Abstract
BackgroundAnemia is a major public health concern that is present in 41.7% of children under 5 worldwide. The prevalence of anemia in Peru was 43.6% in 2017, a decrease by only 6.8% in 8 years. Despite great efforts made by the government to reduce anemia by distributing free multi-micronutrient supplements and promote the consumption of iron rich foods, progress has been slow. The current study sought to better understand why the prevalence remains high by analyzing the dietary intake, incidence of intestinal infectious disease, and access to safe drinking water by children with anemia in Peru.MethodsA cross-sectional analysis was conducted using data from two national surveys that were combined by child ID. Descriptive statistics was analyzed to understand the experience of children with anemia in comparison to child without anemia. Logistic multivariate regression analyses were conducted to test the associations between anemia and dietary intake, intestinal infection, and access to safe drinking water.ResultsThe sample included 586 children between 6 and 35 months. The prevalence of anemia in this population was 53%. The portion of children that consumed sufficient iron to meet the recommendation for their age was 62%. Of the children with anemia, 52% consumed sufficient iron to meet their recommendation, vs. 72% of children without anemia (p < 0.001). The children with anemia were more likely to have an intestinal infection during the previous year (35% vs. 26%, p = 0.057) and less likely to have access to safe drinking water (77% vs. 86%, p = 0.002) than those without anemia. The logistic analysis revealed that having an intestinal infection increased the odds of having anemia (OR = 1.64, CI 95% [1.041–2.584]), and having access to safe drinking waters decreased the odds of having anemia (OR = 0.578, [0.334–0.998]).ConclusionsMore than half of the children with anemia in Peru already consume sufficient iron to meet their daily requirement. However, they continue to have anemia, likely due to intestinal infection, such as diarrhea and parasites, from a lack of access to safe drinking water and hygienic practices.
Highlights
Anemia is a major public health concern that is present in 41.7% of children under 5 worldwide
The current study investigates this proposition by describing the dietary intake of children with anemia and analyzing the primary drivers of anemia independent of dietary intake
The analysis revealed that of the children who did not have access to safe drinking water, 47.4% had an intestinal infection, while 27% of those with safe drinking water had an intestinal disease
Summary
A cross-sectional analysis was conducted with data from two public databases combined by child ID. The intake of nutrients was compared to the dietary recommendations to meet estimated energy requirements (EER) by age and sex, defined by the Department of Nutrition for Health and Development of the World Health Organization [21,22,23,24]. The FNSS survey database provided the following variables; child met iron recommendations, child met micronutrient recommendations (iron, zinc, vitamin A), child met micronutrient and energy requirements (iron, zinc, vitamin A, and calories), anemia diagnosis, access to safe drinking water, basic needs met, sex, age, and area of residence (metropolitan Lima, urban or rural). The second model assessed the association between anemia and access to safe drinking water, intake of iron, a poverty measure, and sex. The analysis was conducted with STATA/SE 16.1 [29]
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