Anemia In Children Research Articles

Food Security is A Determinant of Anemia in Children Aged 6 – 23 Months at UPTD Puskesmas DTP Pedes

In 2019, WHO data showed that the prevalence of anemia in children aged 6-59 months in Indonesia was 38.4%. The impact of anemia in children under two years old causes permanent cognitive damage and increases the risk of death. Objective: This study aims to determine the factors associated with anemia in children aged 6-23 months. Methods: This type of research is an analytic observational study with a cross-sectional design. The accidental sampling method was used to obtain 100 respondents who fit the inclusion and exclusion criteria. The study was conducted with a questionnaire instrument and Hb examination using the Easytouch GcHb tool. Data analysis included univariate, bivariate, and multivariate. Results: variables associated with anemia in under two are maternal education (p = 0.003), maternal age (p = 0.042), maternal knowledge (p = 0.004), maternal parenting (p = 0.003), and food security (p = 0.003). After multivariate test, it was found that food security was the dominant factor of anemia in children with OR 10.052. Conclusion: Food security is the dominant factor in children's anemia status with a 10.052 times higher potential for anemia. Food insecurity is related to changes in food quality that can affect the availability of nutrient-dense foods, including foods with high iron bioavailability. This can lead to anemia through inadequate micronutrient intake. The government should conduct early detection of anemia in children so as to prevent anemia as early as possible and provide non-cash food assistance to communities experiencing food insecurity

Household Food Expenditure Typology and Its Association with Child Stunting and Anemia in Indonesia

Household Food Expenditure Typology and Its Association with Child Stunting and Anemia in Indonesia

Comparison of haemoglobin concentration measurements using HemoCue-301 and Sysmex XN-Series 1500: A survey among anaemic Gambian infants aged 6-12 months.

In low-income countries, point-of-care photometers are used in the screening and management of anaemia in individuals, but also in the assessment of population iron status when evaluating efficacy of intervention studies or public health interventions. We aimed to evaluate the accuracy of a commonly used photometer, HemoCue-301, in determining haemoglobin concentration among anaemic children aged 6-12 months in a field setting in rural Africa. This report concerns a secondary analysis of data from Gambian infants being screened for an ongoing randomized controlled trial. In those found to be anaemic by HemoCue-301, haemoglobin concentration was measured by Sysmex XN-1500, an automated haematology analyser that was used as a reference. Passing-Bablok regression analysis was used to estimate the regression constant (systematic deviation between two measurement methods that remain consistent across the range of measurements) and proportional bias (systematic deviation between two measurement methods that change in magnitude relative to the value being measured). Analysis was based on 227 participants. There was strong evidence of absolute bias among moderately anaemic participants (haemoglobin concentration at 8.0g/dL) (absolute bias: 1.12g/dL; 95% CI: 0.91 to 1.37g/dL; proportional bias: 14.0%; 95% CI: 11.4% to 17.1%) in haemoglobin concentrations measured by HemoCue-301 compared to those measured by Sysmex XN-Series1500. Bias was marginal at haemoglobin concentration of 11.0g/dL (absolute bias: -0.08g/dL; 95% CI: -0.18 to 0.07g/dL; proportional bias: -7.3%; 95% CI: -6.5% to 0.6%). Haemoglobin measurements by HemoCue-301 seem substantially biased in participants with haemoglobin less than 8.0g/dL.

Anemia in children with obesity: is there a higher risk compared to eutrophic children?

Anemia in children with obesity: is there a higher risk compared to eutrophic children?

Diagnostic accuracy of point-of-care devices for detection of anemia in children in community settings: a systematic review and meta-analysis.

