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Asmare AA, Agmas YA. Determinants of coexistence of undernutrition and anemia among under-five children in Rwanda; evidence from 2019/20 demographic health survey: Application of bivariate binary logistic regression model. PLoS One 2024; 19:e0290111. [PMID: 38578819 PMCID: PMC10997128 DOI: 10.1371/journal.pone.0290111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/01/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Undernutrition and anemia are significant public health issues among under-5 children, with potential long-term consequences for growth, development, and overall health. Thus, this study aims to conduct a bivariate binary logistic regression model by accounting for the possible dependency of childhood undernutrition and anemia. METHODS The data came from the DHS program's measurement. A total of 3,206 under-five children were involved in this study. A single composite index measure was calculated for stunting, wasting, and underweight using principal component analysis. A bivariate binary logistic regression model is used to assess the association between undernutrition and anemia given the effect of other predictors. RESULTS Among 3,206 under-five children considered in this study, 1482 (46.2%) and 658 (20.5%) children were agonized by anemia and undernutrition, respectively. In bivariate binary logistic regression model; Urban children [AOR = 0.751, 96% CI: 0.573-0.984; AOR = 0.663, 95% CI: 0.456-0.995] and anemic mothers [AOR = 1.160, 95% CI: 1.104-1.218; AOR = 1.663, 95% CI: 1.242-2.225] were significantly associated with both childhood anemia and undernutrition, respectively. Improved water sources [AOR = 0.681, 95% CI: 0.446-0.996], average-sized children [AOR = 0.567, 95% CI: 0.462-0.696], and diarrhea [AOR = 1.134, 95% CI: 1.120-2.792] were significantly associated with childhood anemia. Large-sized children [AOR = 0.882, 95% CI: 0.791-0.853] and those with fever [AOR = 1.152, 95% CI: 1.312-2.981] were significantly associated with under-five children's undernutrition. CONCLUSION The prevalence of both undernutrition and anemia among under-five-year-old children was high in Rwanda. The following determinants are statistically associated with both childhood undernutrition and anemia: place of residence; source of drinking water; maternal anemia; being a twin; birth size of children; diarrhea; fever; and child age. Anemia and nutritional deficiencies must be treated concurrently under one program, with evidence-based policies aimed at vulnerable populations.
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Affiliation(s)
| | - Yitateku Adugna Agmas
- Department of Rural Development and Agricultural Extension, Mekdela Amba University, Tuluawlyia, Ethiopia
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Li P, Wu J, Ni X, Tong M, Lu H, Liu H, Xue T, Zhu T. Associations between hemoglobin levels and source-specific exposure to ambient fine particles among children aged <5 years in low- and middle-income countries. JOURNAL OF HAZARDOUS MATERIALS 2023; 459:132061. [PMID: 37467606 DOI: 10.1016/j.jhazmat.2023.132061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/14/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE We investigated associations between source-specific fine particulate matter (PM2.5) exposure and hemoglobin levels among children in low- and middle-income countries (LMICs). METHOD 36,675 children aged < 5 years were collected in 11 LMICs during 2017. We associated child hemoglobin with 20 source-specific PM2.5, and calculated changes in hemoglobin that could be attributed to different PM2.5-mixture scenarios, established using real-world data from 88 Asian and African LMICs (AA-LMICs). RESULTS Multiple-source analysis revealed PM2.5 produced by solvents (change in hemoglobin for 1-μg/m3 increment in PM2.5: -10.34 g/L, 95% CI -14.88 to -5.91), industrial coal combustion (-0.51 g/L, 95% CI -9.25 to -0.08), road transportation (-0.50 g/L, 95% CI -6.96 to -0.29), or waste handling and disposal (-0.34 g/L, 95% CI -4.38 to -0.23) was significantly associated with a decrease in hemoglobin level. Decreases in hemoglobin attributable to the PM2.5 mixtures were co-determined by the concentrations and their source profiles. The largest PM2.5-related change in hemoglobin was -10.25 g/L (95% CI -15.54 to -5.27) for a mean exposure of 61.01 μg/m3 in India. CONCLUSION Association between PM2.5 and a decrease in hemoglobin was affected by variations in PM2.5 source profiles. Source-oriented interventions are warranted to protect children in LMICs from air pollution.
