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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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Obasohan PE, Walters SJ, Jacques RM, Khatab K. The Intersection of a Child's Demographics and Household Socioeconomic Status in the Multimorbidity of Malaria, Anaemia, and Malnutrition among Children Aged 6-59 Months in Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:645. [PMID: 38791859 PMCID: PMC11120798 DOI: 10.3390/ijerph21050645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Multimorbidity of malaria, anemia, and malnutrition (MAMM) is a condition in which an individual has two or more of these health conditions, and is becoming an emergent public health concern in sub-Saharan African countries. The independent associations of a child's demographic variables and household socioeconomic (HSE) disparities with a child's health outcomes have been established in the literature. However, the effects of the intersection of these factors on MAMM, while accounting for other covariates, have not been studied. Therefore, this study aimed to determine how children's sex, age, and household socioeconomic status interact to explain the variations in MAMM among children aged 6-59 months in Nigeria. Data from the 2018 Nigeria Demographic and Health Survey and the 2018 National Human Development Report (NHDR) were used. This study included weighted samples of 10,184 children aged 6-59 months in Nigeria. A three-level multilevel mixed effect ordinal logistic regression model was used, such that individual characteristics at level 1 were nested in communities at level 2 and nested in states at level 3. Subsequently, predictive probability charts and average adjusted probability tables were used to interpret the intersectional effects. Five models were created in this scenario. Model 1 is the interaction between the child's sex and household wealth status; model 2 is the interaction between the child's sex and age; model 3 is the interaction between the child's age and household wealth status; model 4 has the three two-way interactions of the child's sex, age, and household wealth status; and model 5 includes model 4 and the three-way interactions between a child's sex, age, and household wealth quintiles; while accounting for other covariates in each of the models. The prevalence of children with a 'none of the three diseases' outcome was 17.3% (1767/10,184), while 34.4% (3499/10,184) had 'only one of the diseases', and 48.3% (4918/10,184) had 'two or more' MAMMs. However, in the multivariate analyses, model 3 was the best fit compared with other models, so the two-way interaction effects of a child's age and household wealth status are significant predictors in the model. Children aged 36-47 months living in the poorest households had a probability of 0.11, 0.18, and 0.32 of existing with MAMM above the probability of children of the same age who live in the middle class, more prosperous, and richest households, respectively, while all other covariates were held constant. Thus, the variation in the prevalence of MAMM in children of different ages differs depending on the household wealth quintile. In other words, in older children, the variations in MAMM become more evident between the richer and the poorer household quintiles. Therefore, it is recommended that policies that are geared toward economic redistribution will help bridge the disparities observed in the prevalence of multiple diseases among children aged 6-59 months in Nigeria.
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Affiliation(s)
- Phillips Edomwonyi Obasohan
- School of Medicine and Population Health, University of Sheffield, Sheffield S1 4AD, UK; (S.J.W.); (R.M.J.)
- Department of Liberal Studies, College of Administrative and Business Studies, Niger State Polytechnic, Bida Campus, Bida 912231, Nigeria
| | - Stephen J. Walters
- School of Medicine and Population Health, University of Sheffield, Sheffield S1 4AD, UK; (S.J.W.); (R.M.J.)
| | - Richard M. Jacques
- School of Medicine and Population Health, University of Sheffield, Sheffield S1 4AD, UK; (S.J.W.); (R.M.J.)
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, UK;
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Omer A, Hailu D, Whiting SJ. Child-Owned Poultry Intervention Effects on Hemoglobin, Anemia, Concurrent Anemia and Stunting, and Morbidity Status of Young Children in Southern Ethiopia: A Cluster Randomized Controlled Community Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5406. [PMID: 37048019 PMCID: PMC10094074 DOI: 10.3390/ijerph20075406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6-18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28-0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24-0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21-0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low.