A number of clinical studies have been conducted comparing the diagnostic accuracy of non-invasive and invasive point-of-care diagnostic tests for anemia, using reference standards such as hematology autoanalyzers. This meta-analysis was performed to determine the pooled estimate for the diagnostic accuracy of point-of-care devices for the detection of anemia in community settings in children aged up to 14years and determining whether the diagnostic accuracy of various point-of-care devices differs significantly. We included only original clinical studies with a sample size of 25 or more in the review. The QUADAS-2 tool was employed to evaluate the risk of bias and concerns regarding the applicability of the included studies. A total of 16 studies (HemoCue in 11; WHO Hemoglobin Color Scale in 3; Masimo, AnemoCheck-LRS, and Sahli's hemoglobinometer in 1 study each) were included. The pooled estimates for the sensitivity and specificity of point-of-care tests were 79.5% (95% CI: 65.6-88.7%) and 90.1% (95% CI: 82.5-94.6%), respectively. The difference in the level of hemoglobin measured was also insignificant between point-of-care and reference standards (MD: 0.2 [95% CI: - 0.2 to 0.6], p = 0.33), as well as for HemoCue and WHO Hemoglobin Color Scale subgroups (p = 0.73 and 0.05, respectively). The sensitivity and specificity of HemoCue and WHO Hemoglobin Color Scale were 79% (95% CI: 78-80%)/93% (95% CI: 92-94%) and 89% (95% CI: 86-91%)/88% (95% CI: 74-95%), respectively. Point-of-care diagnostic tests for anemia have acceptable sensitivity and specificity for screening anemia in children. There was no significant difference between the performance of HemoCue and the WHO Hemoglobin Color Scale. Prospero registration number: CRD42023386952 What is known? • Anemia is a major health prob lem in children in many countries across the world. • Screening for anemia in the community is important for timely therapeutic intervention. • Point-of-care testing (POCT) devices for anemia in children allow for quick Hb assessments at the site of care, providing immediate results. • Both non-invasive and micro-invasive POCT devices for anemia are currently available. What is new? • Point-of-care diagnostic tests for anemia have acceptable sensitivity and specificity for screening anemia in children. • There is no significant difference between the performance of HemoCue and the WHO Hemoglobin Color Scale.

The Impact of Undernutrition and Anemia on HIV-Related Mortality Among Children on ART in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Although there have been significant advancements in providing HIV-infected children with access to antiretroviral therapy (ART), the mortality rates have remained unacceptably high. Inadequate nutrient intake or absorption is a widespread problem in several African nations, resulting in undernutrition and anemia. However, the pooled effect of malnutrition and anemia on HIV-related death related to children receiving ART was not investigated in sub-Saharan Africa. We searched multiple electronic databases (PubMed/MEDLINE, Embase, CINAHL, and Web of Science) for observational studies published between January 1, 2010, and April 24, 2024 that reported the risk factors or effects of undernutrition and, anemia on HIV-related mortality among children. Study selection, data extraction, and quality evaluation were carried out separately by two reviewers. A meta-analysis was conducted using random effect models. The review included 27 studies with a combined total of 61,796 study participants. The study findings showed that severe wasting (HR: 2.49; 95% CI: 1.87-3.30), being underweight (HR: 2.11; 95% CI: 1.64-2.72), and Anemia (HR: 2.58; 95% CI: 2.08-3.19) were highly linked to HIV-related death among children. The risk of death due to anemia was greater among children under the age of 5 years than older children. Undernutrition and anemia in sub-Saharan African children increased the risk of HIV-related death. The impact of malnutrition and anemia among under 5 years old children with HIV/AIDS was more pronounced, suggesting that these conditions at this early age can have more serious consequences for a child's survival. The importance of combining nutrition with HIV treatment programs in sub-Saharan African countries is crucial.

ANÁLISE DA PREVALÊNCIA DE ANEMIA FERROPRIVA NA PRIMEIRA INFÂNCIA

Among the anemias, iron deficiency anemia is the most frequent. It affects about one third of the world's population, a public health problem of all socioeconomic classes. They directly affect the growth and mental development of children. The aim was to identify the prevalence of anemia in early childhood in Presidente Prudente-SP. Cross-sectional, retrospective study over a one-year period. The regions with the highest prevalence of anemia were the north-central and east, with no correlation with income. Regions with the lowest prevalence of anemia were the south-central region, with the highest purchasing power, the northwest and south regions, where the professional investigates the iron balance more. The gateway for the diagnosis of anemia was the Emergency and Emergency services. It is concluded that combating anemia requires mobilizing three essential pillars: professional assistance, encouragement from professionals for adherence by caregivers, and family health education. CAAE Protocol: 53905221.3.0000.5515.

Prevalence of anemia and its associated factors among under-five children living in Arba Minch Health and Demographic Surveillance System Sites (HDSS), Southern Ethiopia.

