Risk factors for anemia in children under 6 years of age in Ethiopia: analysis of the data from the cross-sectional Malaria Indicator Survey, 2007

Reithinger, R., Ngondi, J.M., Graves, P.M., Hwang, J., Getachew, A., Jima, D., and Ethiopia Malaria Indicator Survey Working Group, (2013) Risk factors for anemia in children under 6 years of age in Ethiopia: analysis of the data from the cross-sectional Malaria Indicator Survey, 2007. Transactions of the Royal Society of Tropical Medicine and Hygiene, 107 (12). pp. 769-776.

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Abstract

Background: Malaria is a leading cause of morbidity in Ethiopia. However, its transmission varies in both space and time, and large areas of the country are hypoendemic and epidemic-prone. The Ethiopia National Malaria Indicator Survey 2007 is a cross-sectional, nationally-representative household survey. The objective of the analyses presented here were to use the survey's data to identify factors associated with anemia presence in children under 6 years of age (U6); specifically, investigate the association between malaria and anemia; and discuss using anemia as a malaria proxy biomarker in the Ethiopian hypo-endemic transmission setting.

Methods: The survey sampled 4185 households in 347 enumeration areas ≤2500 m above sea level. Primary outcome was increasing anemia severity in sampled children: no anemia (Hb: ≥11g/dl); mild anemia (Hb: ≥8g/dl and <11g/dl); and moderate–severe anemia (Hb: <8g/dl). Secondary outcomes were positive malaria rapid diagnostic test (RDT) or blood slide microscopy.

Results: The analysis included 6054 (92.0%) children U6 in 3962 households. The proportion of children with no anemia, mild anemia, and moderate-severe anemia was 63.6%, 31.3%, and 5.1%, respectively. The overall prevalence of anemia (Hb <11g/dl) was 36.4% (95% CI 34.4–38.4). Factors independently associated with reduced relative odds of anemia categories were age (OR=0.7, 95% CI 0.7–0.7) and female sex (OR=0.9, 95% CI 0.8–1.0); malaria RDT positivity was associated with increased relative odds of a more severe anemia category (OR=5.8, 95% CI 3.7–9.2).

Conclusions: We conclude that at altitudes ≤2500 m malaria appears to be a significant risk factor for anemia; potentially anemia could be used as a useful proxy biomarker for malaria and its control in Ethiopia.

Item ID: 31743
Item Type: Article (Research - C1)
ISSN: 1878-3503
Keywords: anemia, risk factors, malaria, Ethiopia
Funders: U.S. Agency for International Development, Government of Ethiopia Federal Ministry of Health
Date Deposited: 26 Feb 2014 09:33
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111704 Community Child Health @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 33%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 25%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 25%
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