Anemia and water, sanitation, and hygiene (WASH)—is there really a link?

Baldi, Andrew; Clucas, Danielle; Pasricha, Sant‐Rayn

doi:10.1093/ajcn/nqaa213

Cited by 8 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings suggest that subclinical presence of specific invasive enteropathogenic bacteria, particularly EAEC and EIEC/Shigella, may contribute to anemia in young children. Prior literature has found that poor water and sanitation are associated with anemia among young children living in LMICs [48,49], with the hypothesis that exposure to enteropathogens underlies this relationship [14]. By demonstrating an association between certain enteropathogens and anemia, our results lend direct evidence to support this hypothesis.…”

Section: Discussionsupporting

confidence: 76%

“…However, EIEC/Shigella was associated with both iron deficiency and anemia, and children positive for EIEC/Shigella exhibited 5 g/L lower Hb concentrations on average than children without EIEC/Shigella. Several recent studies have linked indicators of enteropathogen exposure, such as poor water and sanitation conditions [48,49] and biomarkers of EED [28,29,31], to lower hemoglobin concentrations and anemia in young children, prompting the hypothesis that enteropathogen infections are directly linked to anemia [14]. Analysis of the MAL-ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) multi-site birth cohort study indeed demonstrated that the mean number of different parasitic, viral, and bacterial enteropathogens detected in both diarrheal and nondiarrheal stools across children's first 24 months of life was associated with lower hemoglobin concentrations [23].…”

Section: Plos Onementioning

confidence: 99%

“…To reduce the anemia burden, understanding the causes of inflammation, especially from non-malarial infections, is thus critical [12,13]. An emerging, but understudied hypothesis is that exposure to enteropathogens directly contributes to anemia in children [14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

et al. 2022

View full text Add to dashboard Cite

Anemia remains a pervasive public health problem among preschool-age children in Ghana. Recent analyses have found that anemia in Ghanaian children, particularly in Southern regions, is largely attributable to infectious causes, rather than nutritional factors. Infections with enteropathogens can reduce iron absorption and increase systemic inflammation, but few studies have examined direct links between enteropathogens and anemia. This study investigated associations between detection of individual bacterial enteropathogens and systemic inflammation, iron deficiency, and anemia among 6- to 59-month-old children in Greater Accra, Ghana. Serum samples were analyzed from a cross-sectional sample of 262 children for concentrations of hemoglobin (Hb), biomarkers of systemic inflammation [C-reactive protein (CRP) and α-1-acid glycoprotein (AGP)], and biomarkers of iron status [serum ferritin (SF) and serum transferrin receptor (sTfR)]. Stool samples were analyzed for ten bacterial enteropathogens using qPCR. We estimated associations between presence of each enteropathogen and elevated systemic inflammation (CRP > 5 mg/L and AGP > 1 g/L), iron deficiency (SF < 12 μg/L and sTfR > 8.3 mg/L) and anemia (Hb < 110 g/L). Enteropathogens were detected in 87% of children’s stool despite a low prevalence of diarrhea (6.5%). Almost half (46%) of children had anemia while one-quarter (24%) had iron deficiency (low SF). Despite finding no associations with illness symptoms, Campylobacter jejuni/coli detection was strongly associated with elevated CRP [Odds Ratio (95% CI): 3.49 (1.45, 8.41)] and elevated AGP [4.27 (1.85, 9.84)]. Of the pathogens examined, only enteroinvasive Escherichia coli/Shigella spp. (EIEC/Shigella) was associated with iron deficiency, and enteroaggregative Escherichia coli (EAEC) [1.69 (1.01, 2.84)] and EIEC/Shigella [2.34 (1.15, 4.76)] were associated with anemia. These results suggest that certain enteroinvasive pathogenic bacteria may contribute to child anemia. Reducing exposure to enteropathogens through improved water, sanitation, and hygiene practices may help reduce the burden of anemia in young Ghanaian children.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Thus, women with lower socioeconomic status are prone to be undernourished and anaemic condition due to inadequate food consumption [ 18 , 19 ]. Moreover, unhygienic practices and a lack of improved drinking water also directly affect the bioavailability of the food consumed [ 20 ]. High fertility, physical work, parasite infections, and menstrual disorders are similarly responsible for anaemia in women [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying risk factors in explaining women’s anaemia in limited resource areas: evidence from West Bengal of India and Bangladesh

