Prevalence of Anemia and its Risk Factors among Children under 36 Months Old in China

Xin, Qianqian; Chen, Bowen; Yin, Delu; Xiao, Feng; Li, Ruili; Yin, Tao; Yang, Huimin; Zheng, Xiaoguo; Wang, Lihong

doi:10.1093/tropej/fmw049

Cited by 35 publications

(35 citation statements)

References 22 publications

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“…Consistent with previous estimates [10,28,29], this study also highlights the constantly and alarmingly high risk of anemia among children under 3 years old in rural China. The results show that about two-thirds of children aged 6-17 months and one-third of the children aged 18-35 months were anemic, and no significant reduction of risk of anemia was found among these children from 2013 to 2016.…”

Section: Discussionsupporting

confidence: 92%

The association between parental migration and early childhood nutrition of left-behind children in rural China

Shi

Zhang

et al. 2020

BMC Public Health

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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 nonmigrants 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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Section: Discussionsupporting

confidence: 92%

The association between parental migration and early childhood nutrition of left-behind children in rural China

Shi

Zhang

et al. 2020

BMC Public Health

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“…And this study recommends that parents (the primary caregivers) should be well informed about their child's nutritional health and the importance of vaccinating their children against all the basic doses of full immunization. Additionally, special care should be taken to closely monitor those households where parents are not well educated, do not have any employment or source of income and young parents who are not experienced in parenting and child care 46,47 .…”

Section: Resultsmentioning

confidence: 99%

“…Though proper dietary consumption and regular intake of iron can substantially reduce the burden of anaemia 43,45 , still a majority of the children under age five years are anaemic in India. Thus, it could be mentioned that educated mother/parents do take care of dietary intake and are more aware of their child's nutritional health than those parents having no formal education 36,39,46 . Studies conducted in different country settings like-Asia, Africa, Latin America, and the Middle East show positive association between parental education and child's nutritional status 47 and in this study also a parental education gradient in stunting and anaemia is observed which indicates lower burden of child stunting and anaemia among the children of higher educated parents.…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study on selected child health outcomes in India: Quantifying the spatial variations and identification of the parental risk factors

Puri

Khan

Shil

et al. 2020

Sci Rep

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, a transition in the level of child health outcomes can be observed. The proportion of anaemia amongst children was 74.3 percent (1998-99) 12 , 69.5 percent (2005-06) 13 and 58.4 percent (2015-16) 14. Also, the proportion of full immunization amongst children was 42.0 percent (1998-99) 12 , 43.5 percent (2005-06) 13 and 62.0 percent (2015-16) 14. The proportion of stunted children has reduced by 15 percent from year 1998-99 (46%) to 2015-16 (38%) 14 (Supplementary File S1). The country has achieved continued financial progress (over 5% growth in GDP) and decreased the poverty level by half (50% in 1993-94 to 22% in 2011-12). However, the improvement in the child health outcomes are still not at par with the international targets set by the MDGs 10,11. Existing literature suggests that nutritional status, blood anaemia level and VPDs, play a vital role in determining the overall development of child health 10,15. Stunting can be defined as a severe form of undernutrition and is identified as the height that is below two standard deviations from the median child growth standard laid by the World Health Organization (WHO) 16. Stunting proliferates the risk of poor health, which may affect scholastic and economic well-being of an individual in their later life 13,15. WHO defines anemia as a condition where either the number of red blood cells or their oxygen-carrying capacity becomes insufficient to satisfy the physiological needs of an individual's body 1. Children suffering from anaemia have weak immunity and are therefore at higher risk of having infections. Moreover, iron deficiency which is supposed to be the major cause of anemia highly affects the cognitive capacities like learning, memory and behavior of the children throughout their lifetime 16. Full immunization has emerged out as a worthwhile method to prevent a group of lethal diseases, generally referred to as VPDs 17. However, a large proportion of children in India, still do not receive all the doses of the full immunization schedule (around 40%) and it remains a key public health challenge 14. There is abundant literature which focuses on exploring the child health outcomes in terms of socioeconomic factors in different country settings. Though these studies explored the spatial heterogeneity and correlates of child malnutrition and different doses of full immunization coverage 15,17 , the relationship between child health (malnutrition) and health care utilization (immunization) with paternal characteristics has not been previously explored. Recent developments in public health research suggests that geospatial mapping and modeling of different demographic and epidemiological events by inter-linking different exposures help in the identification of the pockets and therefore, help in accurate resource allocation. This would, furthermore, help the government and policymakers to address the need of the community and, therefore, achieve the latest targets set by the Sustainable Development Goals (SDGs)-2015-30. Thus, the present study aims to explore th...

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“…Iron deficiency is a common cause of anemia in children and is associated with 86-93% of anemia in children [4]. Many observational studies indicate that the independent risk factors of anemia in children include preterm birth, low birth weight, and maternal anemia [5][6][7][8][9]. Moreover, childhood anemia is closely related with feeding practice, complementary food introduction, social demographic characteristics, and family income [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Anemia prevalence, severity and associated factors among children aged 6–71 months in rural Hunan Province, China: a community-based cross-sectional study

Liao

Huang

et al. 2020

BMC Public Health

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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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Prevalence of Anemia and its Risk Factors among Children under 36 Months Old in China

Cited by 35 publications

References 22 publications

The association between parental migration and early childhood nutrition of left-behind children in rural China

The association between parental migration and early childhood nutrition of left-behind children in rural China

A cross-sectional study on selected child health outcomes in India: Quantifying the spatial variations and identification of the parental risk factors

Anemia prevalence, severity and associated factors among children aged 6–71 months in rural Hunan Province, China: a community-based cross-sectional study

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