Abstract
Little is known about the prevalence of anaemia and associated factors in school children in Vietnam. In this cross-sectional study, we aimed to determine the prevalence of anaemia and its subtypes, and the associations of types of anaemia with demographic, socio-economic and anthropometric factors among 6–9-year-old primary school children in rural areas of Hai Phong City, Vietnam. Haemoglobin (Hb) and mean corpuscular volume (MCV) were measured, and demographic, socio-economic and anthropometric data were collected in 893 children from eight primary schools. The prevalence of anaemia (Hb < 115 g/L) was 12.9% (95% CI: 8.1%, 19.9%), microcytic anaemia (Hb < 115 g/L and MCV < 80 fL) was 7.9% (95% CI: 5.3%, 11.6%) and normocytic anaemia (Hb < 115 g/L and MCV 80–90 fL) was 5.3% (95% CI: 2.9%, 9.5%). No child presented with macrocytic anaemia (Hb < 115 g/L and MCV > 90 fL). Children who were underweight, wasted, or in anthropometric failure (either underweight, stunted or wasted) were more likely to be anaemic (all p ≤ 0.004), and specifically, to have normocytic anaemia (all p ≤ 0.006), than those who were not underweight, wasted or in anthropometric failure. Stunted children were more likely to be anaemic (p = 0.018) than those who were not stunted. Overweight/obese children were less likely to be anaemic (p = 0.026) or have normocytic anaemia (p = 0.038) compared with children who were not overweight/obese. No anthropometric status indicator was associated with the risk of microcytic anaemia. No demographic or socio-economic factor was associated with any type of anaemia. Anaemia remains a public health issue in rural areas in Hai Phong City, Vietnam, and future approaches for its prevention and control should target undernourished primary school children.
Highlights
Anaemia is used as an indicator of nutritional and health status in children [1] because of its adverse effects on childhood morbidity and mortality
Children included in this study (n = 893) had a lower weight-for-age z-score, height-for-age z-score, and Body Mass Index (BMI)-for-age z-score, and their mothers were less likely to be farmers or unemployed (OR: 0.71; 95% confidence intervals (CI): 0.56, 0.90), compared with children who did not provide a blood sample
Microcytic anaemia appeared to be more common in this sample of children (7.9%) than normocytic anaemia (5.3%), with no child presenting with macrocytic anaemia
Summary
Anaemia is used as an indicator of nutritional and health status in children [1] because of its adverse effects on childhood morbidity and mortality. Anaemia reportedly causes 600,000 child deaths in low- and middle-income countries annually [2], with the highest proportion of deaths occurring. Nutrients 2019, 11, 1478 in South Asia. It is a risk factor for impaired physical activity performance and school participation in children, but it may persist into adulthood. Iron deficiency is often assumed to be a major cause of anaemia [8]. Lower age [9], male sex [10], lower maternal education [11], and lower household income [12] have been associated with increased risk of anaemia in childhood
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