2022

View full text Add to dashboard Cite

Background Anaemia among women is a public health problem with associated adverse outcomes for mother and child. This study investigates the determinants of women’s anaemia in two Bengals; West Bengal (a province of India) and Bangladesh. These two spaces are inhabitated by Bengali speaking population since historic past. The study argues that open defecation, contraceptive method use and food consumption patterns are playing crucial role in explaining anaemia. Methods Using non-pregnant women belonging to different religious groups, we analyzed a total of 21,032 women aged 15–49 from the nationally representative cross-sectional surveys, i.e., Bangladesh Demographic Health Survey (BDHS-VI, 2011) and National Family Health Survey (NFHS round 4, 2015–16). We performed spatial, bivariate and logistic regression analyses to unfold the important risk factors of anaemia in two Bengals. Results The prevalence of anaemia was 64% in West Bengal and 41% in Bangladesh. The significant risk factors explaining anaemia were use of sterilization, vegetarian diet and open defecation. Further, women who used groundwater (tube well or well) for drinking suffered more from anaemia. Also, younger women, poor, less educated and having more children were highly likely to be anaemic. The study also indicates that those who frequently consumed non-vegetarian items and fruits in West Bengal and experienced household food security in Bangladesh were less prone to be anaemic. Hindus of West Bengal, followed by Muslims of that state and then Hindus of Bangladesh were at the higher risk of anaemia compared to Muslims of Bangladesh, indicating the stronger role of space over religion in addressing anaemia. Unlike West Bengal, Bangladesh observed distinct regional differences in women's anaemia. Conclusions Propagating the choices of contraception mainly Pill/ injection/IUDs and making the availability of iron rich food along with a favourable community environment in terms of safe drinking water and improved sanitation besides better education and economic condition can help to tackle anaemia in limited-resource areas.

show abstract

“…En el estudio se puede denotar un variable explicativa importante como la disposición y acceso al agua en los niños tamizados. Diversas investigaciones (13)(14)(15) demuestran la relación directa entre la fuente de agua, saneamiento y anemia. Siendo el acceso al agua mejorada un factor protector para el desarrollo infantil óptimo.…”

Section: Discussionunclassified

Abordaje comunitario para la identificación de casos de anemia en gestantes, niños y niñas en tres comunidades del Perú

Silva¹,

Ancajima²,

Solano³

et al. 2021

Medicina Clínica Y Social

View full text Add to dashboard Cite

Introducción: La anemia por deficiencia de hierro afecta el crecimiento y desarrollo cognitivo desde las primeras etapas de vida de ser humano. Es preciso abordar una estrategia comunitaria para detectar oportunamente los casos a fin de garantizar oportunidades de desarrollo integral en las etapas de vida posteriores. Objetivo: Describir un modelo de abordaje comunitario para la detección de casos de anemia en niños y niñas en tres comunidades urbanos marginales del norte del Perú. Metodología: Estudio epidemiológico descriptivo de corte transversal, se tamizaron con equipo de espectrofotometría a 412 personas entre gestantes, niños y niñas menores de 5 años. Además, se aplicaron cuestionarios anónimos para evaluar las determinantes de salud. Se geo ubicaron las viviendas con casos de anemia y se desarrolló un aplicativo informático para el almacenamiento de la información Resultados: En las comunidades de San José y Salamanca se representaron 3.9 % (16) y 7% (29) casos de anemia respectivamente y solo 1.7 % (7) casos en los Jardines. Existe una relación significativa entre las comunidades y la aparición de casos de anemia p valor = 0.001; intervalo de confianza IC 95%. Además, el 9. 5% (39) de los casos de anemia no tenía acceso a ningún programa social. Finalmente, el 83.7% (345) de tamizados no reportó anemia y estuvo suplementado con micronutrientes. Conclusiones: El modelo comunitario podría ser un referente en la atención primaria de salud como estrategia del determinismo social de los casos de anemia en gestantes, niños y niñas.

show abstract

Anemia and water, sanitation, and hygiene (WASH)—is there really a link?

Cited by 8 publications

References 11 publications

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

Identifying risk factors in explaining women’s anaemia in limited resource areas: evidence from West Bengal of India and Bangladesh

Abordaje comunitario para la identificación de casos de anemia en gestantes, niños y niñas en tres comunidades del Perú

Contact Info

Product

Resources

About