Spatial pattern and determinants of anaemia in Ethiopia

Ejigu, Bedilu Alamirie; Wencheko, Eshetu; Berhane, Kiros

doi:10.1371/journal.pone.0197171

“…Our nding of geospatial inequality of anemia affecting unduly the eastern part of Ethiopia is consistent with other similar studies (13,14). The high anemia cluster found in Somali, Afar and eastern Oromia regions can be partly (18).…”

Section: Discussionsupporting

confidence: 92%

Geospatial Inequality of Anemia Among Children in Ethiopia

Endris

¹

,

Dinant

²

,

Gebreyesus

³

et al. 2020

Preprint

0

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Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.

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“…Our nding of geospatial inequality of anemia affecting unduly the eastern part of Ethiopia is consistent with other similar studies (13,14). The high anemia cluster found in Somali, Afar and eastern Oromia regions can be partly explained by the low economic and human development in these regions.…”

Section: Discussionsupporting

confidence: 92%

“…The causes and environmental drivers of anemia showed a high degree of geographic clustering (10). A growing body of evidence indicated that Hb concentration (anaemia) is clustered geographically (10)(11)(12)(13)(14). A study on spatial heterogeneity of Hb concentration in sub Saharan Africa showed that Hb concentration among preschool children was highly clustered geographically in both western and eastern Africa (10,12).…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, spatial analyses in Hb concentration of the children in Nigeria revealed that Northern Nigeria possess a higher risk of anaemia (11). In a geo-spatial study of anemia among adults in Ethiopia, hotspots of anemia were concentrated in the eastern parts of the country (Somali, Dire Dawa and Harari, Afar regions), while cold spots of anemia were observed in the northern (Tigray and Amhara), central (Addis Ababa and Oromia) and western (Benishangul-Gumuz and Gambella) parts of the country (13,14).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Geospatial Inequality of Anemia Among Children in Ethiopia

Endris

¹

,

Dinant

²

,

Gebreyesus

³

et al. 2020

Preprint

1

0

View full text Add to dashboard Cite

Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.

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“…However, few studies have found a higher prevalence of anemia in boys than in girls. 54,55 The likelihood of children being anemic, residing in poorest households appeared to increase the risk of childhood anemia when compared with other wealth index individuals. The finding is consistent with previous studies 50,56,57 and plausibly reflecting better household nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis

Dutta

¹

,

Bhise

²

,

Prashad

³

et al. 2020

Clinical Epidemiology and Global Health

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A B S T R A C TBackground: Early detection of anemia and subsequent measures to prevent anemia can help children grow healthily. There is considerable attention given to the impact of individual-level factors on Anaemia, but less is known about how community characteristics affect Anaemia among children. The present study was focused at estimating the prevalence and associated risk factors at individual and community level in India among children aged 6-59 months in India. Methods: Descriptive statistics and the chi-square test were applied using fourth round of National Family Health Survey dataset. Later, to explore the association of child anemia and some potential risk factors regarding hierarchy (individual and community level) of data, a multilevel logistic regression model was conducted using STATA-SE 14 software. Results: The results indicate that some aspects of the community influence the anemia risks of children. For instance, a 1% increase in the proportion of mother education in the community decreased the likelihood of anemia by 9% among children. Northeast region was the only region at lesser risk of anemia. Higher community level ethnic and religious homogeneity is associated with decreased odds of anemia among children. Children aged 12-35 months, girl child, children having diarrhoea, mothers of age group 15-24, high parity and low exposure to mass-media were the high risk individual factors of anemia among children. Conclusions: Overall, the present study indicated the requirement to include community-level factors beyond the individual level factors by policymakers to eradicate the burden of anemia in the country and the high prevalence states.

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Spatial pattern and determinants of anaemia in Ethiopia

Cited by 41 publications

References 43 publications

Geospatial Inequality of Anemia Among Children in Ethiopia

Geospatial Inequality of Anemia Among Children in Ethiopia

Geospatial Inequality of Anemia Among Children in Ethiopia

Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis

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