Anemia, malnutrition and their correlations with socio-demographic characteristics and feeding practices among infants aged 0-18 months in rural areas of Shaanxi province in northwestern China: a cross-sectional study.

Wenfang Yang,Shuiping Zhang,Liming Liu,Xu Li,Ying Li,Weimin Li,Xiang Wang

doi:10.1186/1471-2458-12-1127

Abstract

BackgroundThe first 18 months of life are the most important for long-term childhood well-being. Anemia and malnutrition occurring in this key period have serious implications for individuals and societies, especially in rural areas in developing country. We conducted a cross-sectional study as the baseline survey to provide data for developing a policy-based approach to controlling infant anemia and malnutrition in rural areas of Shaanxi province in northwestern China.MethodsWe randomly sampled 336 infants aged 0–18 months in 28 rural villages from 2 counties of Shaanxi province. Anthropometric measurements and household interviews were carried out by well-trained researchers. The hemoglobin concentration was measured for 336 infants and serum concentrations of iron, zinc, and retinol (vitamin A) were measured for a stratified subsample of 55 infants. Anemia was defined using World Health Organization (WHO) standards combined with the Chinese standard for infants <6 months old. Logistic regression modeling was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for anemia with non-anemic group as a reference.ResultsWe found that 35.12% of infants in rural Shaanxi suffered from anemia, and the malnutrition prevalence rates were 32.14% for underweight, 39.58% for stunting, and 11.31% for wasting. Anemia was significantly associated with malnutrition (underweight, OR: 2.42, 95%CI: 1.50-3.88; stunting, OR: 1.65, 95%CI: 1.05-2.61; wasting, OR: 2.89, 95%CI: 1.45-5.76). Low birth weight, more siblings, less maternal education, low family income, crowded living conditions, and inappropriate complementary food introduction significantly increased the risk for infant anemia. Serum concentrations of iron, zinc, and retinol (vitamin A) were significantly lower in anemic infants compared with non-anemic infants.ConclusionsSpecific socio-demographic characteristics and feeding patterns were highly associated with infant anemia in rural areas of Shaanxi province. Health education focusing on feeding practices and nutrition education could be a practical strategy for preventing anemia and malnutrition in young children.

Highlights

The first 18 months of life are the most important for long-term childhood well-being
We conducted a cross-sectional study as the baseline survey to provide data to develop a policy-based approach for controlling infant anemia and malnutrition in rural northwestern China
We discovered that iron, zinc, and Retinol deficiencies in serum were inconsistent with dietary intake; only serum Retinol level was lower than normal

Summary

Introduction

The first 18 months of life are the most important for long-term childhood well-being. Anemia and malnutrition occurring in this key period have serious implications for individuals and societies, especially in rural areas in developing country. Child anemia and malnutrition have both short- and longterm adverse consequences that have serious implications for individuals and societies. It continues to be a major health burden in developing countries and is a substantial contributor to childhood morbidity and mortality [1,2,3]. In northwestern China, child mortality persists at 60.8/1000 live births in children under 5 years old and 49.2/1000 live births in infants as of 2000, and malnutrition remains one of the main causes of childhood mortality [8]. Previous studies have reported that these issues are more serious in northwestern China where economic levels are lower and geographical environments are worse, especially in large rural areas [9]

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