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Determinants of anemia among preschool children in rural, western Kenya.

Abstract
Although anemia in preschool children is most often attributed to iron deficiency, other nutritional, infectious, and genetic contributors are rarely concurrently measured. In a population-based, cross-sectional survey of 858 children 6-35 months of age in western Kenya, we measured hemoglobin, malaria, inflammation, sickle cell, α-thalassemia, iron deficiency, vitamin A deficiency, anthropometry, and socio-demographic characteristics. Anemia (Hb < 11 g/dL) and severe anemia (Hb < 7 g/dL) prevalence ratios (PRs) for each exposure were determined using multivariable modeling. Anemia (71.8%) and severe anemia (8.4%) were common. Characteristics most strongly associated with anemia were malaria (PR: 1.7; 95% confidence interval [CI] = 1.5-1.9), iron deficiency (1.3; 1.2-1.4), and homozygous α-thalassemia (1.3; 1.1-1.4). Characteristics associated with severe anemia were malaria (10.2; 3.5-29.3), inflammation (6.7; 2.3-19.4), and stunting (1.6; 1.0-2.4). Overall 16.8% of anemia cases were associated with malaria, 8.3% with iron deficiency, and 6.1% with inflammation. Interventions should address malaria, iron deficiency, and non-malarial infections to decrease the burden of anemia in this population.
AuthorsEric M Foote, Kevin M Sullivan, Laird J Ruth, Jared Oremo, Ibrahim Sadumah, Thomas N Williams, Parminder S Suchdev
JournalThe American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 88 Issue 4 Pg. 757-64 (Apr 2013) ISSN: 1476-1645 [Electronic] United States
PMID23382166 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Topics
  • Anemia (epidemiology, etiology)
  • Anemia, Iron-Deficiency (diagnosis)
  • Child, Preschool
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Inflammation (complications)
  • Kenya (epidemiology)
  • Malaria (complications, parasitology)
  • Male
  • Multivariate Analysis
  • Nutritional Status
  • Prevalence
  • Rural Population
  • Severity of Illness Index
  • Socioeconomic Factors
  • alpha-Thalassemia (complications)

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