Amaha Nebyu Daniel
Department of Nutrition and Dietetics, College of Health Sciences, Mekelle University, P.O Box: 1871, Mekelle, Ethiopia.
BMC Nutr. 2020 Oct 12;6:43. doi: 10.1186/s40795-020-00371-6. eCollection 2020.
In Ethiopia more than half of the children under 5 years are anemic and between 2011 and 2016 anemia in children under-5 increased by 28.7%. This study aimed to analyze this increase in anemia by socio-demographic characteristics.
This study was a secondary analysis of the data from the Ethiopian Demographic Health Surveys (EDHS) for 2011 and 2016. The increase of anemia was calculated using percentage change. The chi-square test was used to determine the association between anemia and six predictor variables of age, sex, mother's educational level, residence, wealth quintile and region. The strength of association was measured using Cramer's V.
Anemia increased in all age groups, both sexes, urban and rural residencies, across all wealth quintiles, all maternal education levels and all regions of Ethiopia except Benishangul Gumuz. The highest increase of anemia was seen among children born to mothers with above secondary education (65.8%), living in urban areas (40.1%), in the lowest wealth quintile (41.5%), and children from Tigray region (42.9%). Severe anemia increased in all age categories except in infants aged 9-11 months. Children of mothers with above secondary educational level had the highest increase of mild and moderate anemia. Severe anemia decreased in the second and middle wealth quintiles whereas it increased in the rest quintiles. Benishangul Gumuz is the only region where mild, moderate, and severe anemia decreased. Pearson's chi-square (χ) test showed that all the predictor variables except sex were significantly associated with anemia. Although highly significant ( < 0.001) using the chi-square test, Cramer's V showed that residence (V = 0.052-0.066) and maternal education (V = 0.041-0.044) were only weakly associated with anemia.
Anemia in children under-5 continues to be a severe public health problem in Ethiopia. Benishangul Gumuz region is the only region that was able to reduce the prevalence of all forms of anemia under-5 between 2011 and 2016, consequently other regions of Ethiopia could learn from this experience. The high increase of anemia in children born to mothers with above secondary education and highest wealth quintiles points to poor dietary practices, therefore, community based nutrition education for mothers needs to be strengthened.
在埃塞俄比亚，超过半数的5岁以下儿童患有贫血，且在2011年至2016年间，5岁以下儿童的贫血率增长了28.7%。本研究旨在按社会人口学特征分析贫血率的这一增长情况。
本研究是对2011年和2016年埃塞俄比亚人口与健康调查（EDHS）数据的二次分析。贫血率的增长采用百分比变化来计算。卡方检验用于确定贫血与年龄、性别、母亲教育水平、居住地、财富五分位数和地区这六个预测变量之间的关联。关联强度用克莱姆相关系数V来衡量。
除本尚古勒-古穆兹地区外，埃塞俄比亚所有年龄组、男女两性、城乡居住地、所有财富五分位数、所有母亲教育水平以及所有地区的贫血率均有所上升。贫血率增幅最高的是母亲受过高中以上教育的儿童（65.8%）、居住在城市地区的儿童（40.1%）、处于最低财富五分位数的儿童（41.5%）以及提格雷地区的儿童（42.9%）。除9至11个月大的婴儿外，所有年龄组的重度贫血率均有所上升。母亲受过高中以上教育的儿童，轻度和中度贫血率增幅最高。重度贫血率在第二和中间财富五分位数中有所下降，而在其他五分位数中则有所上升。本尚古勒-古穆兹是唯一轻度、中度和重度贫血率均下降的地区。皮尔逊卡方（χ）检验表明，除性别外，所有预测变量均与贫血显著相关。尽管卡方检验显示高度显著（P<0.001），但克莱姆相关系数V表明，居住地（V = 0.052 - 0.066）和母亲教育水平（V = 0.041 - 0.044）与贫血的关联较弱。
在埃塞俄比亚，5岁以下儿童贫血仍然是一个严重的公共卫生问题。本尚古勒-古穆兹地区是2011年至2016年间唯一能够降低5岁以下各类贫血患病率的地区，因此，埃塞俄比亚其他地区可以借鉴这一经验。母亲受过高中以上教育且处于最高财富五分位数的儿童贫血率大幅上升，这表明饮食习惯不良，因此，需要加强针对母亲的社区营养教育。
