Determinants of Anemia Among Young Children in Rural India

Pasricha, Sant‐Rayn; Black, Jim; Muthayya, Sumithra; Shet, Anita; Bhat, Vijay; Nagaraj, Savitha; Prashanth, N S; Sudarshan, H; Biggs, Beverley‐Ann; Shet, Arun S.

doi:10.1542/peds.2009-3108

Cited by 239 publications

(328 citation statements)

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“…Some of these factors, like younger age and male gender, are well-established nonmodifiable predictors of childhood anaemia (6,8,(12)(13)(14)(15)17,25,29) . While the reasons for higher vulnerability of younger children to Fe-deficient anaemia are well known, the reason for boys to be more susceptible to Fe deficiency compared with girls is a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

“…According to recent estimates, the proportion of all childhood anaemia resulting from Fe deficiency ranges from 63 % in Europe to 34 % in Africa, while the proportion of severe anaemia attributable to Fe deficiency is over 50 % globally (2,3) . Low consumption of meat products is considered to be the major cause of Fe deficiency in young children, especially at weaning age when the Fe requirement is high due to rapid growth and Fe intake from inadequate complementary feeding is low (4,12) . Thus, younger age and insufficient consumption of bioavailable Fe are among well-established determinants of childhood anaemia (6,8,(12)(13)(14)(15) .…”

mentioning

confidence: 99%

“…Low consumption of meat products is considered to be the major cause of Fe deficiency in young children, especially at weaning age when the Fe requirement is high due to rapid growth and Fe intake from inadequate complementary feeding is low (4,12) . Thus, younger age and insufficient consumption of bioavailable Fe are among well-established determinants of childhood anaemia (6,8,(12)(13)(14)(15) . Other factors commonly related to anaemia in children include male gender, family's poor socioeconomic status (SES), maternal anaemia (especially during pregnancy) and child's stunted growth (6)(7)(8)12,(14)(15)(16)(17) .…”

mentioning

confidence: 99%

“…Thus, younger age and insufficient consumption of bioavailable Fe are among well-established determinants of childhood anaemia (6,8,(12)(13)(14)(15) . Other factors commonly related to anaemia in children include male gender, family's poor socioeconomic status (SES), maternal anaemia (especially during pregnancy) and child's stunted growth (6)(7)(8)12,(14)(15)(16)(17) . In some populations, a substantial proportion of anaemia is attributable to sickle cell disorder, thalassaemia, hookworm, schistosomiasis and malaria (1) .…”

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confidence: 99%

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Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

Demirchyan

Petrosyan

Sargsyan

et al. 2015

Public Health Nutr.

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Objective: Despite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia. Design: Blood Hb level was measured among a representative sample of children using the HemoCue Hb201 + analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively. Setting: Talin communities, Aragatsotn Province, Armenia. Subjects: Children under 5 years of age in Talin region. Results: Of the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6-12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions. Conclusions: The study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

Demirchyan

Petrosyan

Sargsyan

et al. 2015

Public Health Nutr.

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“…1 In a study of children aged 12-23 months in two rural districts in India, 72% of children with anaemia had low ferritin levels. 13 Another study done by Reha et al in Tanzania the overall prevalence rate of anaemia in the under 5 age group was 77.2%. 14 The reasons for high prevalence of anaemia in children are increased iron requirements due to rapid growth, early weaning, low availability of foods rich in iron and dietary monotony.…”