Childhood anemia affects around half of under five children and has impacts on physical, mental, and social development, both in the short and long term. The objective of the study was to determine the prevalence of anemia and its associated factors among under-five children living in Arba Minch Health and Demographic Surveillance System Sites (HDSS). A community-based cross-sectional study was conducted among randomly selected under-five children with their caregivers living in Arba Minch HDSS from June to August 2023. The questionnaire was developed to assess sociodemographic, nutrition, healthcare, and environmental characteristics. Hemoglobin concentration was adjusted for altitude of the village. Anemia was defined as the hemoglobin concentration below 11 g/dL. It was further categorized as mild (between 10-10.9 g/dL), moderate (7-9.9 g/dL), and severe (less than 7 g/dL). The analysis of factors associated with anemia was assessed by using logistic regression and significance was determined at p-value <0.05. A total of 332 under-five children with a mean (SD) age of 33(15) months participated. The overall prevalence of anemia among under-five children was 35.3% (95% CI: 30.4, 40.7). The magnitude of mild, moderate, and severe anemia was 12.4% (95%CI: 9.2, 16.4), 22.1% (95%CI: 17.9, 26.9), and 0.9% (95%CI: 0.3, 2.8), respectively. Anemia had a negative association with the advancing age of the children (0.95, 95%CI: 0.93, 0.97) and improvement in the family wealth score (0.86, 95%CI: 0.75, 0.99). Nearly one-third of the under-five children were anemic and childhood anemia is a moderate public health problem in the study area. The magnitude of anemia was negatively associated with the advance in child age and with the increase in the wealth status of the household. It is important to provide due attention to reduce the magnitude of anemia specifically for the youngest children and for those children from poor households.

Enhancing Hemoglobin Levels and Macro-Micronutrient Intake Through the Well-Being Workshop of First 8000 Days of Life

Introduction: Chronic malnutrition is a major source of concern in the malnutrition community. Addressing nutritional needs that are inappropriate for pre-conception adolescents in the first 8000 days of life is a trigger for anemia and stunting in children later in life. The authors developed The Well-Being Workshop of First 8000 Days of Life. This study compared the hemoglobin levels and macro-micro nutrient intake of female adolescents before and after the well-being workshop of first 8000 days of life and their assistance. Methods: An experimental design, within group method, with an equivalent time series design, and 3 times interventions were carried out. A hundred female adolescents aged 14-19 years Yogyakarta city were assigned to this study. All respondents underwent a pretest and posttest before and after being given interventions of well-being workshop. On completion of the three times workshop, blood sampling of haemoglobin level and food record were collected analyzed. In total, the data was collected 3 times after each workshop was held. The data generated was processed using a paired t test. Results: The average hemoglobin level in female adolescents has increased from the first to the fourth examination, with a standard limit value (&gt; 12.0 gr/dL), but the average of macro and micronutrients intake, as assessed using the Nutrisurvey, is below the standard threshold value. A paired T-test revealed a significant difference within the increase in Hb levels on all examinations. The analysis of macronutrients showed that only fiber had a significant difference before and after a series of well-being workshops of first 8000 days of life interventions, i.e. the first and second examinations. Meanwhile the micronutrient analysis, only iron and zinc there were significant differences before and after being given a series of workshops. Conclusions: "The well-being workshops of first 8000 days of life" can be considered in changing the eating behavior of female adolescents to increase hemoglobin levels.

The problem of treating anaemia in children: Medicinal plants versus blood transfusion

Introduction: This study looked at the problem of treating anaemia using both medicinal plants and blood transfusions. The aim was to identify the problems associated with treating children's anaemia using blood transfusions or medicinal plants, to show why parents choose to treat their children's anaemia, to identify the reasons for using medicinal plants to treat children's anaemia and to list the medicinal plants used to treat anaemia. Methodology: To achieve these objectives, we used a cross-sectional descriptive approach based on direct structured interviews with mothers hospitalized with their children in the paediatrics department of the GRH/Makiso and at the Centre Traditional-modern Jesus Heals, during the three-month period from 1 June to 31 August 2023. As a result, 40 study subjects were selected, 20 from each investigation site. Results: The following results were obtained in relation to problems associated with the treatment of anaemia in children: 30.0% of the subjects in the study who had had a relapse to traditional anaemia treatment at the CTM Jesus Heals and problems related to the treatment of anaemia by transfusion and traditional treatment, 50.0% of the subjects in the study mentioned the reason why traditional treatment corrects anaemia, i.e. 25.0% at the CTM Jesus Heals and blood transfusion improves the child's state of health, i.e. 25.0% at the HGR/Makiso. At the CTM Jesus Heals, anaemia was treated with medicinal plants, in particular sweet potato leaves (20.0%), papaya leaves (12.5%), avocado leaves (10.0%) and Bokomu leaves (7.5%). Conclusion: Anaemia is a public health problem in Kisangani, causing a high morbidity rate among children. It is therefore important to provide effective medical treatment with a view to reducing the number of deaths due to anaemia.

