Severity of Anemia among Children under 36 Months Old in Rural Western China

John W Glod,Wenlong Gao,Duolaowang Duolaowang,Hong Yan,Shaonong Dang,Leilei Pei

doi:10.1371/journal.pone.0062883

John W Glod, Wenlong Gao + Show 4 more

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https://doi.org/10.1371/journal.pone.0062883

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Abstract

ObjectiveTo describe severity of anemia and explore its determinants among children under 36 months old in rural western China.Study DesignThe family information of 6711 children was collected and their hemoglobin was measured in 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of severity of childhood anemia.ResultsThe prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively. GEE model analysis showed that province-level region and severity of maternal anemia affected the severity of childhood anemia not only in 0–5 months but also beyond 5 months. In addition, children aged 0–5 months in families using iron pot (coefficient = −0.26 95%CI −0.41,−0.12) had seldom more severe anemia, and children aged 6–36 months in families more than 4 members (coefficient = −0.03 95%CI −0.06,−0.01) or of Han ethnicity (coefficient = −0.08 95%CI −0.13,−0.04) seldom had more severe anemia but boys (coefficient = 0.03 95%CI 0.01,0.06) or younger children (6–11 month vs 30–36 month: coefficient = 0.23 95%CI 0.17, 0.28; 12–17 month vs 30–36 month: coefficient = 0.19 95%CI 0.15,0.24; 18–23 vs 30–36 month: coefficient = 0.09 95%CI 0.04,0.13) had more severe anemia.ConclusionThe prevalence of moderate-to-severe anemia in these children was about 25%. Province-level region, iron pot use, family size, ethnicity, age and gender of children and severity of maternal anemia were important determinants of the severity of childhood anemia. These findings have some important implications for health policy decision for childhood anemia in rural western China.

Highlights

ResultsThe prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively
Anemia is a global public health problem with major consequences for human health and has affected more than 2 billion people worldwide [1,2]
Though the prevalence of wasting and underweight was much lower than 10%, the prevalence of stunting was approximately 15%

Summary

Results

Sample selection and characteristics Due to different regional location from other province-level areas, Jiangxi was excluded from the study. 36 months in 9 province-level regions of rural western China. The prevalence of anemia among children younger than 36 months in rural western China was 52.5% (95%CI 51.3%–53.7%), of which mild anemia covered 27.4%, moderate anemia 21.9% and severe anemia 3.2%. Among the 9 province-level regions, Qinghai had the highest prevalence of anemia and Inner Mongolia the lowest. The prevalence of 3 types of anemia in children aged 6–11 months were the highest and the prevalence of mild and moderate anemia in those aged. GEE model analysis shows that province-level region and severity of maternal anemia affected severity of childhood anemia in 0–5 months and beyond 6 months.

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