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Affiliation(s)
- Anteneh Omer
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa P.O. Box 5, Ethiopia
| | - Dejene Hailu
- School of Public Health, Hawassa University, Hawassa P.O. Box 5, Ethiopia
| | - Susan Joyce Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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Descarpentrie A, Estevez M, Brabant G, Vandentorren S, Lioret S. Lifestyle Patterns of Children Experiencing Homelessness: Family Socio-Ecological Correlates and Links with Physical and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16276. [PMID: 36498355 PMCID: PMC9737210 DOI: 10.3390/ijerph192316276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6-12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children's behaviours, and mental health (the latter was also child-reported). Nurses measured children's haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and "outcome-wide" analyses assessed, respectively, these patterns' relations to health and family socio-ecological factors. A rather healthy lifestyle pattern-similarly characterized by diverse diet and high sleep time-was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity-inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Mégane Estevez
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
| | - Gilles Brabant
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
| | - Stéphanie Vandentorren
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
- Institut Convergences Migration/CNRS, F-93322 Aubervilliers, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
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Obasohan PE, Walters SJ, Jacques R, Khatab K. Individual, household and area predictors of anaemia among children aged 6–59 months in Nigeria. PUBLIC HEALTH IN PRACTICE 2022; 3:100229. [PMID: 36101749 PMCID: PMC9461611 DOI: 10.1016/j.puhip.2022.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/11/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aims to determine the prevalence of anaemia among children aged 6–59 months in all states of Nigeria, including the Federal Capital Territory (FCT), and to quantify the predicted probabilities by individual, household and area factors. Study design This study is a secondary analysis of data sets from two national representative cross-sectional surveys in Nigeria: the Nigeria Demographic and Health Survey (2018 NDHS) and the National Human Development Index (2018 NHDR). The state human development index (HDI) and the state multidimensional poverty index (MPI) from the 2018 NHDR were incorporated into the 2018 NDHS. Methods The study included a weighted sample of 10,222 children aged 6–59 months. Both univariate and bivariate analyses were computed to determine the prevalence and factors associated with anaemia status, respectively. Multiple binary logistic regression analyses with adjusted predicted probabilities (APPs) were performed to quantify the predictors’ probabilities. Results The prevalence of anaemia among children aged 6–59 months in Nigeria was 68.1% (6962/10,222). Zamfara state had the highest prevalence (84.0% [266/317]), while Kaduna state recorded the lowest (50.0% [283/572]). The APPs of being anaemic decreased from 82.9% (95% confidence interval [CI]: 80.0–85.8) for children aged 6–18 months to 60.6% (95% CI: 56.8–64.4) for children aged 43–59 months, when other predictors were held constant. The APP for a child of an anaemic mother is 10.2% points higher than the APP for a child whose mother is not anaemic. In addition, the APPs for children decreased as the age group of their mothers increased. A child from a state that is mildly deprived in the MPI has a lower APP (67.2% [95% CI: 62.2–72.2]) compared with a child from highly deprived MPI state (79.0% [95% CI: 73.4–84.5]). Conclusions Health strategies, including supplementation programmes, should be carried out at both ante-natal and post-natal clinics to reduce the prevalence of anaemia, especially in vulnerable population groups.
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Eshete T, Anteneh K, Getahun F, Marie T, Sahile E, Kidane R, Bazezaw Y. Geographical pattern and associated factors of anemia among children aged 6–59 months in Ethiopia: Further analysis of Ethiopian demographic and health survey 2016. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hasan MM, Magalhaes RJS, Ahmed S, Pervin S, Tariqujjaman M, Fatima Y, Mamun AA. Geographical variation and temporal trend in anemia among children aged 6-59 months in low- and middle-income countries during 2000-2018: forecasting the 2030 SDG target. Public Health Nutr 2021; 24:6236-6246. [PMID: 34103114 PMCID: PMC11148617 DOI: 10.1017/s1368980021002482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine geographical variations, trends and projections in the prevalence of childhood anemia at national and subpopulation levels. DESIGN Repeated cross-sectional Demographic and Health Survey (DHS) conducted during 2000-2018. SETTING Fifty-three low- and middle-income countries (LMIC). PARTICIPANTS Totally, 776 689 children aged 6-59 months. RESULTS During the latest DHS rounds between 2005 and 2018, the prevalence of child anemia was > 20 % in fifty-two out of fifty-three countries and ranged from 15·9 % in Armenia in 2016 to 87·8 % in Burkina Faso in 2010. Out of thirty-six countries with at least two surveys during 2000-2018, the prevalence of child anemia decreased in twenty-two countries, highest in Zimbabwe (-4·2 %) and increased in fourteen countries, highest in Burundi (5·0 %). Based on the trend, eleven and twenty-two out of thirty-six countries are projected to experience, respectively, moderate and severe public health problem according to the WHO criteria (moderate problem: 20-39·9 % and severe problem: ≥ 40 %) due to child anemia in 2030, with the highest prevalence in Liberia (87·5 %, 95 % credible interval 52·0-98·8 %). The prevalence of child anemia varied across the mother's education and age, child sex, wealth quintiles, and place of residence, with the highest rate of child anemia among the poorest, rural and low-educated mothers. These scenarios are projected to continue. The probability of reducing child anemia at < 0·5 % by 2030 is 0 % for all study countries. CONCLUSIONS The prevalence of child anemia varied between and within countries. None of the thirty-six LMIC is likely to eradicate child anemia by 2030.
