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      Prevalence of anemia and its associated factors among children under five years of age attending at Guguftu health center, South Wollo, Northeast Ethiopia

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          Abstract

          Background

          Anemia during childhood adversely affects mental, physical and social development of the children. This study is aimed to assess the prevalence of anemia and its associated factors among children less than five years of age in Guguftu, South Wollo, Northeast Ethiopia.

          Method

          A cross-sectional health facility based study was conducted among 404 children aged 6 to 59 months. Systematic random sampling technique was used to include the participants. Pretested and structured questionnaires were used to collect socioeconomic and demographic characteristics of the family and child. Data on nutritional status, capillary blood and stool samples were collected from each child. Multivariate logistic regression was used to calculate adjusted odds ratios and the corresponding 95% confidence intervals.

          Result

          The overall prevalence of anemia was 41.1% (95% CI;36.6% - 45.8%). Of the anemic under five children, 112 (67.5%) had mild anemia, 52(31.3%) had moderate anemia, and 2(1.2%) had severe anemia. Children who were in the age group of 6–11(AOR = 4.52; 95% CI: 1.67–12.34) and 12–23 (AOR = 2.79; 95% CI: 1.04–7.51) months, living in an urban (AOR = 1.83; 95% CI: 1.05–3.18), with no formal education mothers (AOR = 7.05; 95% CI: 2.93–17.01) and primary education mothers (AOR = 3.26; 95% CI: 1.29–8.24), with a family monthly income of <750 ETB(AOR = 5.19; 95% CI: 1.24–21.75) and 750–1500 ETB(AOR = 5.89; 95% CI: 1.45–23.98), with early (<6 months) introduction of complementary foods (AOR = 3.53; 95% CI: 1.23–10.18), Underweight (AOR = 2.11; 95% CI: 1.21–3.69) were more likely to become anemic.

          Conclusion

          This study has revealed that the prevalence of anemia in children less than five years is high and a severe public health problem in the study area. Therefore, the policymakers should make a strategy that can reduce poverty and increase the awareness of women on breastfeeding, nutrition, and other associated factors to reduce anemia.

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          Most cited references28

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          Iron and its relation to immunity and infectious disease.

          The continuing unresolved debate over the interaction of iron and infection indicates a need for quantitative review of clinical morbidity outcomes. Iron deficiency is associated with reversible abnormalities of immune function, but it is difficult to demonstrate the severity and relevance of these in observational studies. Iron treatment has been associated with acute exacerbations of infection, in particular, malaria. Oral iron has been associated with increased rates of clinical malaria (5 of 9 studies) and increased morbidity from other infectious disease (4 of 8 studies). In most instances, therapeutic doses of oral iron were used. No studies in malarial regions showed benefits. Knowledge of local prevalence of causes of anemia including iron deficiency, seasonal malarial endemicity, protective hemoglobinopathies and age-specific immunity is essential in planning interventions. A balance must be struck in dose of oral iron and the timing of intervention with respect to age and malaria transmission. Antimalarial intervention is important. No studies of oral iron supplementation clearly show deleterious effects in nonmalarious areas. Milk fortification reduced morbidity due to respiratory disease in two very early studies in nonmalarious regions, but this was not confirmed in three later fortification studies, and better morbidity rates could be achieved by breast-feeding alone. One study in a nonmalarious area of Indonesia showed reduced infectious outcome after oral iron supplementation of anemic schoolchildren. No systematic studies report oral iron supplementation and infectious morbidity in breast-fed infants in nonmalarious regions.
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            An analysis of anemia and child mortality.

            The relationship of anemia as a risk factor for child mortality was analyzed by using cross-sectional, longitudinal and case-control studies, and randomized trials. Five methods of estimation were adopted: 1) the proportion of child deaths attributable to anemia; 2) the proportion of anemic children who die in hospital studies; 3) the population-attributable risk of child mortality due to anemia; 4) survival analyses of mortality in anemic children; and 5) cause-specific anemia-related child mortality. Most of the data available were hospital based. For children aged 0-5 y the percentage of deaths due to anemia was comparable for reports from highly malarious areas in Africa (Sierra Leone 11.2%, Zaire 12.2%, Kenya 14.3%). Ten values available for hemoglobin values <50 g/L showed a variation in case fatality from 2 to 29.3%. The data suggested little if any dose-response relating increasing hemoglobin level (whether by mean value or selected cut-off values) with decreasing mortality. Although mortality was increased in anemic children with hemoglobin <50 g/L, the evidence for increased risk with less severe anemia was inconclusive. The wide variation for mortality with hemoglobin <50 g/L is related to methodological variation and places severe limits on causal inference; in view of this, it is premature to generate projections on population-attributable risk. A preliminary survival analysis of an infant cohort from Malawi indicated that if the hemoglobin decreases by 10 g/L at age 6 mo, the risk of dying becomes 1.72 times higher. Evidence from a number of studies suggests that mortality due to malarial severe anemia is greater than that due to iron-deficiency anemia. Data are scarce on anemia and child mortality from non-malarious regions. Primary prevention of iron-deficiency anemia and malaria in young children could have substantive effects on reducing child mortality from severe anemia in children living in malarious areas.
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              Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action.

              Anemia is one of the commonest and most intractable public health problems in Africa. This paper illustrates how, in areas of stable malaria transmission, anemia is apparent from the first few months of life, with the highest prevalence towards the end of the first year. The antenatal and postnatal factors predisposing to anemia in infants and young children are discussed, together with the interventions that are available for prevention. The paper stresses the need to target interventions at pregnant women and infants, the groups at highest risk of anemia, and to develop an integrated, non disease-specific approach to this complex problem. Copyright 2004 The American Society of Tropical Medicine and Hygiene
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                5 July 2019
                2019
                : 14
                : 7
                : e0218961
                Affiliations
                [1 ] Department of Medical Laboratory Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
                [2 ] Department of Laboratory, Dessie Referral Hospital, Dessie, Ethiopia
                University of Ghana, GHANA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-2992-574X
                Article
                PONE-D-19-01068
                10.1371/journal.pone.0218961
                6611584
                31276472
                2ee7d38b-5420-4965-9481-9d215a0b77d8
                © 2019 Gebreweld et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 January 2019
                : 12 June 2019
                Page count
                Figures: 2, Tables: 4, Pages: 13
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Hematology
                Anemia
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Biology and Life Sciences
                Nutrition
                Medicine and Health Sciences
                Nutrition
                People and Places
                Population Groupings
                Families
                Mothers
                Medicine and Health Sciences
                Hematology
                Anemia
                Iron Deficiency Anemia
                People and Places
                Geographical Locations
                Africa
                Ethiopia
                Medicine and Health Sciences
                Health Care
                Patients
                Outpatients
                Custom metadata
                All relevant data are within the manuscript and Supporting Information files.

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