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Affiliation(s)
- Pengfei Li
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - Jingyi Wu
- Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Xueqiu Ni
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Mingkun Tong
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Hong Lu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
| | - Tong Zhu
- State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China; College of Environmental Sciences and Engineering, Peking University, Beijing, 100084, China
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Vélez León EM, Albaladejo Martínez A, Preciado Sarmiento MA, Cordero López MA, Armas ADC, Encalada Verdugo LS, Melo M. Caries Experience in Preschoolers in Three Ecuadorian Communities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1123. [PMID: 37508620 PMCID: PMC10378548 DOI: 10.3390/children10071123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
Dental caries in the preschool population presents a significant challenge in the field of global public health, including Ecuador. Early detection of this disease is crucial for developing effective strategies for prevention and promotion of oral health, which can have a substantial impact on the quality of life of preschool-aged children. This study evaluated 600 children aged 3 to 5 years attending preschool education centers using the ICDAS II diagnostic criteria. The Student's t-test was used to analyze differences between the means of two independent groups. Additionally, an analysis of variance (ANOVA) was conducted to assess differences between the means of three or more groups. The prevalence of caries was 87%, with a dft index of 3.85 in the three provinces studied. A high treatment need was observed in 84.17% of the population. No significant differences in the DFT index were found based on gender, although both groups exhibited elevated values. No significant differences were observed in relation to province and environment. The second molar was the most affected tooth, with a caries prevalence of 58.8%. Despite the lack of significant differences among the evaluated variables, a high prevalence and experience of dental caries were found in the studied population.
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Affiliation(s)
- Eleonor María Vélez León
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
- School of Dentistry, Catholic University of Cuenca, Cuenca 010107, Ecuador
| | | | | | | | | | | | - María Melo
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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Bakrim S, Hichou NE, Driss EKB, Aboulaghras S, Balahbib A, Bouyahya A, Masrar A. Prevalence of anemia and associated factors in a Moroccan population from the Northwestern region of Morocco (M'diq-Fnideq-Martil Prefecture). Pan Afr Med J 2023; 44:131. [PMID: 37333783 PMCID: PMC10276341 DOI: 10.11604/pamj.2023.44.131.35991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/08/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction anemia remains a major public health challenge worldwide, frequently having multifactorial causes and wide-ranging, largely underestimated repercussions. The purpose of this paper is to assess the prevalence of anemia and identify associated factors in a group of children, adults, and pregnant women. Methods our sample consisted of a total of 1360 volunteers (group I: 410 school-aged children aged 5-11 years; group II: 533 adults aged 16 to 65 years; group III: 417 pregnant women aged 17 to 45 years) randomly selected from different towns of the M'diq-Fnideq prefecture, Morocco from March 2018 to September 2018. Data on socio-demographic, anthropometric, and dietary status were collected from a questionnaire survey. A complete blood count was performed using a hematology analyzer, Sysmex KX21N® (Sysmex Corporation, Kobe, Japan), in the hematology laboratory of the Mohamed VI Hospital of M'diq. Results anemia was found in 31% of children, 52.4% of adults, and 22.5% of pregnant women. Microcytic hypochromic anemia was the most dominant type of anemia in children, adults, and pregnant women with percentages of 40.6%, 48.7%, and 43.5%, respectively. Mild anemia was much more common than moderate and severe anemia in all groups. Furthermore, anemia was associated with low socioeconomic and educational levels in adults (22.8% versus 27.9%) and pregnant women (18.1% versus 16.8%). Schoolchildren with illiterate parents and low socioeconomic levels are the most affected by anemia, with a prevalence of 75% and 69.44%, respectively. Also, children with insufficient stature are at a high risk for anemia compared to children of normal stature (p<0.001). As for weight for age, the odds ratio (OR) was 4.32. A significant difference between underweight and anemia was revealed (p<0.001). A frequency of meat product, vegetables, and fruit consumption lower than 1.5 times per week increases the risk of anemia in schoolchildren. Conclusion these findings showed a significant prevalence of anemia in all study groups associated with socioeconomic, anthropometric, and nutritional factors. However, further studies are needed to focus on interventions and etiologies in order to limit potential complications, especially in schoolchildren and pregnant women.
