Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
University of New South Wales, Sydney, New South Wales, Australia.
BMJ Open. 2024 Mar 8;14(3):e079856. doi: 10.1136/bmjopen-2023-079856.
Iron deficiency is a major public health problem that affects the physical and cognitive development of children under 5 years of age (under-5 children) in sub-Saharan Africa (SSA). However, the factors associated with the limited consumption of iron-rich foods in the region are poorly understood.
This study examined the prevalence and determinants of iron-rich food deficiency among under-5 children in 26 SSA countries.
This nationally representative quantitative study employed pooled data from Demographic and Health Surveys conducted between 2010 and 2019.
Representative samples comprising 296 850 under-5 children from the various countries were used. Bivariate and multivariate logistic regression models were used to determine the associations between the lack of iron-rich food uptake and various sociodemographic factors.
The overall prevalence of iron-rich food deficiency among the children in the entire sample was 56.75%. The prevalence of iron-rich food deficiency varied widely across the 26 countries, ranging from 42.76% in Congo Democratic Republic to 77.50% in Guinea. Maternal education, particularly primary education (OR 0.62, 95% CI 0.57 to 0.68) and higher education (OR 0.58, 95% CI 0.52 to 0.64), demonstrated a reduced likelihood of iron-rich food deficiency in the sample. Likewise, paternal education, with both primary education (OR 0.69, 95% CI 0.63 to 0.75) and higher education (OR 0.66, 95% CI 0.60 to 0.73) showed decreased odds of iron-rich food deficiency. Postnatal visits contributed significantly to reducing the odds of iron-rich food deficiency (OR 0.90, 95% CI 0.83 to 0.95), along with antenatal visits, which also had a positive impact (OR 0.84, 95% CI 0.74 to 0.95). Finally, residents in rural areas showed slightly higher odds of iron-rich food deficiency (OR 1.12, 95% CI 1.10 to 1.28).
Based on the findings, interventions targeting iron-food deficiency in the SSA region should take into strong consideration the key determinants highlighted in this study.
缺铁是一个重大的公共卫生问题，影响着撒哈拉以南非洲（SSA）5 岁以下儿童（5 岁以下儿童）的身体和认知发育。然而，该地区与铁丰富食物摄入有限相关的因素尚未得到充分理解。
本研究调查了撒哈拉以南非洲 26 个国家 5 岁以下儿童缺铁食物缺乏的流行率和决定因素。
本研究采用 2010 年至 2019 年期间进行的人口与健康调查的汇总数据进行全国代表性定量研究。
使用来自各国的 296850 名 5 岁以下儿童的代表性样本。采用二变量和多变量逻辑回归模型确定缺铁食物摄入不足与各种社会人口因素之间的关联。
整个样本中儿童缺铁食物缺乏的总体流行率为 56.75%。26 个国家的缺铁食物缺乏率差异很大，刚果民主共和国为 42.76%，几内亚为 77.50%。母亲的教育，特别是小学教育（OR 0.62，95%CI 0.57 至 0.68）和高等教育（OR 0.58，95%CI 0.52 至 0.64），表明样本中缺铁食物缺乏的可能性降低。同样，父亲的教育，包括小学教育（OR 0.69，95%CI 0.63 至 0.75）和高等教育（OR 0.66，95%CI 0.60 至 0.73）也显示缺铁食物缺乏的可能性降低。产后访视显著降低了缺铁食物缺乏的几率（OR 0.90，95%CI 0.83 至 0.95），而产前访视也产生了积极影响（OR 0.84，95%CI 0.74 至 0.95）。最后，农村地区的居民略高的缺铁食物缺乏几率（OR 1.12，95%CI 1.10 至 1.28）。
根据研究结果，针对撒哈拉以南非洲地区铁缺乏食物的干预措施应充分考虑本研究强调的关键决定因素。
