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![Height for age, Weight for age and Weight for height Z-scores* for 0–18 month-old infants in rural Shaanxi province, China, 2010. *Weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), and weight-for-length Z-score (WHZ) was calculated with 2006 WHO Anthro and WHO Child Growth Standards [WHO, 2006].](profile/Wenfang-Yang/publication/234009771/figure/fig2/AS:202735279448071@1425347265860/Height-for-age-Weight-for-age-and-Weight-for-height-Z-scores-for-0-18-month-old-infants.png)
Height for age, Weight for age and Weight for height Z-scores* for 0–18 month-old infants in rural Shaanxi province, China, 2010. *Weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), and weight-for-length Z-score (WHZ) was calculated with 2006 WHO Anthro and WHO Child Growth Standards [WHO, 2006].
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Abstract Background The first 18 months of life are the most important for long-term childhood well-being. Anemia and malnutrition occurring in this key period have serious implications for individuals and societies, especially in rural areas in developing country. We conducted a cross-sectional study as the baseline survey to provide data for deve...
Context in source publication
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Vitamin A deficiency (VAD) is a public health problem affecting millions in developing nations. Supple- mentation for lactating women, whose needs are high, in- volves large oral doses of the preformed vitamin. The safety and efficacy of these doses has been inadequately studied. Lactating women typically receive 210 mol of retinyl ester during ear...
Background:
In developing countries such as Nepal, many children aged below 3 years do not grow at a sufficiently high rate and are vulnerable to micronutrient deficiencies (e.g. vitamin A). Challenges to child nutrition can result from poverty, unhealthy traditional practices, inadequate caring and feeding practices. The present study aimed to as...
Citations
... One cross-sectional study in a rural area of northern China also verified an association of low birth weight and infants having anemia during the first 0-18 months (aOR, 2.89; 95% CI, 1.45-5.76) [22]. Another study conducted in India between 2015 and 2016 confirmed that infants having a birth weight less than 1500 g had significantly increased risk of anemia in children who were aged 6-59 months compared with those having a normal weight (aOR, 1.48; 95% CI, 1.20-1.83) ...
Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown–heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28–42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown–heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, −0.008; 95% CI, −0.011–−0.004; p < 0.001) and head circumference (β coefficient, −0.004; 95% CI, −0.007–−0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown–heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation.
... 134 Second, both anemia and stunting share similar disadvantageous sociodemographic characteristics, including poor household environment, low maternal education, poor living conditions, and low birth weight. 135,136 This suggests the need for additional statistical analysis, such as bias analysis, to investigate the role of these factors further. ...
Context
Despite shifting from addressing isolated forms of malnutrition to recognizing its multifaceted nature, evidence on the prevalence and determinants of micronutrient deficiencies, and their coexistence with undernutrition in children under 5, remains insufficient, unsystematic, and incohesive.
Objective
The aim of this systematic review and meta-analysis was to assess the prevalence and determinants of stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies in children under 5 in the least-developed countries (LDCs).
Data Sources
Electronic searches took place from January 15, 2023, to February 14, 2024, across multiple databases, including PubMed, Embase, Web of Science, SCOPUS, African Index Medicus (AIM), World Health Organization's Institutional Repository for Information Sharing (IRIS), and African Journals Online. The search spanned the years 2000 to 2024, yet it yielded eligible full-text English research articles from only 2005 to 2021 conducted in LDCs. Studies lacking quantitative data on malnutrition types and their determinants were excluded.
Data Extraction
Two independent authors assessed articles for bias and quality using Hoy et al's 10-item scale and Newcastle-Ottawa Scale (NOS) criteria. Prevalence and other details were extracted using a Joanna Briggs Institute Excel template. Authors extracted adjusted odds ratios (aORs) for determinant factors such as sex and vitamin A and iron supplementation.
Data Analysis
The search yielded 6248 articles from 46 LDCs. Sixty-nine articles, with a total sample size of 181 605, met inclusion criteria for the final meta-analysis. Vitamin A deficiency affected 16.32% of children, and iodine deficiency affected 43.41% of children. The pooled prevalence of wasting-anemia and stunting-anemia comorbidity was 5.44% and 19.47%, respectively. Stunting was associated with vitamin A deficiency (aOR: 1.54; 95% CI: 1.01–2.37), and not taking vitamin A supplementation was associated with iron-deficiency anemia (aOR: 1.37; 95% CI: 1.21–1.55).
Conclusion
A significant proportion of children under 5 in LDCs experienced stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies. This study underscores the urgent need to address factors driving these burdens.
Systematic Review Registration
PROSPERO registration no. CRD42023409483.
... This finding was supported by the study conducted in Bangladesh, [38] Haiti, [36] Sudan, [35] and other parts of Ethiopia. [9][10][11][12] The possible explanation could be increased demand for iron in this age group owing to rapid physical growth and high physiological demands [39] coupled with low intake of iron-rich supplementary foods [40,41] to compensate for this physiological state. Besides, evidence showed that high depletion of the prenatal iron store starting at 6 months of life, [42] low maternal iron reserve during pregnancy, [43,44] and inadequate complementary feed [45,46] increase the risk of anemia for younger children. ...