Section: Discussionmentioning

confidence: 93%

Prevalence and Severity of Anaemia Among Hospitalised Children Aged 6-59 Months

Varghese¹,

Kamalakarababu²,

Vadakkedam³

2017

jemds

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BACKGROUNDAnaemia is ubiquitous and has a global prevalence, more so in developing countries. Globally, anaemia affects 1.62 billion people, which corresponds to 24.8% of the population and the highest prevalence is noted in preschool-age children (47.4%). Anaemia is a major health problem in India. Iron deficiency, the most common cause for anaemia can be effectively prevented and in case already developed, can be easily treated by simple measures. Hence, there is a dire necessity for comprehensive studies to determine the prevalence of anaemia in children. MATERIALS AND METHODSThis is a retrospective descriptive study conducted at Institute of Child Health, Government Medical College, Kottayam. Data pertaining to gender, age, weight, serum haemoglobin level, diagnosis that led to admission and duration of hospitalisation were collected. The WHO criteria (haemoglobin < 11 g/dL) were used to diagnose anaemia. Chi-square test was used to find the association between grades of anaemia and various study parameters. RESULTSPrevalence of anaemia was 56.1% in the study group with 28.7%, 25.3% and 2.1% as mild, moderate and severe anaemia respectively. Proportion of anaemic cases decreased with age, varying from 71.3% in children between 6 and 12 months to 31.5% in children >36 months. CONCLUSIONA large proportion of hospitalised children less than 5 years of age were found anaemic. Among all the anaemic children, iron deficiency anaemia was high and it should be considered as a public health problem.

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Effect of a Community Health Worker–Delivered Parental Education and Counseling Intervention on Anemia Cure Rates in Rural Indian Children

et al. 2019

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Iron deficiency anemia, the largest cause of anemia worldwide, adversely affects cognitive development in children. Moreover, the imperceptible childhood anemia prevalence reduction in response to anemia control measures is associated with tremendous social and economic cost.OBJECTIVE To evaluate the effects of community-based parental education/counseling when combined with usual treatment on children's anemia cure rate. DESIGN, SETTING, AND PARTICIPANTSA pragmatic cluster randomized clinical trial in children aged 12 to 59 months from 55 villages from the rural Chamrajnagar district in southern India was conducted between November 2014 and July 2015; 6-month follow-up ended in January 2016. Villages were randomly assigned to either usual treatment (n = 27) or to the intervention (n = 28). Among 1144 participating children, 534 were diagnosed as having anemia (hemoglobin levels <11 g/dL and >7.9 g/dL; to convert to grams per liter, multiply by 10) and constituted the study sample in this analysis. Data were analyzed between July 2016 and September 2017. INTERVENTIONS Iron and folic acid (IFA), 20 mg/d, 5 times daily per week, for 5 months (usual treatment) or health worker-delivered education/counseling combined with usual treatment (intervention). MAIN OUTCOMES AND MEASURESThe primary outcome was anemia cure rate defined as hemoglobin level at or greater than 11 g/dL during follow-up. RESULTSOf the children included in the study, the mean age was 30 months, with a slightly higher ratio of boys to girls. Of 534 children with anemia (intervention n = 303; usual treatment n = 231), 517 were reassessed after 6 months (intervention n = 298; usual treatment n = 219) while 17 were lost to follow-up (intervention n = 5 and usual treatment n = 12). Anemia cure rate was higher in children in the intervention group compared with children receiving usual treatment (55.7% [n = 166 of 298] vs 41.4% [n = 90 of 219]). The risk ratio derived through multilevel logistic regression was 1.37(95%CI,1.04-1.70);themodel-estimatedriskdifferencewas15.1%(95%CI,3.9-26.3).Interventiongroup children demonstrated larger mean hemoglobin increments (difference, intervention vs control: 0.25 g/dL; 95% CI, 0.07-0.44 g/dL) and improved IFA adherence (61.7%; 95% CI, 56.2-67.3 vs 48.4%; 95% CI, 41.7-55.1 consumed >75% of tablets provided). Adverse events were mild (intervention: 26.8%; 95% CI, 21.8-31.9 vs usual treatment: 21%; 95% CI, 15.6-26.4). To cure 1 child with anemia, 7 mothers needed to be counseled (number needed to treat: 7; 95% CI, 4-26).CONCLUSIONS AND RELEVANCE Parental education and counseling by a community health worker achieved perceivable gains in curing childhood anemia. Policy makers should consider this approach to enhance population level anemia control.

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Determinants of Anemia Among Young Children in Rural India

Cited by 239 publications

References 39 publications

Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

Prevalence and Severity of Anaemia Among Hospitalised Children Aged 6-59 Months

Effect of a Community Health Worker–Delivered Parental Education and Counseling Intervention on Anemia Cure Rates in Rural Indian Children

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