Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America.
Meds and Food for Kids, Haiti.
PLoS One. 2021 Apr 6;16(4):e0247975. doi: 10.1371/journal.pone.0247975. eCollection 2021.
In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed.
To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban vs. rural areas of Haiti.
This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5-13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect.
In rural areas, stunting was more prevalent in children with anemia vs. no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults vs. rural children with no anemia, ([Formula: see text] = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia vs. no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32-3.18)], age [AOR = 0.89; 95%CI (0.85-0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67-0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed.
In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.
在海地，城乡地区的贫血患病率存在差异。
确定可能有助于解释海地贫困城乡地区儿童贫血患病率差异的调节因素。
这是一项使用评估营养干预有效性的城乡学校为基础的试验的二次数据的横断面研究。该研究在 ClinicalTrials.gov 上注册为 NCT02747524。共纳入了 300 名农村地区和 981 名城市地区 2.5-13 岁的儿童。使用 SPSS® 版本 26 中的样本权重进行二元逻辑广义线性混合模型中的效应修饰。模型调整了年龄和收入。学校集群被纳入随机效应。
在农村地区，贫血儿童的发育迟缓发生率高于非贫血儿童（分别为 16.6%和 6.3%，P = 0.008）。此外，贫血农村儿童的成人居住人数少于非贫血农村儿童（[Formula: see text] = 2.83±1.29，和 3.30±1.54，P = 0.005）。在贫困的城市地区，贫血儿童的寄生虫病发病率高于非贫血儿童（分别为 21.9%和 13.9%，P = 0.011）。在合并样本中，发育迟缓（AOR = 2.05；95%CI（1.32-3.18））、年龄（AOR = 0.89；95%CI（0.85-0.93））和成人较多的家庭（AOR = 0.77；95%CI（0.67-0.87））与贫血有关。居住地的效应修饰在成人较多的家庭中观察到（t = 3.83，P<0.001）。未观察到其他营养、饮食、卫生或发病因素或效应修饰物。
在这个样本中，与海地贫困城乡地区儿童贫血相关的因素包括家庭结构和寄生虫病。在合并样本中，发育迟缓且年龄较小会增加贫血的几率。家庭结构似乎在贫血中起着重要作用，需要进一步研究家庭结构对贫血的影响。
