Mapping, trends, and factors associated with anemia among children aged under 5 y in East Africa

Abstract

Child anemia is a severe public health concern in low- and middle-income countries. Identifying anemia change over time, its spatial heterogeneity, and the influencing factors is critical to monitoring and prioritizing successful interventions.This analysis uses nationally representative Demographic and Health Surveys administrated in 11 East African countries, which included 149 864 children. Trend analysis, interpolation, and Kulldorff scan statistics were used. Trend and hotspot areas were identified and multilevel (three-level) ordinal logistic regression analyzed.More than half of the children in East Africa suffer from anemia. In all but two countries, the prevalence of child anemia was considered a severe public health problem; no country had an anemia prevalence < 35%. Anemia reduction efforts and the prevalence of anemia exhibit fluctuations over time in East African countries. Zimbabwe has shown a more consistent reduction in all forms of anemia. Most countries have experienced a significant reduction in the severe form of anemia in recent years. Community-based spatial analysis indicates that child anemia is heterogeneous within and between countries. Many communities are experiencing a high prevalence of anemia among children, with a maximum of four of five and a minimum one of five of their children infected by any anemia. Nutrition, genetic hemoglobin disorders, physical environment, poverty, and maternal and community characteristics influence child anemia.Multisectorial interventions that improve maternal and child nutrition are needed. These analyses support the design and prioritization of interventions in high-risk areas and communities.