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Affiliation(s)
- Saad Bakrim
- Geo-Bio-Environment Engineering and Innovation Laboratory, Molecular Engineering, Biotechnology and Innovation Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir, Morocco
- Hematology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, Central Hematology Laboratory, Ibn Sina University Hospital, Rabat, Morocco
| | - Najoua El Hichou
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan, Morocco
| | - El Khalil Ben Driss
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan, Morocco
| | - Sara Aboulaghras
- Physiology and Physiopathology Team, Faculty of Sciences, Genomic of Human Pathologies Research, Mohammed V University in Rabat, Rabat, Morocco
| | - Abdelaali Balahbib
- Laboratory of Biodiversity, Ecology and Genome, Faculty of Sciences, Mohammed V University, Rabat 10106, Rabat, Morocco
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| | - Azlarab Masrar
- Hematology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, Central Hematology Laboratory, Ibn Sina University Hospital, Rabat, Morocco
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Rivadeneira MF, Moncayo AL, Cóndor JD, Tello B, Buitrón J, Astudillo F, Caicedo-Gallardo JD, Estrella-Proaño A, Naranjo-Estrella A, Torres AL. High prevalence of chronic malnutrition in indigenous children under 5 years of age in Chimborazo-Ecuador: multicausal analysis of its determinants. BMC Public Health 2022; 22:1977. [PMID: 36307789 PMCID: PMC9617340 DOI: 10.1186/s12889-022-14327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background Despite the multiple initiatives implemented to reduce stunting in Ecuador, it continues to be a public health problem with a significant prevalence. One of the most affected groups is the rural indigenous population. This study aimed to analyze the prevalence of chronic malnutrition in indigenous children under 5 years of age and its association with health determinants, focusing on one of the territories with the highest prevalence of stunting. Methods A cross-sectional study in 1,204 Kichwa indigenous children under the age of five, residing in rural areas of the counties with the highest presence of indigenous in the province of Chimborazo-Ecuador. A questionnaire on health determinants was applied and anthropometric measurements were taken on the child and the mother. Stunting was determined by the height-for-age z-score of less than 2 standard deviations, according to the World Health Organization´s parameters. Data were analyzed using bivariate and multivariate Poisson regression. Results 51.6% (n = 646) of the children are stunted. Height-for-age z-scores were significantly better for girls, children under 12 months, families without overcrowding, and families with higher family income. The variables that were significantly and independently associated with stunting were: overcrowding (PR 1.20, 95% CI 1–1.44), the mother required that the father give her money to buy medicine (PR 1.33, 95% CI 1.04–1.71), the father did not give her money to support herself in the last 12 months (1.58, 95% CI 1.15–2.17), mother’s height less than 150 cm (PR 1.42, 95% CI 1.19–1.69) and the child was very small at birth (PR 1.75, 95% CI 1.22–2.5). Conclusion One out of every two rural indigenous children included in this study is stunted. The high prevalence of stunting in the indigenous and rural population is multicausal, and requires an intersectoral and multidisciplinary approach. This study identified three fundamental elements on which public policy could focus: (a) reduce overcrowding conditions, improving economic income in the rural sector (for example, through the strengthening of agriculture), (b) provide prenatal care and comprehensive postnatal care, and (c) promote strategies aimed at strengthening the empowerment of women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14327-x.
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Gaston RT, Habyarimana F, Ramroop S. Joint modelling of anaemia and stunting in children less than five years of age in Lesotho: a cross-sectional case study. BMC Public Health 2022; 22:285. [PMID: 35148690 PMCID: PMC8840695 DOI: 10.1186/s12889-022-12690-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia and stunting remain jointly a serious health issue worldwide especially in developing countries. In Lesotho, their prevalence is high, particularly among children less than 5 years of age. OBJECTIVES The primary objective was to determine the association between anaemia and stunting, and identify factors relating to both conditions among children younger than 5 years in Lesotho. METHODS This cross-sectional study used secondary data from 3112 children collected during the 2014 Lesotho Demographic Health Survey (LDHS). Haemoglobin (Hb) levels were adjusted for altitude and a level less than 11 g per deciliters (11 g/dl) was determined as the cutoff for being anaemic. A child with the height-for-age z score (HAZ) below minus two standard deviations (SD) was considered to have stunting. We linked factors relating to anaemia and stunting using a multivariate joint model under the scope of the generalized linear mixed model (GLMM). RESULTS The prevalence of anaemia and stunting in children younger than 5 years were 51% and 43% respectively. The multivariate results revealed a strong association between anaemia and stunting. In addition, maternal education, urban vs. rural residence, wealth index and childbirth weight significantly impacted childhood stunting or malnutrition, while having fever and/or diarrhoea was linked to anaemia. Lastly, age was shown to have a significant effect on both stunting and anaemia. CONCLUSION Anaemia and stunting or malnutrition showed linked longitudinal trajectories, suggesting both conditions could lead to synergetic improvements in overall child health. Demographic, socio-economic, and geographical characteristics were also important drivers of stunting and anaemia in children younger than 5 years. Thus, children living in similar resources settings as Lesotho could benefit from coordinated programs designed to address both malnutrition and anaemia.
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Affiliation(s)
- Rugiranka Tony Gaston
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa. .,Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, Private Bag X01, Westville, 3629, South Africa.
| | - Faustin Habyarimana
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa
| | - Shaun Ramroop
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa
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