Department of Health Behavior and Social Science, Sichuan University, Chengdu, Sichuan, China.
California State University Long Beach, Long Beach, California, USA.
BMJ Paediatr Open. 2022 Jan;6(1). doi: 10.1136/bmjpo-2021-001185.
Iron-deficiency anaemia disproportionately affects children in low-income and middle-income areas; Western China is a prime example. Given the health risks associated with childhood anaemia and the large heterogeneity of published studies on this subject, we conducted a systematic review of the evidence regarding anaemia prevalence and associated factors in children under 5 years in Western China.
We searched for all relevant studies on the prevalence of iron deficiency anaemia in children under 5 years in Western China, obtaining research between 1 January 2011 and 30 June 2021, in English and Chinese from Medline, Embase, PubMed, Web of Science, CNKI, WanFang Data and VIP. Two reviewers independently screened titles and abstracts; three reviewed full texts of relevant articles for data extraction and performed quality assessments. The median prevalence was calculated on unweighted pooling, stratified by region, sex, age and ethnic group. Associated factors and a linear trend chart were conducted to identify trends and research highlights.
Among the 55 articles included, most were cross-sectional studies (39, 70.91%). The prevalence of anaemia in children under 5 years in Western China ranged from 3.69% to 75.74% (median 42.54% (IQR 25.62%-52.56%)); the highest levels were in Qinghai province: 59.10%-75.74% (median 67.80% (IQR 64.70%-72.75%)); the highest levels were reported in the subgroup of children aged 6-12 months (median 50.09% (IQR 34.35%-59.04%)). Regional contexts, individual sociodemographic characteristics and feeding behaviours, and nutritional programme interventions were factors associated with anaemia prevalence.
The prevalence of anaemia in children under 5 years in Western China is concerningly high. For this multiethnic and economically underdeveloped region, more high-quality and prospective studies are needed to inform evidence based and targeted preventive strategies to decrease the high prevalence of anaemia among young children.
缺铁性贫血在中低收入地区的儿童中不成比例地高发；中国西部就是一个典型的例子。鉴于儿童贫血带来的健康风险，以及关于这一主题的发表研究存在较大的异质性，我们对中国西部 5 岁以下儿童贫血患病率及相关因素进行了系统评价。
我们检索了 2011 年 1 月 1 日至 2021 年 6 月 30 日期间在中文学术数据库（CNKI、万方数据、维普）和西文数据库（Medline、Embase、PubMed、Web of Science）中发表的关于中国西部 5 岁以下儿童缺铁性贫血患病率的所有相关研究，由两位评审员独立筛选标题和摘要，有三位评审员对相关文章的全文进行了数据提取和质量评估。采用加权荟萃分析计算未加权患病率，并按地区、性别、年龄和民族进行分层。采用线性趋势图来确定趋势和研究重点。
在纳入的 55 篇文章中，大多数为横断面研究（39 篇，占 70.91%）。中国西部 5 岁以下儿童贫血患病率为 3.69%75.74%（中位数为 42.54%[25.62%52.56%]）；青海地区的患病率最高，为 59.10%75.74%（中位数为 67.80%[64.70%72.75%]）；年龄在 612 个月的儿童亚组中报告的患病率最高，为 50.09%（34.35%59.04%）。区域背景、个体社会人口学特征和喂养行为以及营养规划干预是与贫血患病率相关的因素。
中国西部 5 岁以下儿童贫血患病率居高不下。对于这个多民族、经济欠发达的地区，需要开展更多高质量的前瞻性研究，为制定基于证据的有针对性的预防策略提供信息，以降低该地区幼儿贫血的高患病率。