Vitamin C-Rich Guava Consumed with Mungbean Dal Reduces Anemia and Increases Hemoglobin but not Iron Stores: A Randomized Controlled Trial of Food-to-Food Fortification in Indian Children

BackgroundAdding vitamin C-rich fruit to staples containing iron could be an effective strategy to improve iron bioavailability and thereby reduce iron-deficiency anemia in children. ObjectivesWe aimed to assess the effect of consuming a mungbean-based meal with or without guava fruit on body iron stores, hemoglobin concentration, and anemia of children as part of a school feeding program. MethodsWe conducted a 7-mo randomized, controlled trial with 6- to 10-y-old school children (n = 200; 46% anemic, 71% iron-deficient) from a rural community in Haryana, North India. Children were assigned to 2 treatment groups to daily receive either a meal of mungbean dal only (3.0 mg iron; vitamin C:iron molar ratio ∼0.5:1), or mungbean dal with fresh guava (3.2 mg iron; ∼170 mg vitamin C; molar ratio ∼18:1). Meals were served every school day under supervision. The primary outcome was body iron stores, whereas concentrations of hemoglobin and other iron indicators were secondary outcomes. ResultsDaily consumption of mungbean dal along with guava did not result in an overall improvement of body iron stores [mean treatment effect: 0.65 mg/kg body weight; 95% confidence interval (CI): −0.34, 1.63; P = 0.197]. However, compared with children who consumed mungbean dal only, children in the guava group showed a larger increase in hemoglobin concentration (3.7 g/L; 95% CI: 1.6, 5.6; P = 0.001), and a larger drop in the prevalence of anemia (−51%; 95% CIs: −74, −10; P = 0.022) and iron-deficiency anemia (−56%, 95% CI: −83, 13; P = 0.087). These effects were more pronounced in children who were iron deficient at study start. ConclusionsAddition of guava to a mungbean-based meal containing a moderate amount of iron increased hemoglobin and reduced anemia but did not provide enough additional absorbed iron to also increase body iron stores. Food-to-food fortification by inclusion of vitamin C-rich fruits in iron-containing school meals may help alleviate the burden of anemia in children. Trial registration numberThis trial was registered at https://clinicaltrials.gov/ct2/show/NCT01191463.

Malnutrition in infants aged 6-23 months in China’s poorest rural counties from 2016 to 2021: cross sectional study

ObjectivesTo assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China’s poorest rural counties.DesignSix consecutive cross sectional surveys were conducted annually.SettingThe study was...

Haematopoietic cell transplantation for 106 infants and preschoolers with acquired and inherited bone marrow failures.

Aplastic anaemia in infants and young children presents unique challenges due to high prevalence of inherited bone marrow failure syndromes (IBMFS) in this age group. The objective of this study is assessing clinical characteristics and outcomes of haematopoietic cell transplantation in children ≤5 years with bone marrow failure syndromes. We analysied 106 patients (66% males), median age 4.6 years, including 40 with Fanconi anaemia (FA), 32 with Acquired Severe Aplastic anaemia (aSAA), 15 with Diamond-Blackfan Anaemia, 11 with Amegakaryocytic Purpura and 8 with other IBMFS. Molecular testing was limited (39%), with 25.4% confirmed genetically. Retrospective longitudinal study across three paediatric transplantation centres (1982-2020). Overall survival (OS) was 76.4% over a median 10-year follow-up. OS rates were similar between aSAA and IBMFS (FA 77.5%, other IBMFS 76.5%). Transplant-related mortality (TRM) was lower in aSAA (9.4%) compared with IBMFS (16.2%). Recent years showed improved outcomes, with TRM declining post-2010. Choice of stem cell source impacted OS, favouring bone marrow over umbilical cord, but showing encouraging results with haploidentical. Late complications were common, including endocrine-metabolic issues and delayed neuropsychomotor development. Diagnosing and managing bone marrow failures in young children pose significant challenges. Despite advancements in transplant practices, ongoing vigilance and comprehensive care are necessary to improve long-term survival rates.

Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression

BackgroundSudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing β-globin mRNA expression and reticulocyte parameters. Additionally, it classifies anemia among Sudanese pediatric patients based on iron status, considering age and gender as biological markers for evaluating treatment response.MethodsA prospective observational cohort study was conducted from January 2019 to February 2020 in Khartoum, Sudan, involving 45 anemic children aged 2 to 15 years diagnosed with ESKD. The treatment protocol included rHuEPO injections and maintenance hemodialysis. Laboratory assessments consisted of complete blood count (CBC), absolute reticulocyte count, ferritin, and transferrin measurements. β-globin mRNA expression was quantified using reverse transcription polymerase chain reaction (RT-PCR), and reticulocyte parameters, including Reticulocyte Hemoglobin Content (CHr), percentage of hypochromic reticulocytes (HYPO%), and Immature Reticulocyte Fraction (IRF), were measured via flow cytometry.ResultsSignificant variations in hemoglobin levels were observed across different age groups (p = 0.011). Gender analysis revealed a significant association with IRF, showing a lower IRF in male patients (p = 0.017). However, there were no significant differences in hemoglobin levels between genders (p = 0.999). β-globin mRNA expression showed considerable variability, with a strong positive correlation with hemoglobin levels (r = 0.875, p < 0.0001).ConclusionAge and gender significantly influence treatment responses in children with ESKD, highlighting the need to consider growth physiology in anemia management. This study underscores the variability in β-globin mRNA expression and its association with Flow Cytometry parameters, demonstrating their effectiveness in evaluating iron status and guiding rHuEPO dosage.

Diagnosis and Treatment of Iron Deficiency and Iron Deficiency Anemia in Children and Adolescents: Recommendations of the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Society of Neonatology, and the Polish Society of Family Medicine.

Background/Objectives. Iron deficiency is one of the most common nutritional deficiencies worldwide and is the leading cause of anemia in the pediatric population (microcytic, hypochromic anemia due to iron deficiency). Moreover, untreated iron deficiency can lead to various systemic consequences and can disrupt the child's development. Methods/Results. Therefore, a team of experts from the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Neonatology Society, and the Polish Society of Family Medicine, based on a review of the current literature, their own clinical experience, and critical discussion, has developed updated guidelines for the diagnosis, prevention, and treatment of iron deficiency in children from birth to 18 years of age. These recommendations apply to the general population and do not take into account the specifics of individual conditions and diseases.

Iron-fortified biscuits in the prevention and treatment of anemia in preschool children

Iron-fortified biscuits in the prevention and treatment of anemia in preschool children

Assessing the burden of submicroscopic Plasmodium infections in a pre-elimination malaria setting in sub-Saharan Africa, Guinea-Bissau.

Submicroscopic Plasmodium infections can be a source of persistent malaria transmission. The aim of this study was to assess their frequency, distribution, morbidity and associated factors in a pre-elimination malaria setting in sub-Saharan Africa, Guinea-Bissau, where the Plasmodium falciparum is the predominant Plasmodium species. Dried fingerprick whole blood samples from 601 participants in the 2017 national, household-based, cross-sectional survey to estimate malaria prevalence were subjected to DNA extraction. The DNA was used in nested end-point PCR assays targeting genus- and species-specific regions of the Plasmodium 18S rRNA genes. Statistical analysis of socio-demographic, clinical and molecular data was carried out using the Statistical Package for the Social Sciences, version 29. Factors associated with submicroscopic P. falciparum infections and their magnitude were sought using Chi-square test and multiple logistic regression models, respectively. Statistically significant level was considered at P-value < 0.05. Nested PCR assays detected submicroscopic P. falciparum infections in 20.3% (95% CI = 16.8-23.8) of individuals microscopically negative for Plasmodium species in the general population and in 21.4% (95% CI = 9.9-36.5) of microscopically negative pregnant women. Submicroscopic Plasmodium malariae infections were also detected as co-infections in 3.0% individuals who were microscopically positive only for P. falciparum. Infections with other Plasmodium species were not detected. Submicroscopic P. falciparum infections were not associated with age, sex, or the presence of fever. A logistic regression model adjusted for ethnicity and health region showed that individuals from the Balanta and Bijagos ethnic groups, most of whom live in the low malaria-transmission areas of Quinara and Bissau, and the Bijagos archipelago, respectively, were less likely to have submicroscopic P. falciparum infections than individuals from the large Fula ethnic group, most of whom live in the high malaria-transmission area of Gabu. Submicroscopic P. falciparum infections were not associated with anaemia in children under 5years of age. The results obtained highlight the contribution of asymptomatic and submicroscopic P. falciparum infections to malaria transmission in high malaria-transmission areas and the need for molecular-based tools to detect submicroscopic Plasmodium species.