Childhood anemia is a significant global public health problem. It influences the physical and cognitive development, as well as immunity of affected children. This in turn leads to poor academic performance, low working potential, and increased morbidity and mortality. There is limited facility-based data on the magnitude and predictors of anemia among under-five children. This study aimed to determine the prevalence and associated factors of anemia among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia. Institution-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized University Hospital and Jugal Hospital from July 1, 2022, to August 31, 2022. A total of 330 under-five children were involved by systematic random sampling technique. Data on sociodemographic characteristics and other possible factors were collected through face-to-face interviews with children’s parents/legal guardians. Four milliliters of venous blood samples were collected for a complete blood cell count. Collected data were checked for completeness, entered into Epi-Data Statistical Software Version 4.6, and exported into the Statistical Package for Social Sciences version 25 for analysis. Bivariable and multivariable logistic regression was conducted and P < .05 were considered statistically significant. The overall prevalence of anemia was 33% (95% confidence interval [CI]: 27.9%–37.9%). Age of children 6 to 11 months (adjusted odd ratio [AOR] = 3.94, 95% CI: 1.55–10.01) and 12 to 23 months (AOR = 2.93, 95% CI: 1.15–7.43), no maternal education (AOR = 4.34, 95% CI: 1.53–12.35), not exclusively breastfeeding (AOR = 1.98, 95% CI: 1.11–3.52), being severely stunted (AOR = 3.39, 95 CI: 1.70–6.75), and underweight (AOR = 2.1, 95% CI: 1.12–3.87) were significantly associated with anemia among under-five children. In this study, anemia among under-five children is a moderate public health problem. This study revealed that young child age, maternal education level, early initiation of complementary feeding, and child undernutrition were factors associated with anemia. Thus, efforts should be made to improve the child’s nutritional status as well as enhance maternal awareness of nutrition and child-feeding practice through health education. Regular childhood nutritional screening and appropriate intervention for malnutrition are needed. Besides, further studies assessing serum micronutrient levels should be conducted to differentiate the specific cause and type of anemia.
... Furthermore, the coexistence of anemia and malnutrition has also been reported in previous studies conducted in different countries [13,14]. The results of a study in a population of infants, where anemia and malnutrition were both prevalent, also indicate lower serum iron, zinc, and retinol in anemic infants compared to non-anemic ones [12] This present study supports the premise that children who are malnourished throughout childhood are more likely to develop anemia. Anemia can also be caused by adverse complications of malnutrition, such as susceptibility to infections and chronic inflammations, as well as inhibition of hematopoiesis due to lack of protein synthesis [29,30]. ...
... Anemia affects 54% of children below the age of 5 in Sub-Saharan Africa, making it one of the worst-affected regions. 10,11 Anemia was present in 57% of preschool children in Ethiopia. 12 Anemia has both long-term and short-term effects on the lives of affected children as well as the community at large. ...
Introduction
Anemia is a serious public health concern that affects more than 25% of the world's population. It is still widespread and at its most severe in Ethiopia. This study pointed to identify the magnitude and predictors of anemia in preschool children in Atinago.
Method
A structured interview and anthropometric metrics had been used in a cross‐sectional study to collect data from 309 preschool children using a systematic sampling strategy from May 10 to June 25, 2022. Frequencies, percentages, means, and a bar chart were created as descriptive statistics. Factors that were significant at the 25% level in univariate analysis were run through multiple logistic models. Odds ratios with respective 95% confidence intervals were developed to determine the relevant predictors.
Result
The majority (51.7%) of preschool children in Atinago town had anemia. The finding reveals that poor dietary diversity (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.02–3.07), children from families with food insecurity (AOR = 2.28, 95% CI = 1.31–3.9), child–mothers used iron folate for less than 3 months during pregnancy (AOR = 1.93, 95% CI = 1.07–3.48), households with more than five children (AOR = 1.880, 95% CI = 1.12–3.18), and stunted children (AOR = 1.78, 95% CI = 1.05–3.01) were highly susceptible to anemia.
Conclusion
The findings indicate that anemia was a serious issue among preschool children in Atinago. Therefore, stakeholders should provide community‐based nutrition training on consuming diverse diets, dietary improvements in the home, consuming iron‐rich meals, and the like; encourage mothers to participate in early ANC follow‐up; and strengthen activities aimed at identifying households with food insecurity status.
... 3 Its adverse effects are related to neurodevelopment, particularly when it occurs before 2 years old, which is known as the golden period (the first 1,000 days of life). 1 Some studies showed that the characteristics of anemic children are as follows: age group below 2 years, male sex, low birth weight, short birth length, preterm, having more than one sibling, low nutritional status (stunted, wasted, and underweight), smaller head circumference, no history of exclusive breastfeeding, introduction of complementary foods below 6 months of age, formula milk consumption, incomplete immunization, pale, low maternal education, younger maternal age, low-income families, and living in a rural area. [3][4][5][6][7][8] Hb is a parameter for anemia related to hematocrit or packed cell volume (PCV) and the red blood cell (RBC) count. It is necessary to check the level of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentrations (MCHC) in the anemia diagnostic approach. ...
