Factors associated with anemia in young children in Brazil.

Lara Livia Santos Da Silva,Wafaie Wahib Fawzi,Marly Augusto Cardoso,Enfac Working Group

doi:10.1371/journal.pone.0204504

Lara Livia Santos Da Silva, Wafaie Wahib Fawzi + Show 2 more

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https://doi.org/10.1371/journal.pone.0204504

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Abstract

BackgroundAnemia is recognized as a major public health problem in childhood, especially in children under 24 months of age. Despite improvements in public health strategies to prevent and control anemia in Brazilian young children in the last decade, few studies have assessed the predictors for this condition in primary health care. Thus, this study aimed to assess the associated factors of anemia in young children who visited primary public health care facilities in Brazil.MethodsA cross-sectional study was conducted with 520 children aged 11 to 15 months who visited the primary health care in four Brazilian cities. Anemia was defined as hemoglobin concentration < 110 g/L in venous blood samples. Multilevel Poisson regression models were used to describe the associations between anemia and independent variables.ResultsThe frequency of anemia was 23.1%. A higher frequency was observed in children who live with more than one other child younger than 5 years in the house (Prevalence Ratio [PR] 1.47; 95% Confidence Interval [CI] 1.01–2.14), who started to receive fruits and vegetables after 8 months of age (PR 1.92; 95% CI 1.19–3.10), who were stunted (PR 2.44; 95% CI 1.32–4.50), who were hospitalized at least once in their life (PR 1.55; 95% CI 1.03–2.33) and who were in the lower tertile of serum folate concentration (PR 2.24; 95% CI 1.30–3.85).ConclusionsInadequate complementary feeding practices and morbidity were the main predictors for anemia in early childhood in this population. Improvements in current strategies to promote healthy complementary feeding along with better control of morbidities are recommended to reduce anemia in Brazilian young children.

Highlights

Anemia refers to a condition in which the blood hemoglobin concentration is lower than normal [1], resulting in poor cognitive and motor development in children and loss of work productivity in adulthood [2, 3].Iron deficiency is the most common cause of anemia
Despite improvements in public health strategies to prevent and control anemia in Brazilian young children in the last decade, few studies have assessed the predictors for this condition in primary health care
A higher frequency was observed in children who live with more than one other child younger than 5 years in the house (Prevalence Ratio [Prevalence ratios (PR)] 1.47; 95% Confidence Interval [CI] 1.01–2.14), who started to receive fruits and vegetables after 8 months of age (PR 1.92; 95% CI 1.19–3.10), who were stunted (PR 2.44; 95% CI 1.32–4.50), who were hospitalized at least once in their life (PR 1.55; 95% CI 1.03–2.33) and who were in the lower tertile of serum folate concentration (PR 2.24; 95% CI 1.30– 3.85)

Summary

Introduction

Iron deficiency is the most common cause of anemia. It is estimated that about 50% of anemia cases are attributed to this micronutrient deficiency [3], this proportion probably varies substantially across regions and countries [4]. Other causes of anemia include other micronutrient deficiencies, such as folic acid, vitamin A and vitamin B12 deficiencies; the presence of infectious diseases and genetic hemoglobin disorders [2]. Anemia is recognized as a major public health problem in childhood, especially in children under 24 months of age. Despite improvements in public health strategies to prevent and control anemia in Brazilian young children in the last decade, few studies have assessed the predictors for this condition in primary health care.

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