Objective: To examine changes in the prevalence of anaemia and its correlates among children of pre-school age after implementation of wheat flour fortification with multiple micronutrients in Jordan.
Design: Retrospective analysis of the data from two repeated national cross-sectional panels of pre-school children.
Setting: The two surveys were conducted in 2007 and 2009, 16-20 months and 34-36 months, respectively, after implementation of wheat flour fortification with multiple micronutrients in Jordan. Anaemia was considered if Hb level was <11 g/dl. An anaemia prevalence of ≥40 % was considered a severe public health problem, while that of 20-39·9 % was considered a moderate public health problem.
Subjects: A total of 3789 and 3447 children aged 6-59 months tested in 2007 and 2009, respectively.
Results: The prevalence of anaemia in pre-school children declined from 40·4 % in 2007 to 33·9 % in 2009 (adjusted OR=0·74; P24 months (-13·7 points), children living in urban areas (-8·0 points), children from rich households (-9·0 points), children who had never been breast-fed (-17·0 points) and well-nourished children (-6·8 points). In both surveys, presence of childhood anaemia was strongly associated with child age ≤24 months, living in poor households, breast-feeding for ≥6 months, malnourishment, poor maternal education and maternal anaemia.
Conclusions: The public health problem of childhood anaemia declined from severe in 2007 to moderate in 2009, after the implementation of wheat flour fortification with multiple micronutrients in Jordan.
Keywords: Anaemia; Childhood anaemia; Fortification with multiple micronutrients; Wheat flour fortification.