... This finding is similar to study reports in Northeast Ethiopia and China. 3,6 This could be because male stunted children are at risk of anemia, perhaps related to X-linked diseases such as glucose-6 phosphate dehydrogenase. 18 The stunted children group aged 13 to 24 months was found with the highest prevalence of anemia (80.5%). ...
... 19 Those children with more than one sibling had the highest prevalence of anemia (75.6%), which was similar to the study conducted in China. 6 Having more children means more mouths to feed and unmet food needs resulting in stunted growth and anemia. Our study found that the subjects who were severely underweight (31.7%) and underweight (29.3%) had a greater prevalence rate of anemia, which was similar to studies conducted in Northeast Ethiopia 3 and China. ...
Anemia and stunted growth are major health problems with adverse consequences for children. This study aimed to determine the prevalence, characteristics, and hematological profile of anemia among stunted children under 2 years old. A nested cross-sectional study from a child cohort was conducted in Bandung Regency, West Java, Indonesia. Two hundred twenty-two children aged 6 to 24 months were randomly selected. These children were reexamined from November 2019 to March 2020 for anthropometric measurements and hematological assessment and interviewed for relevant risk factors of stunted growth and anemia. Ninety-eight stunted children were identified and distributed into stunted and severely stunted groups (47.96 vs. 52.04%). Around 85.4% of the children came from low-income families and 31.7% were severely underweight for age. Surprisingly most of these stunted children had normal birth weight and length and were born at term (68.3, 53.7, and 85.4%). The prevalence rate of anemia among stunted children was 41.8%, they had decreased mean corpuscular volume (56%), decreased mean corpuscular hemoglobin (73%), and normochromic mean corpuscular hemoglobin concentrations (51.2%). Leucocytosis was higher than leucopenia (10 vs. 3.7%) and thrombocytosis ( n = 15, 36%) as compared to thrombocytopenia ( n = 5, 12%). The prevalence of anemia was high among stunted children. The characteristics of stunted children with and without anemia were similar. The fact that these stunted children had few risk factors for stunting emphasizes the need to focus on improved postnatal care to prevent faltering. Based on the hematology profile, iron deficiency anemia was suspected to be the most etiology in these cases warranting further follow-up and management.
... The risk for infant anemia is significantly increased with less low family income, crowded living conditions, and inappropriate complementary food introduction maternal education, particularly with low birth weight. anemic infants were reported to have significantly lower Serum concentrations of iron, zinc, and retinol (vitamin A) [24]. Iron deficiency shares 50% of all causes of anemia, and it is basically linked with poor dietary intake [25], serious implications for individuals and societies may result because of anemia and malnutrition among Children who have both short-and long-term malnutrition. ...
... underweight, OR: 2.42, 95% CI: 1.50-3.88) [62]. ...
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.
... The odds of wasting were 6.84 times more likely in anemic children compared to their counterparts. The finding was in agreement with studies done in Menz Gera Midir district, Eastern Amhara, Ethiopia [70], and rural areas of Shaanxi, northwestern China [71]. Anemia and undernutrition often have common causes. ...
Background:
Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months.
Methods:
A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition.
Result:
In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82).
Conclusion:
According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.
... Children's nutritional status and anemia were correlated in the current study, which corresponds to the findings related to another population-based cohort [32]. Although an underweight BMI classification only showed a non-significant correlation, stunting was a confounding variable in child anemia independent of maternal pre-pregnancy anemia. ...
Objectives:
Under 5 years old (under-5) anemia is overlooked despite its detrimental effect. The approach to anemia prevention has been extended to maternal pre-pregnancy phase. This research is aimed to analyze pre-pregnancy anemia association and risk of anemia in under-5 children.
Methods:
This cohort study observed non-pregnant women in the Indonesian Family Life Survey (IFLS) 2007 and their under-5 children in the IFLS 2014. Anemia status was determined based on Hemoglobin (Hb) measurement using HemocueTM in mothers and children. Mantel-Haenszel adjusted relative risk (aRR) analysis including risk stratification by the covariates was used to get final risk assessment.
Results:
A total of 637 under-5 children in the IFLS 2014 were included. The risk of having under-5 child with anemia increased 1.71-fold in women with pre-pregnancy anemia compared to women without pre-pregnancy anemia (aRR=1.71, 1.03-2.85 95% CI). After risk stratification based on the potential confounding variables, maternal pre-pregnancy anemia is still an independent risk of under-5 anemia in child that still breastfed at the time of data collection (RR=2.11, 1.16-3.86 95% CI), in child that fed water earlier than 6 months old (RR=2.08, 1.20-3.61 95% CI), in child of mother with normal and underweight pre-pregnancy BMI (RR=1.94, 1.20-3.14 95% CI), and in child of mother with no current anemia (RR=2.20, 1.21-3.99 95% CI).
Conclusion:
Pre-pregnancy anemia increased the risk of under-5 anemia based on Indonesian population study. Public health approach to extend maternal health provision to preconception phase would provide better maternal and child morbidity risk prevention.
