Maternal Risk Factors for Childhood Anaemia in Ethiopia

Dereje Habte, Kalid Asrat, Mgaywa GMD Magafu, Ibrahim M. Ali, Tadele Benti, Wubeshet Abtew, Girma Tegegne, Dereje Abera, Solomon Shiferaw

Abstract

A total of 8260 children between the ages of 6-59 months were analyzed to identify the risk factors associated with childhood anaemia in Ethiopia. The overall mean (SD/ standard deviation) haemoglobin (Hgb) level among the under-five children was 10.7 (2.2) g/dl and 50.3% were anaemic. Childhood anaemia demonstrated an increasing trend with maternal anaemia levels of mild, moderate and severe anaemia: odds ratio of 1.82, 2.16 and 3.73 respectively (p< 0.01). Children whose mothers had no formal education were 1.38 times more likely to be anaemic (p<0.01). The poorest and poorer wealth index groups had 1.52 and 1.25 increased odds of childhood anaemia respectively (p< 0.01). Childhood anaemia in Ethiopia is a severe public health problem. Maternal anaemia and socio-economic status were found to be associated with anaemia in children. A holistic approach of addressing mothers and children is of paramount importance. (Afr J Reprod Health 2013; 17[3]: 110-118).

 

Résumé

Un total de 8260 enfants âgés de 6-59 mois ont été analysés afin d'identifier les facteurs de risque associés à l'anémie de l'enfance en Ethiopie. La moyenne (type SD / écart standard) hémoglobine niveau global (Hgb) chez les enfants qui ont moins de cinq ans était de 10,7 (2,2) g / dl et 50,3% étaient anémiques.  L’anémie de l'enfance a démontré une tendance à la hausse des niveaux d'anémie maternelle de l'anémie légère, modérée et sévère: odds ratio de 1,82, 2,16 et 3,73 respectivement (p <0,01). Les enfants dont les mères n'avaient pas été  scolarisées étaient 1,38 fois plus susceptibles d'être anémiques (p <0,01). Les groupes de l'indice de richesse les plus pauvres et les moins pauvres avaient 1,52 et 1,25 probabilité accrue d'anémie infantile, respectivement (p <0,01).  L’anémie chez les enfants en Éthiopie est un problème de santé publique grave. L’on a découvert que l'anémie maternelle et la situation  socio-économique ont été  associées à l'anémie chez les enfants. Une approche holistique pour s’occuper des mères et des enfants est d'une importance primordiale. (Afr J Reprod Health 2013; 17[3]: 110-118).

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References

World Health Organization. Worldwide prevalence of anemia 1993–2005: WHO global database on anemia. Edited by Bruno de Benoist, Erin McLean, Ines Egli and Mary Cogswell, Geneva, 2008. Available at: http://apps.who.int/iris/bitstream/10665/43894/1/9789

_eng.pdf

Schellenberg D, Schellenberg JRMA, Muchi A, et al. The silent burden of anemia in Tanzanian children: a community-based study. Bulletin of the World Health Organization 2003; 81: 581–590.

Cornet M, Le Hesran JY, Fievet N, et al. Prevalence of and risk factors for anemia in young children in southern Cameroon. Am J Trop Med Hyg 1998; 58: 606–611.

Micronutrient Initiative/UNICEF. Vitamin and mineral deficiency: A global progress report. Ottawa, 2004. Available at: http://micronutrient.org/CMFiles/PubLib/VMd-GPREnglish1KWW-3242008-4681.pdf

Adish A, Esrey S, Gyorkos T, Johns T. Risk factors for iron deficiency anemia in preschool children in Northern Ethiopia. Public Health Nutr 1999; 2: 243252.

Zein ZA. Hematocrit levels and anemia in Ethiopian children. East AFR Med J. 1991; 68(6):412-9.

Central Statistical Agency (Ethiopia), ORC Macro. Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton; Maryland, Central Statistical Agency and ORC Marco, 2006: 128-165.