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Affiliation(s)
- Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, QLD, Australia
| | - Ricardo J Soares Magalhaes
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
- UQ Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Saifuddin Ahmed
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sonia Pervin
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, QLD, Australia
| | - Md Tariqujjaman
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, QLD, Australia
- Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD, Australia
| | - Abdullah A Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, QLD, Australia
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Said FA, Khamis AG, Habib A, Yang H, He Z, Luo X. Prevalence and Determinants of Anemia among Children in Zanzibar, Tanzania: Analysis of Cross-Sectional Population Representative Surveys. CHILDREN 2021; 8:children8121091. [PMID: 34943287 PMCID: PMC8700233 DOI: 10.3390/children8121091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/03/2022]
Abstract
The aim of this study was to assess the prevalence of anemia and its determinants among children aged 6–59 months in Zanzibar, Tanzania, from 2005 to 2015. We used secondary data from the Tanzania Demographic and Health Surveys from three different periods: 2005, 2010, and 2015. A sample of 3502 child-mother pairs from three survey datasets was used to analyze the overall prevalence of anemia and reveal its determinants. Hierarchical logistic regression was used to demonstrate the prevalence odds ratio of factors, both from the mothers and children, for anemia prevalence. The study indicated a significant decrease in anemia prevalence from 76.1% in 2005 to 65.4% in 2015 (p < 0.001). Hierarchical logistic regression between variables and anemia showed a significant association (p = 0.02) with households that improperly disposed of stool, children with minimum dietary diversity (p = 0.041), children in low age quartiles (p = < 0.001), and underweight children (p = 0.025). Maternal, household characteristics, and child factors were associated with childhood anemia in Zanzibar, Tanzania. Despite the significant decrease of anemia in Zanzibar, the overall prevalence rate is still a significant public health concern. Designing and strengthening comprehensive interventions to address anemia in the general population and different categories should be given special consideration.
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Affiliation(s)
- Fatma Ally Said
- Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, China; (F.A.S.); (A.H.); (H.Y.); (Z.H.)
- Department of Preventive Services and Health Promotion, Ministry of Health Zanzibar, Zanzibar, Tanzania
| | - Ahmed Gharib Khamis
- Department of Epidemiology and Biostatics, Muhimbili University of Health and Allied Science, Dar-es-salaam, Tanzania;
| | - Amanat Habib
- Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, China; (F.A.S.); (A.H.); (H.Y.); (Z.H.)
| | - Hexiang Yang
- Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, China; (F.A.S.); (A.H.); (H.Y.); (Z.H.)
| | - Zhangya He
- Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, China; (F.A.S.); (A.H.); (H.Y.); (Z.H.)
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, China; (F.A.S.); (A.H.); (H.Y.); (Z.H.)
- Correspondence: ; Tel.: +86-29-8265-5470
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Family Socioecological Correlates of Lifestyle Patterns in Early Childhood: A Cross-Sectional Study from the EDEN Mother-Child Cohort. Nutrients 2021; 13:nu13113803. [PMID: 34836060 PMCID: PMC8623755 DOI: 10.3390/nu13113803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022] Open
Abstract
Energy balance-related behaviors (EBRBs), i.e., diet, sedentary behavior, physical activity, and sleep, combine into lifestyle patterns, which we aim to identify in French preschoolers and analyze their family correlates within the framework of a comprehensive socioecological model. Parental questionnaires provided information about family characteristics and children’s EBRBs for 978 5-year-olds of the EDEN cohort. We used principal component analysis to derive lifestyle patterns from EBRBs and hierarchical multivariable linear regressions to assess their associations with family socio-demographics, parent health/behaviors, and parent-child interactions. Analyses were stratified by sex. Of the three lifestyle patterns identified (unhealthy, healthy, and mixed), the mixed pattern differed the most between sexes. Lower parental education, suboptimal maternal diet, TV during meals, and later bedtime were associated with higher adherence to unhealthy patterns. Children cognitively stimulated at home and boys of mothers not employed adhered more to the healthy pattern. Older siblings (for girls) and higher engagement of parents in leisure-time physical activity (for boys) were related to greater adherence to mixed patterns. The identification of various correlates from multiple socioecological levels suggests that tackling the potentially synergistic effect of lifestyle patterns on health requires addressing processes relevant to the parent-child dimension and structural barriers parents may encounter.
