ANEMIA IN PRESCHOOL CHILDREN AND ITS ASSOCIATION WITH NUTRITIONAL STATUS AND OTHER FACTORS IN DUHOK PROVINCE, IRAQ
Abstract
Anemia is a very important nutritional issue all over the world. It is most commonly present in preschool children with a prevalence of47.4%. Factors like low socio-economic status, large family size, ignorance and illiteracy are associated with anemia among children less than five years. Aim: To estimate the prevalence of anemia and identify the factors associated with it in children aged 2–5 years.
Patients and Methods: A cross sectional study included 798 pre-school children (2–5 years of age) selected from those children who visited health care centres and Heevi Pediatric Teaching Hospital. Dietary, biochemical and anthropometrical, and information were collected through a questionnaire. Children with hemoglobin (Hb) values of <11.0 g/dl were considered anemic. Heights, weights and Body Mass Index [BMI] were measured. Children with [BMI] above 85th centile was considered as overweight and above 95th centile as obese. Data such as past breastfeeding practices, birth weights, time of starting weaning food, duration of breastfeeding, type of weaning food, time of starting infant formula, child’s chronic illness, child’s eating habits, mother’s age, occupation and education were collected.
Results: The overall incidence of anemia is 29.8% (238/798). The male: female ratio 1.03:1 in the anemic children. The body weight of the anemic patients was most commonly between 5th and 85th centiles, 155 (65.12%). The most frequent birth weight of the anemic patients was between 2.5 and 4 Kg,191(80.25%). Most of anemic patients had history of breast feeding for equal to or more than six months ,113(47.47%). The weaning foods of most of the anemic patients were cereals, vegetables and fruit 146 (61.34%). About 139 (58.4%) of patients were eating regularly and 156 (65.54%) with the family. Chronic illnesses were present in 63 (26.47%) among anemic patients. About 135(56.72%) of anemic patients had less than three siblings. The age of the mothers was less than 30 years in 112(47.05%). Illiterate mothers were 63(26.47%) among anemic patients and only 18 (7.56%) were employed mothers. The significant association was with the age (p<0.038), the frequency of eating with family (p<0.01) and chronic illnesses (p<0.001). There was a strongly significant correlation between hemoglobin concentration and age group, weight and height. Female was 1.009 times more likely to be anemic.
Conclusion: The overall incidence of anemia is 29.8%. The gender, the age of starting weaning foods, the type of weaning foods and the presence of chronic illnesses are significant factors associated with the risk of anemia in the children in Duhok.
Downloads
References
Kebede, D., Getaneh, F., Endalamaw, K. et al. Prevalence of anemia and its associated factors among under-five age children in Shanan gibe hospital, Southwest Ethiopia. BMC Pediatr 21, 542 (2021). https://doi.org/10.1186/s12887-021-03011-5
Hasan MM, Magalhaes RJ, Ahmed S, Pervin S, Tariqujjaman M, Fatima Y, et al. Geographical variation and temporal trend in anemia among children 6-59 months of age in low-and middle-income countries during 2000-2018: forecasting the 2030 SDG target. Public Health Nutr. 2021;9:1–20.
Ginzburg YZ, Glassberg J. Inflammation, hemolysis, and erythropoiesis lead to competitive regulation of hepcidin and possibly systemic iron status in sickle cell disease. EBio Medicine. 2018;34:8–9.
Georgieff MK. Long-term brain and behavioural consequences of early iron deficiency. Nutr Rev 2011;69:S43–S48.
El-Asheer, O.M., Naeem, M.S., Abdel-Hafez, F.A. et al. Iron deficiency in preschool non-anemic Egyptian children. Egypt Pediatric Association Gaz 69, 32 (2021).
Gebreweld A, Ali N, Ali R, Fisha T. Prevalence of anemia and its associated factors among children under five years of age attending at Guguftu health center, South Wollo, Northeast Ethiopia. PLoS One. 2019 Jul 5;14(7):e0218961.
Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. The Lancet. 2016;387(10021):907–16.
Janus J, Moerschel SK. Evaluation of Anemia in Children.American Family Physician. 2010;81(12):1462–1471.
Woldie H, Kebede Y, Tariku A. Factors associated with anemia among children aged 6–23 months attending growth monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia. Journal of nutrition and metabolism. 2015;2015.
Cardoso MA, Scopel KK, Muniz PT, Villamor E, Ferreira MU. Underlying factors associated with anemia in Amazonian children: a population-based, cross-sectional study. PloS one. 2012;7(5):e36341
Sunuwar, D.R., Singh, D.R., Pradhan, P.M.S. et al. Factors associated with anemia among children in South and Southeast Asia: a multilevel analysis. BMC Public Health 2023;23:343 .
Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet. 2011;378:2123–35.
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Heal. 2013;1:16–25.
Ntenda PAM, Nkoka O, Bass P, Senghore T. Maternal anemia is a potential risk factor for anemia in children aged 6–59 months in Southern Africa: a multilevel analysis. BMC Public Health. 2018;18:1–13.
Ngesa O, Mwambi H. Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya. PLoS ONE. 2014;9.
