TY - JOUR
T1 - Anaemia prevalence and determinants in under 5 years children
T2 - findings of a cross-sectional population-based study in Sudan
AU - Elmardi, Khalid Abdelmutalab
AU - Adam, Ishag
AU - Malik, Elfatih Mohamed
AU - Ibrahim, Abdalla Ahmed
AU - Elhassan, Asma Hashim
AU - Kafy, Hmooda Toto
AU - Nawai, Lubna Mohammed
AU - Abdin, Mujahid Sheikhedin
AU - Kremers, Stef
N1 - Funding Information:
Funding to support the planning, implementation, logistics, and analysis of the malaria indicator survey, of which this study was part, was provided by the Global Fund to Fight AIDS, TB and Malaria through the principal recipient; the United Nation Development Programme. The government of Sudan provided additional financial and logistical support for the survey management component and the fieldwork. The WHO-EMR through the Sudan WHO-Country office provided the financial support for recruitment of the national consultant.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/11/30
Y1 - 2020/11/30
N2 - Background Early childhood is an age at risk of anaemia and its deleterious consequences. In Sudan, there is limited evidence on the prevalence and determinant of anaemia in under-five children. This study was conducted in Sudan to assess the prevalence of anaemia in children and to identify its determinants. Methods We conducted a household survey involving children aged 6 months to 5 years in November 2016. A representative population was sampled across rural, urban and camps settlements across 18 states in Sudan. We used a pre-designed questionnaire data collection. Haemoglobin (Hb) level and malaria infection were checked. In this cross-sectional study, we dichotomized the outcome variable and performed logistic regression analyses. Results A total of 3094 children under 5 years enrolled in the study, 1566 (50.6%) of them were female and 690 (22.3%) of them were under 2 years old. Anaemia prevalence in the whole cohort (6 months - <5 years) was 49.4% and the mean haemoglobin concentration was 108.1 (standard deviation (SD): 15.4) g/L. The prevalence in younger (6 months - <2 years) children (61.9%) was higher than in older (2 - <5 years) children (45.6%) (p <0.001). Severe anaemia (Hb <70 g/L) prevalence in the whole population was 1.6%. Age (Odds ratio (OR) 2.25, 95% confidence interval (95%CI) 1.75-2.90, p <0.001), type of place of residence (OR 0.37, 95%CI 0.18-0.74, p = 0.005), maternal anaemia (OR 1.74, 95%CI 1.39-2.17, p <0.001), and malaria infection (OR 2.82, 95%CI 1.56-5.11, p <0.001) were the identified predictors of anaemia in the whole cohort. In younger children, only the economic class was an anaemia predictor, with a lower anaemia risk among the rich wealth class (OR 2.70, 95%CI 1.29-5.62, p = 0.008). However, in older children, three anaemia predictors were identified. These are maternal anaemia (OR 1.79, 95%CI 1.40-2.28, <0.001), malaria infection (OR 2.77, 95%CI 1.48-5.21, p = 0.002), and type of residency (where camps' residents were less likely affected with anaemia than rural children (OR 0.38, 95%CI 0.17-0.87, p = 0.022)). Conclusions About half of the under-5 children in Sudan are anaemic, with worse prevalence in younger children. Efforts targeted at improving socio-economic status, decreasing maternal anaemia and childhood malaria infection may mitigate this alarming trend.
AB - Background Early childhood is an age at risk of anaemia and its deleterious consequences. In Sudan, there is limited evidence on the prevalence and determinant of anaemia in under-five children. This study was conducted in Sudan to assess the prevalence of anaemia in children and to identify its determinants. Methods We conducted a household survey involving children aged 6 months to 5 years in November 2016. A representative population was sampled across rural, urban and camps settlements across 18 states in Sudan. We used a pre-designed questionnaire data collection. Haemoglobin (Hb) level and malaria infection were checked. In this cross-sectional study, we dichotomized the outcome variable and performed logistic regression analyses. Results A total of 3094 children under 5 years enrolled in the study, 1566 (50.6%) of them were female and 690 (22.3%) of them were under 2 years old. Anaemia prevalence in the whole cohort (6 months - <5 years) was 49.4% and the mean haemoglobin concentration was 108.1 (standard deviation (SD): 15.4) g/L. The prevalence in younger (6 months - <2 years) children (61.9%) was higher than in older (2 - <5 years) children (45.6%) (p <0.001). Severe anaemia (Hb <70 g/L) prevalence in the whole population was 1.6%. Age (Odds ratio (OR) 2.25, 95% confidence interval (95%CI) 1.75-2.90, p <0.001), type of place of residence (OR 0.37, 95%CI 0.18-0.74, p = 0.005), maternal anaemia (OR 1.74, 95%CI 1.39-2.17, p <0.001), and malaria infection (OR 2.82, 95%CI 1.56-5.11, p <0.001) were the identified predictors of anaemia in the whole cohort. In younger children, only the economic class was an anaemia predictor, with a lower anaemia risk among the rich wealth class (OR 2.70, 95%CI 1.29-5.62, p = 0.008). However, in older children, three anaemia predictors were identified. These are maternal anaemia (OR 1.79, 95%CI 1.40-2.28, <0.001), malaria infection (OR 2.77, 95%CI 1.48-5.21, p = 0.002), and type of residency (where camps' residents were less likely affected with anaemia than rural children (OR 0.38, 95%CI 0.17-0.87, p = 0.022)). Conclusions About half of the under-5 children in Sudan are anaemic, with worse prevalence in younger children. Efforts targeted at improving socio-economic status, decreasing maternal anaemia and childhood malaria infection may mitigate this alarming trend.
KW - Anaemia
KW - Haemoglobin
KW - Pre-school children
KW - Urban
KW - Rural
KW - Camps
KW - Sudan
KW - Regression analysis
KW - Survey
U2 - 10.1186/s12887-020-02434-w
DO - 10.1186/s12887-020-02434-w
M3 - Article
C2 - 33250057
SN - 1471-2431
VL - 20
JO - Bmc Pediatrics
JF - Bmc Pediatrics
IS - 1
M1 - 538
ER -