Abstract

Data on the nutritional situation and prevalence of micronutrient deficiencies in Azerbaijan are scarce, and knowledge about anemia risk factors is needed for national and regional policymakers. A nationally representative cross-sectional survey was conducted to assess the prevalence of micronutrient deficiencies, over- and undernutrition, and to disentangle determinants of anemia in children and women in Azerbaijan. The survey generated estimates of micronutrient deficiency and growth indicators for children aged 0–59 months of age (6–59 months for blood biomarkers) and non-pregnant women 15–49 years of age. Questionnaire data, anthropometric measurements, and blood samples were collected to assess the prevalence of under- and over-nutrition, anemia, iron deficiency, and iron deficiency anemia, in both groups. In children only, vitamin A deficiency and zinc deficiency were also assessed. In women only, folate and vitamin B12 deficiencies and vitamin A insufficiency were assessed. In total, 3926 household interviews were successfully completed with a response rate of 80.6%. In the 1455 children, infant and young child feeding practices were relatively poor overall; the prevalence of wasting and stunting were 3.1% and 18.0%, respectively; and 14.1% of children were overweight or obese. The prevalence of anemia was 24.2% in 6–59 months old children, the prevalence of iron deficiency was 15.0% in this age group, and the prevalence of iron deficiency anemia was 6.5%. Vitamin A deficiency was found in 8.0% of children, and zinc deficiency was found in 10.7%. Data from 3089 non-pregnant women 15–49 years of age showed that while undernutrition was scarce, 53% were overweight or obese, with increasing prevalence with increasing age. Anemia affected 38.2% of the women, iron deficiency 34.1% and iron deficiency anemia 23.8%. Vitamin A insufficiency was found in 10.5% of women. Folate and vitamin B12 deficiency were somewhat more common, with prevalence rates of 35.0% and 19.7%, respectively. The main risk factors for anemia in children were recent lower respiratory infection, inflammation and iron deficiency. In women, the main risk factors for anemia were iron deficiency and vitamin A insufficiency. Anemia is a public health problem in Azerbaijani children and women, and additional efforts are needed to reduce anemia in both groups.

Highlights

  • Anemia affects about 40% of children under 5 years of age and 30% of non-pregnant women [1]

  • A recent model of anemia determinants estimated that the risk factors of anemia in Eastern Europe and Central Asia included micronutrient deficiencies, inflammation, and hemoglobinopathies, with iron deficiency speculated as the major cause [3]

  • Iron deficiency is a strong determinant of anemia in children and produces other negative health and nutrition outcomes. It should be addressed in future nutritional programs targeting children. These findings clearly suggest that factors other than iron deficiency are contributing to most of the anemia observed in Azerbaijani children

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Summary

Introduction

Anemia affects about 40% of children under 5 years of age and 30% of non-pregnant women [1]. Anemia can cause reduced work capacity, poor pregnancy outcomes, increased maternal and perinatal mortality and morbidity, impaired cognitive performance and poorer educational achievement [2]. Vitamin A and zinc deficiencies are amongst the most prevalent micronutrient deficiencies globally, affecting all population groups, but young children and women of reproductive age [4]. Vitamin A and zinc deficiencies often occur concomitantly and substantially contribute to the burden of disease, in particular in young children [5]. Milder forms of single or multiple micronutrient deficiencies can lead to increased morbidity and mortality as well as impaired cognitive and psychomotor development [4]

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