Severity of anemia among children under 36 months old in rural western China

PLoS One. 2013 Apr 23;8(4):e62883. doi: 10.1371/journal.pone.0062883. Print 2013.


Objective: To describe severity of anemia and explore its determinants among children under 36 months old in rural western China.

Study design: The family information of 6711 children was collected and their hemoglobin was measured in 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of severity of childhood anemia.

Results: The prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively. GEE model analysis showed that province-level region and severity of maternal anemia affected the severity of childhood anemia not only in 0-5 months but also beyond 5 months. In addition, children aged 0-5 months in families using iron pot (coefficient = -0.26 95%CI -0.41,-0.12) had seldom more severe anemia, and children aged 6-36 months in families more than 4 members (coefficient = -0.03 95%CI -0.06,-0.01) or of Han ethnicity (coefficient = -0.08 95%CI -0.13,-0.04) seldom had more severe anemia but boys (coefficient = 0.03 95%CI 0.01,0.06) or younger children (6-11 month vs 30-36 month: coefficient = 0.23 95%CI 0.17, 0.28; 12-17 month vs 30-36 month: coefficient = 0.19 95%CI 0.15,0.24; 18-23 vs 30-36 month: coefficient = 0.09 95%CI 0.04,0.13) had more severe anemia.

Conclusion: The prevalence of moderate-to-severe anemia in these children was about 25%. Province-level region, iron pot use, family size, ethnicity, age and gender of children and severity of maternal anemia were important determinants of the severity of childhood anemia. These findings have some important implications for health policy decision for childhood anemia in rural western China.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Anemia / epidemiology*
  • Child, Preschool
  • China / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prevalence
  • Public Health Surveillance
  • Rural Population
  • Severity of Illness Index
  • Socioeconomic Factors

Grant support

Financial support came from the Chinese Ministry of Health (MOH) and the United Nations Children's Fund (UNICEF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.