 11/13/2022] Open
Abstract
The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14-20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being.
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Affiliation(s)
- Daoyang Wang
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal UniversityBeijing, China
- Department of Psychology, Anhui Normal UniversityWuhu, China
| | - Shuting Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal UniversityBeijing, China
| | - Mingming Hu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal UniversityBeijing, China
| | - Dan Dong
- Department of Psychology, Anhui Normal UniversityWuhu, China
| | - Sha Tao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal UniversityBeijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China
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17
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Clark KM, Li M, Zhu B, Liang F, Shao J, Zhang Y, Ji C, Zhao Z, Kaciroti N, Lozoff B. Breastfeeding, Mixed, or Formula Feeding at 9 Months of Age and the Prevalence of Iron Deficiency and Iron Deficiency Anemia in Two Cohorts of Infants in China. J Pediatr 2017; 181:56-61. [PMID: 27836288 PMCID: PMC5274569 DOI: 10.1016/j.jpeds.2016.10.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/25/2016] [Accepted: 10/12/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants. STUDY DESIGN Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron < 0 mg/kg, and IDA as iron deficiency + hemoglobin < 110 g/L. Multiple logistic regression assessed associations between feeding pattern and iron status. RESULTS Breastfeeding was associated with iron status (P < .001). In Zhejiang, 27.5% of breastfed infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9). CONCLUSIONS In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed. TRIAL REGISTRATION ClinicalTrials.gov: NCT00642863 and NCT00613717.
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Affiliation(s)
- Katy M. Clark
- Center for Human Growth and Development, University of Michigan, Ann Arbor, USA
| | - Ming Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Bingquan Zhu
- Department of Child Health Care, Zhejiang University Children’s Hospital, Hangzhou, China
| | - Furong Liang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jie Shao
- Department of Child Health Care, Zhejiang University Children’s Hospital, Hangzhou, China
| | - Yueyang Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chai Ji
- Department of Child Health Care, Zhejiang University Children’s Hospital, Hangzhou, China
| | - Zhengyan Zhao
- Department of Child Health Care, Zhejiang University Children’s Hospital, Hangzhou, China
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, USA
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, USA,Department of Pediatrics and Communicable Diseases, CS Mott Children’s Hospital, University of Michigan, USA
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A Cross-Sectional Population-Based Survey of Trachoma among Migrant School Aged Children in Shanghai, China. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8692685. [PMID: 27610383 PMCID: PMC5005553 DOI: 10.1155/2016/8692685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/28/2016] [Accepted: 07/28/2016] [Indexed: 11/17/2022]
Abstract
We investigated the prevalence of clinical trachoma in 154,265 children aged 6 to 16 years in 206 Shanghai migrant schools. Clean water availability in school, each child's facial cleanliness, eyelids, corneas, and the presenting distance visual acuities were examined. Trachoma was clinically diagnosed in accordance with the World Health Organization simplified classification. Eyes diagnosed with trachoma were swabbed to test for ocular Chlamydia trachomatis infections (OCTI) with a rapid latex immunochromatographic test. Among 153,977 students, no blindness was found related to trachoma. Trachoma was diagnosed in 8029 children (5.2%). In 87 schools clinical trachoma prevalence was higher than 5%. OCTI was confirmed in 2073 of 6823 trachoma diagnosed children (30.4%). Clinical trachoma prevalence was higher among females than males (p < 0.001), but gender comparison showed no statistical difference in the prevalence of OCTI (p = 0.077). Age and clinical trachoma (r = -0.014; p < 0.001) or OCTI (r = -0.026; p = 0.031) prevalence were negatively correlated. Clinical trachoma was different in different districts and counties (p < 0.001). Trachoma warrants close attention in Shanghai migrant children because the condition remains endemic in some schools.
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Ni S, Chui CHK, Ji X, Jordan L, Chan CLW. Subjective well-being amongst migrant children in China: unravelling the roles of social support and identity integration. Child Care Health Dev 2016; 42:750-8. [PMID: 27349854 DOI: 10.1111/cch.12370] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 05/22/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Migrant children refer to rural children who accompany one or both parents to urban area. Empirical evidence showed that compared with their urban counterparts, migrant children had poorer developmental, emotional and psychological health. METHOD A sample of 1306 migrant children were recruited to examine the characteristics of migrant children and investigate the effects of identity integration, support and socioeconomic factors (e.g. age, gender, type of school, family socioeconomic status, city type) on their subjective wellbeing. RESULTS Children with higher levels of identity integration, social support, family socioeconomic status, who attended public school and who lived in the third-tiered city of Weihai demonstrated better subjective wellbeing. Social support remained a strong predictor for subjective wellbeing, despite a significant mediating effect of identity integration. CONCLUSIONS These results highlight the need for policymakers and practitioners alike to address individual factors pertaining to psychological adjustments, as well as social determinants of subjective wellbeing in the context of migration.
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Affiliation(s)
- S Ni
- Center for Social Work and Mental Health, Tsinghua University Graduate School at Shenzhen, Shenzhen, Guangdong, China
| | - C H-K Chui
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - X Ji
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - L Jordan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - C L-W Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
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The Migrant Paradox in Children and the Role of Schools in Reducing Health Disparities: A Cross-Sectional Study of Migrant and Native Children in Beijing, China. PLoS One 2016; 11:e0160025. [PMID: 27459507 PMCID: PMC4961441 DOI: 10.1371/journal.pone.0160025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 05/27/2016] [Indexed: 11/19/2022] Open
Abstract
Migrants usually exhibit similar or better health outcomes than native-born populations despite facing socioeconomic disadvantages and barriers to healthcare use; this is known as the “migrant paradox.” The migrant paradox among children is highly complex. This study explores whether the migrant paradox exists in the health of internal migrant children in China and the role of schools in reducing children’s health disparities, using a multi-stage stratified cluster sampling method. Participants were 1,641 student and parent pairs from Grades 4, 5, and 6 of eight primary schools in Beijing. The following school types were included: state schools with migrant children comprising over 70% of total children (SMS), private schools with migrant children comprising over 70% (PMS), and state schools with permanent resident children comprising over 70% (SRS). Children were divided into Groups A, B, C or D by the type of school they attended (A and B were drawn from SRSs, C was from SMSs, and D was from PMSs) and whether they were in the migrant population (B, C, and D were, but A was not). Related information was collected through medical examination and questionnaires completed by parents and children. Prevalence of caries, overweight and obesity, poor vision, and self-reported incidence of colds and diarrhea in the previous month were explored as health outcomes. The results partially demonstrated the existence of the migrant paradox and verified the role of schools in lowering health disparities among children; there are theoretical and practical implications for improving the health of migrant children.
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Shi Z, Taylor AW. Nutritional determinants of anemia among adults in Eastern China. World J Transl Med 2015; 4:55-59. [DOI: 10.5528/wjtm.v4.i2.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/03/2015] [Accepted: 07/27/2015] [Indexed: 02/06/2023] Open
Abstract
Historically, Eastern China has the highest prevalence of anemia among adults in China. It is commonly believed that iron deficiency is the main cause of anemia in China. Iron fortified soysauce is used to prevent anemia. Findings from Jiangsu Nutrition Study suggest that diet is related to anemia in this region. However, iron deficiency is not the main cause. Micronutrients other than iron (e.g., riboflavin) need to be considered in the prevention of anemia in the region.
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