Moschovis PP, Wiens MO, Arlington L, Antsygina O, Hayden D, Dzik W, et al. Individual, maternal and household risk factors for anaemia among young children in sub-saharan Africa: a cross-sectional study. BMJ Open. 2018;8:1–14.
Wieringa FT, Dahl M, Chamnan C, Poirot E, Kuong K, Sophonneary P et al. The high prevalence of anemia in cambodian children and women cannot be satisfactorily explained by nutritional deficiencies or hemoglobin disorders.Nutrients. 2016;8.
Hurrell RF, Reddy M, Cook JD. Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. Br J Nutr. 1999;81:289–95.
Desai MR, Terlouw DJ, Kwena AM, Phillips-Howard PA, Kariuki SK, Wannemuehler KA, et al. Factors associated with hemoglobin concentrations in pre-school children in western Kenya: cross-sectional studies. Am J Trop Med Hyg. 2005;72:47–59.
Sunardi, D., Bardosono, S., Basrowi, R. W., Wasito, E., & Vandenplas, Y. (). Dietary determinants of anemia in children aged 6–36 months: A cross-sectional study in Indonesia. Nutrients 2021;13(7).
Kejo D, Petrucka PM, Martin H, Kimanya ME, Mosha TCE. Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania. Pediatric Health Med Ther. 2018;9:9-15 https://doi.org/10.2147/PHMT.S148515
Nambiema, A., Robert, A. & Yaya, I. Prevalence and risk factors of anemia in children aged from 6 to 59 months in Togo: analysis from Togo demographic and health survey data, 2013–2014. BMC Public Health 2019;19: 215.
Dutta, M., Bhise, M., Prashad, L., Chaurasia, H., & Debnath, P. (). Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis. Clinical Epidemiology and Global Health 2020;8(3):868–878.
Keokenchanh S, Kounnavong S, Midorikawa K, Ikeda W, Morita A, Kitajima T, et al. Prevalence of anemia and its associated factors among children aged 6–59 months in the Lao People’s Democratic Republic: A multilevel analysis. PLoS ONE 2021;16(3): e0248969.
Gedfie S, Getawa S, Melku M. Prevalence and Associated Factors of Iron Deficiency and Iron Deficiency Anemia Among Under-5 Children: A Systematic Review and Meta-Analysis. Glob Pediatr Health. 2022 Jul 6;9:2333794X221110860.
Teni D, Bedaso T. Risk factors for the prevalence of anemia in children aged 6–59 months at different levels in Ethiopia. An International Interdisciplinary Journal for Research, Policy and Care 2022;17(4):359-67
Zewude BT, Debusho LK. Prevalence rate and associated risk factors of anaemia among under five years children in Ethiopia. Nutrients. 2022;14(13):1–13.
Oliveira DN, Martorell, R. & Nguyen, P. Risk factors associated with hemoglobin levels and nutritional status among Brazilian children attending daycare centers in Sao Paulo City, Brazil. Arch. Latinoam. Nutr.
Aliyo A, Jibril A . Assessment of anemia and associated risk factors among children under-five years old in the West Guji Zone, southern Ethiopia: Hospital-based cross-sectional study. PLoS ONE 2022;17(7):
Obasohan PE, Walters SJ, Jacques R, Khatab K. A Scoping review of the risk factors associated with anaemia among children under five years in Sub-Saharan African Countries. Int. J. Environ. Res. Public Health. 2020;17:23.
Ngesa O, Mwambi H. Prevalence and Risk Factors of Anaemia among Children Aged between 6 Months and 14 Years in Kenya. PLoS ONE 2014;9(11): e113756.
Zuffo CRK, Osório MM, Taconeli CA, Schmidt ST, Silva BHC, Almeida CCB. Prevalence and risk factors of anemia in children. J Pediatr (Rio J); 2016: (92):353–60.
Legason ID, Atiku A, Ssenyonga R, Olupot-Olupot P, Barugahare JB. Prevalence of Anaemia and associated risk factors among children in North-Western Uganda: a cross sectional study. BMC Hematology. 2017;17(1):1–9.
Parbey PA, Tarkang E, Manu E, Amu H, Ayanore MA, Aku FY, Ziema SA et al. Risk Factors of Anaemia among Children under Five Years in the Hohoe Municipality, Ghana: A Case Control Study. Anemia, vol. 2019, Article ID 2139717, 9 pages, 2019.
Endris, B.S., Dinant, GJ., Gebreyesus, S.H. et al. Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model. BMC Nutr 2022;8:2.
Kejo D, Petrucka PM, Martin H, Kimanya ME, Mosha TCE. Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania. Pediatric Health Med Ther. 2018;9:9-15
Muleviciene A, Sestel N, Stankeviciene S, et al.. Assessment of risk factors for iron deficiency anemia in infants and young children: a case-control study. Breastfeed Med.2018;13(7):493-499.
It is the policy of the Journal of Duhok University to own the copyright of the technical contributions. It publishes and facilitates the appropriate re-utilize of the published materials by others. Photocopying is permitted with credit and referring to the source for individuals use.
Copyright © 2017. All Rights Reserved.



