Seifu Beminate Lemma, Tesema Getayeneh Antehunegn
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Arch Public Health. 2022 Aug 6;80(1):183. doi: 10.1186/s13690-022-00950-y.
Anemia among children aged 6-23 months is a major public health problem worldwide specifically in sub-Saharan Africa (SSA). Anemia during the childhood period causes significant short-and long-term health consequences. However, there is a paucity of evidence on Anemia among children aged 6-23 months in SSA. Therefore, this study examined the individual- and community-level factors associated with anemia among children aged 6-23 months in sub-Saharan Africa.
A secondary data analysis was done based on the most recent Demographic and Health Survey (DHS) of 32 sub-Saharan African countries. A total weighted sample of 51,044 children aged 6-23 months was included for analysis. We have used a multilevel proportional odds model to identify predictors of severity levels of anemia. Variables with p < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel proportional odds model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of the association.
In this study, about 76.6% (95% CI: 76.2%, 76.9%) of children aged 6-23 months in sub-Saharan Africa were anemic. In the multivariable multilevel proportional odds model, being female, being aged 18-23 months, higher level of maternal education, being larger size at birth, belonging to a wealthier household, getting four ANC visits and above, advanced maternal age, and belonging to a community with high maternal education were significantly associated with lower odds of higher levels of anemia. On the other hand, being twin birth, being smaller size at birth, being of a higher order of birth, having fever in the last two weeks, and distance to a health facility were significantly associated with higher odds of higher levels of anemia.
The study found that more than three-fourths of children aged 6-23 months in sub-Saharan Africa were anemic. This finding proved that the severity levels of anemia among children in sub-Saharan Africa remain a serious public health concern. Therefore, to curve this problem enhancing maternal education, promoting maternal health service utilization, and improving health care access is crucial. In addition, health care providers better give special emphasis to twin births, higher-order birth, and those belonging to poor households to reduce the incidence of anemia among children aged 6-23 months in SSA.
6至23个月大儿童的贫血是全球范围内，尤其是撒哈拉以南非洲地区的一个主要公共卫生问题。儿童期贫血会导致严重的短期和长期健康后果。然而，关于撒哈拉以南非洲地区6至23个月大儿童贫血情况的证据很少。因此，本研究调查了撒哈拉以南非洲地区6至23个月大儿童贫血相关的个体和社区层面因素。
基于32个撒哈拉以南非洲国家的最新人口与健康调查（DHS）进行二次数据分析。纳入了51,044名6至23个月大儿童的加权样本进行分析。我们使用多水平比例优势模型来确定贫血严重程度的预测因素。在双变量分析中p<0.2的变量被纳入多变量分析。在多变量多水平比例优势模型中，报告调整后的优势比（AOR）及其95%置信区间（CI）以说明关联的统计学意义和强度。
在本研究中，撒哈拉以南非洲地区约76.6%（95%CI：76.2%，76.9%）的6至23个月大儿童贫血。在多变量多水平比例优势模型中，女性、18至23个月大、母亲教育水平较高、出生时体型较大、属于较富裕家庭、接受四次及以上产前检查、母亲年龄较大以及属于母亲教育水平较高的社区与贫血程度较高的较低几率显著相关。另一方面，双胞胎出生、出生时体型较小、出生顺序较高、过去两周发烧以及距离医疗机构较远与贫血程度较高的较高几率显著相关。
研究发现，撒哈拉以南非洲地区超过四分之三的6至23个月大儿童贫血。这一发现证明，撒哈拉以南非洲地区儿童贫血的严重程度仍然是一个严重的公共卫生问题。因此，为了解决这个问题，加强母亲教育、促进孕产妇保健服务利用以及改善医疗保健可及性至关重要。此外，医疗保健提供者应特别关注双胞胎、多胞胎以及贫困家庭的儿童，以降低撒哈拉以南非洲地区6至23个月大儿童的贫血发生率。