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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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Anteneh ZA, Van Geertruyden JP. Spatial variations and determinants of anemia among under-five children in Ethiopia, EDHS 2005-2016. PLoS One 2021; 16:e0249412. [PMID: 33793640 PMCID: PMC8016260 DOI: 10.1371/journal.pone.0249412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/18/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anemia has severe public health significance in sub-Saharan Africa. In Ethiopia, anemia has been increasing in the last two decades, reaching the highest national level in 2016, however, the geospatial distribution and determinants of anemia in children weren't well explored at a national level. METHODS We used the Ethiopian Demographic and Health Survey(EDHS) data from 2005-2016. The data consists of samples of households (HHs) obtained through a two-stage stratified sampling procedure. Our analysis included 19,699 children. Descriptive statistics, geospatial analysis, and Generalized Linear Mixed Model (GLMMs) were used. RESULTS The overall prevalence of anemia was 51.5%; the spatial distribution of anemia significantly different across clusters in each survey. Children from 6 to 11 months had higher odds of anemia compared to 24-59 months (Adjusted Odds ratio (AOR) = 3.4, 95%Confidence level (CI): 2.99-3.76). Children with the first and second birth order were less likely to be anemic compared to fifth and above (AOR = 0.60, 95%CI: 0.38-0.95, and AOR = 0.83, 95%C: 0.73-0.93) respectively. Mothers' age 15 to 24 years was associated with higher odds of anemia compared to 35 to 49 years (AOR = 1.37, 95%CI: 1.20-1.55). Children from HHs with the poorest and poorer wealth category showed a higher odds of anemia compared to the richest (AOR = 1.67, 95%CI: 1.45-1.93, and AOR = 1.25, 95%CI: 1.08-1.45) respectively. Moreover, children from HHs with one to two under-five children were less likely to be anemic compared to those three and more (AOR = 0.83, 95%CI: 0.76-0.91). CONCLUSIONS The geospatial distribution of anemia among children varies in Ethiopia; it was highest in the East, Northeast, and Western regions of the country. Several factors were associated with anemia; therefore, interventions targeting the hotspots areas and specific determinant factors should be implemented by the concerned bodies to reduce the consequences of anemia on the generation.
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Obasohan PE, Walters SJ, Jacques R, Khatab K. A Scoping Review of the Risk Factors Associated with Anaemia among Children Under Five Years in Sub-Saharan African Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238829. [PMID: 33261060 PMCID: PMC7731158 DOI: 10.3390/ijerph17238829] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023]
Abstract
Background/Purpose: Globally, anaemia is a severe public health condition affecting over 24% of the world’s population. Children under five years old and pregnant women are the most vulnerable to this disease. This scoping review aimed to evaluate studies that used classical statistical regression methods on nationally representative health survey data to identify the individual socioeconomic, demographic and contextual risk factors associated with developing anaemia among children under five years of age in sub-Saharan Africa (SSA). Methods/Design: The reporting pattern followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases were searched: MEDLINE, EMBASE (OVID platform), Web of Science, PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Cochrane library, African Journal of online (AJOL), Google Scholar and Measure DHS. Results: The review identified 20 relevant studies and the risk factors for anaemia were classified as child-related, parental/household-related and community- or area-related factors. The risk factors for anaemia identified included age, birth order, sex, comorbidities (such as fever, diarrhoea and acute respiratory infection), malnutrition or stunting, maternal education, maternal age, mother’s anaemia status, household wealth and place of residence. Conclusion: The outcome of this review is of significant value for health policy and planners to enable them to make informed decision that will correct any imbalances in anaemia across socioeconomic, demographic and contextual characteristics, with the view of making efficient distributions of health interventions.
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Affiliation(s)
- Phillips Edomwonyi Obasohan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.J.W.); (R.J.)
