Determinants of anemia severity levels among children aged 6–59 months in Ethiopia: Multilevel Bayesian statistical approach

Abstract

Anemia is a widespread public health problem that affects all stages of life particularly preschool children and pregnant mothers. Anemia among children had significant impact on their growth, development, school performance and mortality. Different strategies like deworming of young children, vitamin A supplementation for children aged 6–59 months, and ferrous sulphate supplementation and provision of insecticide treated bed net for pregnant women were designed to control and prevent anemia. Also, previous studies on anemia factors were conducted but they were not considering the ordered nature of anemia. Therefore, this study aimed to identify the factors of anemia severity levels among children aged 6–59 months in Ethiopia by using ordinal analysis based on Bayesian hierarchical statistical approach. A secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 8483 weighted children were included. Due to the ordered nature of the anemia and nested nature of DHS data, ordinal logistic regression model based on hierarchical Bayesian statistical approach was employed to identify the determinants of anemia severity levels. In this study, moderate anemia level was found to be the commonest type which accounts around 29.4%. Female children, poorer, middle, and richest wealth index, primary maternal education and having ANC visit had lower risk of having higher order of anemia. Moderate maternal anemia and stunted children had higher chance of having higher order of anemia. Children age had significant different effect on mild and moderate anemia. Meanwhile, multiple birth/s and deworming had effect on moderate anemia. In addition, normal birth weight had also significant and different effect on mild and severe anemia and history of feverlike illness on mild anemia. The prevalence of anemia among children aged 6–59 months anemia was found to be a severe public health problem. Children age, sex, maternal education, child stunting, history of fever, multiple birth, birth weight, provision of deworming and maternal anemia was found to be the most important factors for child anemia severity levels. Therefore, intervention efforts to control and prevent anemia in Ethiopia requires targeting of these hindering factors.

Child anemia in Cambodia: A descriptive analysis of temporal and geospatial trends and logistic regression-based examination of factors associated with anemia in children

“…Cambodia is one of the malaria-endemic areas in Southeast Asia [52]. An association between childhood anemia and inflammatory infections, which includes fever, cough, and worm infestation, has been well established [53]. The possible pathway of this association is due to iron losses during the time of infections [54].…”

Child Anemia in Cambodia: A Descriptive Analysis of Temporal and Geospatial Trends and Logistic Regression-Based Examination of Factors Associated with Anemia in Children

“…Cambodia is one of the malaria-endemic areas in Southeast Asia [44]. An association between childhood anemia and inflammatory infections, which includes fever, cough, and worm infestation, has been well established [45]. The possible pathway of this association is due to iron losses during the time of infections [46].…”

“…The possible pathway of this association is due to iron losses during the time of infections [46]. One previous study reported that iron-deficiency anemia may depend on inadequate iron-rich food intake, increased iron use in the body, and iron depletion due to parasitic infection [45]. Also, previous studies have reported that malaria increases erythrocyte destruction with a simultaneous failure of the bone marrow thus jeopardizing the ability to compensate for the losses [46].…”

Childhood undernutrition mediates the relationship between open defecation with anemia among Ethiopian children: a nationally representative cross-sectional study

“…A control variable, also known as a covariate, is a variable that is included in an analysis to account for potential confounding factors or to control for their influence on the relationship between the independent and dependent variables. The control variables used in this study were generated based on literature [ 8 , 51 , 53 , 56 , 69 , 78 , 79 ] and their availability in the EDHS dataset. The sex of the child (male, female), age of the child (6–11 months, 12–23, 24–35, and 36–59 months), perceived size of the child at birth (large, average and small), received deworming medication in the last 6 month (yes, no), received iron supplementation in the last 6 months (yes, no), mother's age (< 18, 18–24, 25–34, or > = 35), mother's education (no education, primary and above), mother's current work status (yes, no), household wealth index (poor, middle, and rich), place of residence (rural, urban), and region.…”