Murphy SC, Breman JG. Gaps in the childhood malaria burden in Africa: cerebral malaria, neurological sequelae, anemia, respiratory distress, hypoglycemia, and complications of pregnancy. Am J Trop Med Hyg 2001; 64: 57 – 67.

Brooker S, Akhwale W, Pullan R, et al. Epidemiology of plasmodium-helminth co-infection in Africa:

populations at risk, potential impact on anemia, and prospects for combining control. Am J Trop Med Hyg 2007; 77: (6 Suppl)88–98.

Semba RD, Bloem MW. The anemia of vitamin A deficiency: epidemiology and pathogenesis. Eur J Clin Nutr 2002; 56: 271–281.

Stoltzfus R, Mullany L, Black RE. Iron deficiency anemia. In: Ezzati M, Lopez A, Rodgers A, Murray CJL, eds. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva, World Health Organization, 2004, 163–210.

Fleming, A. F. Iron deficiency in the tropics. Clin. Haematol 1982; 11:365-388.

Thane CW, Walmsley CM, Bates CJ, Prentice A and Cole TJ. Risk factors for poor iron status in British toddlers: further analysis of data from the National Diet and Nutrition Survey of children aged 1.5–4.5 years. Public Health Nutrition 2000; 3: 433-440.

Tatala S, Svanberg U, Mduma B. Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania. Am J Clin Nutr 1998; 68:171-78.

Tympa-Psirropoulou E, Vagenas C, Dafni O, and et al. Environmental risk factors for iron deficiency anemia in children 12–24 months old in the area of Thessalia in Greece. Hippokratia 2008; 12: 240–250.

Sibabrata D and Harihar S. An Investigation into Factors Affecting Child Under-nutrition in Madhya Pradesh. Anthropologist 2011; 13(3): 227-233..

Bharati P, Shome S, Chakrabarty S, Bharati S, and Pal M. Burden of anemia and its socioeconomic determinants among adolescent girls in India. Food and Nutrition Bulletin 2009; 30(3): 217-226.

Block SA. Maternal nutrition knowledge versus schooling as determinants of child micronutrient status. Oxford Economic Papers 2007; 59(2): 330-353.

Stoltzfus R. J. Iron deficiency: Global prevalence and consequences. Food & Nutrition Bulletin 2003; 24(Supplement 2): 99-103.

Grantham-McGregor S and Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 2001; 131: 649S–66S.

Idjradinata P and Pollitt E. Reversal of developmental delays in iron-deficient anemic infants treated with iron. The Lancet 1993; 341(8836): 1-4.

Stoltzfus RJ, Kvalsvig JD, Chwaya HM, et al. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study. BMJ 2001; 323: 1389–93.

WHO: Major issues for nutrition strategies food and agriculture organization and WHO Theme paper no. 6. In FAO/WHO International conference on nutrition, 1992, 12-23.

Cusick S. E., Z. Mei, Freedman DS, et al. Unexplained decline in the prevalence of anemia among US children and women between 1988-1994 and 19992002. The Am J Clin Nutr 2008; 88(6): 1611-1617.

Central Statistical Agency (Ethiopia), ORC Macro. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, Central Statistical Agency and ORC Marco, 2012.

Federal Ministry of Health (Ethiopia), Ethiopian national guideline for control and prevention of micronutrient deficiencies. Addis Ababa, Family Health

Department, 2004: 16-21.

Mwanri L, Worsley A, Ryan P, Masika J. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. J Nutr 2000; 130:2691– 2696.

Meinzen-Derr JK, Guerrero ML, Altaye M, OrtegaGallegos H, Ruiz- Palacios GM, Morrow AL. Risk of infant anemia is associated with exclusive breastfeeding and maternal anemia in a Mexican cohort. J Nutr. 2006; 136: 452–8.

Rohner F, Zimmermann MB, Amon RJ, et al. In a Randomized Controlled Trial of Iron Fortification, Anthelmintic Treatment, and Intermittent Preventive Treatment of Malaria for Anemia Control in Ivorian Children, only Anthelmintic Treatment Shows Modest Benefit. J. Nutr 2010; 140: 635–641.

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