- Department of Liberal Studies, College of Administrative and Business Studies, Niger State Polytechnic, Bida Campus, Bida 912231, Nigeria
- Correspondence:
| | - Stephen J. Walters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.J.W.); (R.J.)
| | - Richard Jacques
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.J.W.); (R.J.)
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, UK;
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Mohammed SH, Habtewold TD, Arero AG, Esmaillzadeh A. The state of child nutrition in Ethiopia: an umbrella review of systematic review and meta-analysis reports. BMC Pediatr 2020; 20:404. [PMID: 32847552 PMCID: PMC7448348 DOI: 10.1186/s12887-020-02301-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Malnutrition remains to be a major public health problem in developing countries, particularly among children under-5 years of age children who are more vulnerable to both macro and micro-nutrient deficiencies. Various systematic review and meta-analysis (SRM) studies were done on nutritional statuses of children in Ethiopia, but no summary of the findings was done on the topic. Thus, this umbrella review was done to summarize the evidence from SRM studies on the magnitude and determinants of malnutrition and poor feeding practices among under-5 children in Ethiopia. METHODS PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and Google Scholar were searched for SRM studies on magnitude and risk factors of malnutrition and child feeding practice indicators in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and determinants of stunting, wasting, underweight, and poor child feeding practices were pooled and summarized with random-effects meta-analysis models. RESULT We included nine SRM studies, containing a total of 214,458 under-5 children from 255 observation studies. The summary estimates of prevalence of stunting, underweight, and wasting were 42% (95%CI = 37-46%), 33% (95%CI = 27-39%), and 15% (95%CI = 12-19%), respectively. The proportion of children who met the recommendations for timely initiation of breastfeeding, exclusive breastfeeding during the first 6 months, and timely initiation of complementary feeding were 65, 60, and 62%, respectively. The proportion of children who met the recommendations for dietary diversity and meal frequency were 20, and 56%, respectively. Only 10% of children fulfilled the minimum criteria of acceptable diet. There was a strong relationship between poor feeding practices and the state of malnutrition, and both conditions were related to various health, socio-economic, and environmental factors. CONCLUSION Child malnutrition and poor feeding practices are highly prevalent and of significant public health concern in Ethiopia. Only a few children are getting proper complementary feeding. Multi-sectoral efforts are needed to improve children's feeding practices and reduce the high burden of malnutrition in the country.
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Affiliation(s)
- Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Tasic H, Akseer N, Gebreyesus SH, Ataullahjan A, Brar S, Confreda E, Conway K, Endris BS, Islam M, Keats E, Mohammedsanni A, Wigle J, Bhutta ZA. Drivers of stunting reduction in Ethiopia: a country case study. Am J Clin Nutr 2020; 112:875S-893S. [PMID: 32844167 PMCID: PMC7487434 DOI: 10.1093/ajcn/nqaa163] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic undernutrition in children continues to be a global public health concern. Ethiopia has documented a significant decline in the prevalence of childhood stunting, a measure of chronic undernutrition, over the last 20 y. OBJECTIVES The aim of this research was to conduct a systematic assessment of the determinants that have driven child stunting reduction in Ethiopia from 2000 to 2016, focused on the national, community, household, and individual level. METHODS This study employed both quantitative and qualitative methods. Specifically, a systematic literature review, retrospective quantitative data analysis using Demographic and Health Surveys from 2000-2016, qualitative data collection and analysis, and analyses of key nutrition-specific and -sensitive policies and programs were undertaken. RESULTS National stunting prevalence improved from 51% in 2000 to 32% in 2016. Regional variations exist, as do pro-rich, pro-urban, and pro-educated inequalities. Child height-for-age z score (HAZ) decomposition explained >100% of predicted change in mean HAZ between 2000 and 2016, with key factors including increases in total consumable crop yield (32% of change), increased number of health workers (28%), reduction in open defecation (13%), parental education (10%), maternal nutrition (5%), economic improvement (4%), and reduced diarrhea incidence (4%). Policies and programs that were key to stunting decline focused on promoting rural agriculture to improve food security; decentralization of the health system, incorporating health extension workers to improve rural access to health services and reduce open defecation; multisectoral poverty reduction strategies; and a commitment to improving girls' education. Interviews with national and regional stakeholders and mothers in communities presented improvements in health service access, women and girls' education, improved agricultural production, and improved sanitation and child care practices as drivers of stunting reduction. CONCLUSIONS Ethiopia's stunting decline was driven by both nutrition-specific and -sensitive sectors, with particular focus on the agriculture sector, health care access, sanitation, and education.