Linezolid Pharmacokinetic-Anemia Modeling in Children with Rifampicin-Resistant Tuberculosis.

Linezolid, an important component of rifampicin- and multidrug-resistant tuberculosis (RR/MDR-TB) treatment, is associated with treatment-limiting toxicities, including anemia. Patient-level and linezolid pharmacokinetic risk factors for anemia have not been well described in children treated for RR/MDR-TB. We evaluated the pharmacokinetics of linezolid and longitudinal hemoglobin data to validate an existing population linezolid pharmacokinetic model. We assessed the impact of linezolid pharmacokinetics and the risk of developing anemia in a prospectively enrolled cohort of children. The validation of a previously published population pharmacokinetic linezolid model used nonlinear mixed effects modeling. A multivariable ordinal logistic regression model was built to predict the incidence of anemia. A total of 112 children, median age 7.2 (IQR: 2.2-16.3) years, were included from South Africa (n=87) and India (n=25). Of these, 24 children contributed new linezolid pharmacokinetic data. The population pharmacokinetic model which informs the currently recommended linezolid dosing in children (10-15 mg/kg) was validated with these additional new data. For every 1 g/dL lower baseline hemoglobin, the odds of developing grade 3 or 4 anemia increased by 2.64 (95% CI 1.98-3.62). For every 1 mg/L*h higher linezolid area under the concentration-time curve (AUC), the odds of developing a grade 3 or 4 anemia increased by 1.012 (95% CI 1.007-1.017). These data taken together, confirm currently recommended linezolid doses in children. The risk of anemia in children should be carefully considered and monitored throughout. Initiating linezolid in children with low baseline hemoglobin increases the probability of experiencing grade 3 or 4 anemia.

Global burden of anemia and cause among children under five years 1990-2019: findings from the global burden of disease study 2019.

Anemia represents a significant global health issue affecting numerous children and women, characterized by diminished hemoglobin levels that may impede cognitive and developmental progress. Although commonly attributed to iron deficiency, the etiology of anemia in this demographic is multifaceted, encompassing nutritional, genetic, and infectious contributors. Nonetheless, there is a lack of high-quality data on anemia prevalence and causes analysis among children under 5 years. The aim of this study was to provide a comprehensive global assessment of the burden of anemia and its causes among children under 5 years, using data from the Global Burden of Disease Study 2019. This investigation utilized data from the Global Burden of Disease Study (GBD) 2019 to assess the prevalence and years lived with disability (YLD) attributable to anemia in children under five from 1990 to 2019. Analyses were conducted to delineate age-specific YLD, prevalence rates, and etiological factors, with stratification by gender and Socio-Demographic Index (SDI). In 2019, anemia imposed a substantial global burden on children under five, with a reported YLD of 1,252.88 (95% UI: 831.62-1,831.34) per 100,000 population. The prevalence of moderate anemia was highest at 985.46 (95% UI: 646.24-1,450.49) per 100,000, surpassing both severe anemia at 197.82 (95% UI: 132.53-277.80) per 100,000 and mild anemia at 69.59 (95% UI: 24.62-152.53) per 100,000. Globally, the total prevalence was 39,517.75 (95% UI: 38,784.81 - 40,239.62) cases per 100,000 population. Notably, disparities were evident between genders, with males demonstrating higher YLD and prevalence rates than females. Iron deficiency emerged as the leading cause globally, with significant contributions from hemoglobinopathies and other nutritional deficiencies. Regions with a low Socio-Demographic Index, particularly sub-Saharan Africa and South Asia, exhibited the most pronounced burdens. Despite a declining trend over three decades, persistent regional and gender-based disparities highlight the necessity for continuous and focused public health interventions. The burden of anemia among children under five continues to be considerable, marked by stark regional and socioeconomic disparities. These findings underscore the urgent need for advanced nutritional and healthcare strategies tailored to alleviate anemia in this vulnerable population, with a particular emphasis on regions exhibiting low SDIs. The sustained prevalence of high anemia rates in these areas underscores the imperative for persistent, localized intervention efforts.

Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia.

Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.