Determinants of anemia among preschool children in rural, western Kenya

Am J Trop Med Hyg. 2013 Apr;88(4):757-64. doi: 10.4269/ajtmh.12-0560. Epub 2013 Feb 4.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anemia / epidemiology
  • Anemia / etiology*
  • Anemia, Iron-Deficiency / diagnosis
  • Child, Preschool
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Inflammation / complications
  • Kenya / epidemiology
  • Malaria / complications*
  • Malaria / parasitology
  • Male
  • Multivariate Analysis
  • Nutritional Status
  • Prevalence
  • Rural Population
  • Severity of Illness Index
  • Socioeconomic Factors
  • alpha-Thalassemia / complications