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Affiliation(s)
- Hana Tasic
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nadia Akseer
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Seifu H Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samanpreet Brar
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Erica Confreda
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kaitlin Conway
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bilal S Endris
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muhammad Islam
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Emily Keats
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Afrah Mohammedsanni
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jannah Wigle
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
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Gebremedhin S. Soluble transferrin receptor level, inflammation markers, malaria, alpha-thalassemia and selenium status are the major predictors of hemoglobin in children 6-23 months in Malawi. Food Sci Nutr 2020; 8:4601-4610. [PMID: 32884740 PMCID: PMC7455940 DOI: 10.1002/fsn3.1780] [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: 02/19/2020] [Revised: 06/21/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022] Open
Abstract
In sub-Saharan Africa, nearly three-fourths of children 6-23 months are anemic. Yet, the underlying causes had not been sufficiently explored. This study, based on data (n = 348) extracted from the Malawi Micronutrient Survey-2015/2016 dataset, evaluated the contribution of multiple factors to the hemoglobin status of children 6-23 months. The association between hemoglobin and 19 predictors was assessed using multiple linear regression analysis, and the relative contribution of the covariates was determined based on delta-R 2 value. The study found that 43.9% of children were anemic and 76.9% had elevated soluble transferrin receptor (sTfR) levels. Unit changes in serum ferritin (µg/L) and sTfR (mg/L) were associated with 0.01 g/dl rise (p = .041) and 0.05 g/dl decline (p < .001) in hemoglobin, respectively. Each 1 ng/ml increase in plasma selenium was met with 0.007 g/dl (p = .02) rise in hemoglobin. Hemoglobin showed negative relationships with α-1-acid glycoprotein (AGP) (β = -.339, p = .007) and C-reactive protein (CRP) (β = -.014, p = .004) and positive association with child's age in months (β = .038, p = .003) and altitude in meters (β = .001, p = .015). Children affected by α-thalassemia (β = -.75, p < .001), malaria (β = -.43, p = .029), and fever (β = -.39, p = .008) had significantly lower hemoglobin levels. On the contrary, nine variables including serum zinc and retinol binding protein were not significant predictors of hemoglobin. sTfR had the highest delta-R 2 contribution (9.1%) to hemoglobin variations, followed by inflammation (5.2%), α-thalassemia (2.5%), age (2.1%), fever (1.9%), and malaria (1.5%). The analysis suggested iron status, inflammation, and malaria were the major predictors of hemoglobin among Malawian infants and young children.
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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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Mohammed SH, Habtewold TD, Muhammad F, Esmaillzadeh A. The contribution of dietary and non-dietary factors to socioeconomic inequality in childhood anemia in Ethiopia: a regression-based decomposition analysis. BMC Res Notes 2019; 12:646. [PMID: 31585547 PMCID: PMC6778376 DOI: 10.1186/s13104-019-4691-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/28/2019] [Indexed: 12/16/2022] Open
Abstract
Objective There is a scarcity of evidence on socioeconomic inequalities of childhood anemia in Ethiopia. We determined the magnitude of socioeconomic inequality in anemia and the contribution of dietary and non-dietary factors to the observed inequality, using a nationally representative data of 2902 children included in the 2016 Ethiopian demographic and health survey. The data were collected following a multistage, stratified cluster sampling strategy. We followed the Blinder–Oaxaca regression-based approach to decompose the inequality and determine the relative contribution (%) of the dietary and non-dietary factors to the observed inequality. Result We found a significant pro-poor socioeconomic inequality in childhood anemia in Ethiopia. A third (~ 33%) of the inequality was attributable to compositional differences in the dietary determinants of anemia (dietary diversity, meal frequency, and breastfeeding factors). Non-dietary factors like residence place, maternal education, and birth weight) jointly explained ~ 36% of the inequality. Maternal education was the single most important factor, accounting alone for ~ 28% the inequality, followed by rural residence (~ 17%) and dietary diversity (~ 16%). Efforts to narrow socioeconomic gaps and/or designing equity sensitive interventions by prioritizing the poor in health/nutrition interventions stands worth of consideration to reduce the burden of childhood anemia in Ethiopia and beyond.
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Affiliation(s)
- Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.
| | | | - Fatima Muhammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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