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Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011-2012.
PLoS One. 2016; 11(5):e0155051.Plos

Abstract

BACKGROUND

Iron deficiency Anemia (IDA) in children is a recognized public health problem that impacts adversely on child morbidity, mortality and impairs cognitive development. In Pakistan information on the true prevalence and predictors of IDA is limited. This study sought to investigate IDA in children under five years of age using data from a nationally representative stratified cross-sectional survey.

METHODS

Secondary analysis was performed on the National Nutrition Survey in Pakistan 2011-2012. We used a pre-structured instrument to collect socio demographic and nutritional data on mothers and children. We also collected Anthropometric measurements and blood samples for micronutrient deficiencies. IDA was defined as having both haemoglobin levels of <110 g/L and ferritin levels of < 12 μg/L. Data analysis was performed by applying univariate and multivariate techniques using logistic regression through SPSS.

FINDINGS

A total of 7138 children aged between 6-59 months were included in the analysis. The prevalence of IDA was 33.2%. In multivariate regression analysis adjusted odds ratios (AOR) were calculated. Age < 24 months (AOR 1.40, 95% CI 1.18-1.55 p <0.05), stunting (AOR 1.42 CI 1.23-1.63 p<0.05), presence of clinical anemia (AOR 5.69 CI 4.93-6.56 p<0.05), having a mother with IDA (AOR 1.72 CI 1.47-2.01 p<0.05) and household food insecurity (AOR 1.20 CI 1.10-1.40 P<0.05) were associated with IDA. Living in a rural area (AOR 0.77 CI 0.65-0.90 p<0.05) and being a female child (AOR 0.87 CI 0.76-0.98 p<0.05) were associated with reduced odds of IDA.

CONCLUSION

The prevalence of IDA amongst Pakistani children represents a moderate burden that disproportionately affects the youngest, growth retarded children, affected children are more likely to have mothers with IDA and live in areas where food security is lacking. National efforts to alleviate the burden of IDA should involve both short term vertical programs such as iron supplementation and long term horizontal programs including wheat flour fortification.

Authors+Show Affiliations

Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia. Women and Child Health Division, Aga Khan University, Karachi, Pakistan.Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.Women and Child Health Division, Aga Khan University, Karachi, Pakistan.Women and Child Health Division, Aga Khan University, Karachi, Pakistan.Women and Child Health Division, Aga Khan University, Karachi, Pakistan.Women and Child Health Division, Aga Khan University, Karachi, Pakistan.Sydney Medical School, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27171139

Citation

Habib, Muhammad Atif, et al. "Prevalence and Predictors of Iron Deficiency Anemia in Children Under Five Years of Age in Pakistan, a Secondary Analysis of National Nutrition Survey Data 2011-2012." PloS One, vol. 11, no. 5, 2016, pp. e0155051.
Habib MA, Black K, Soofi SB, et al. Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011-2012. PLoS One. 2016;11(5):e0155051.
Habib, M. A., Black, K., Soofi, S. B., Hussain, I., Bhatti, Z., Bhutta, Z. A., & Raynes-Greenow, C. (2016). Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011-2012. PloS One, 11(5), e0155051. https://doi.org/10.1371/journal.pone.0155051
Habib MA, et al. Prevalence and Predictors of Iron Deficiency Anemia in Children Under Five Years of Age in Pakistan, a Secondary Analysis of National Nutrition Survey Data 2011-2012. PLoS One. 2016;11(5):e0155051. PubMed PMID: 27171139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011-2012. AU - Habib,Muhammad Atif, AU - Black,Kirsten, AU - Soofi,Sajid Bashir, AU - Hussain,Imtiaz, AU - Bhatti,Zaid, AU - Bhutta,Zulfiqar A, AU - Raynes-Greenow,Camille, Y1 - 2016/05/12/ PY - 2015/11/20/received PY - 2016/04/22/accepted PY - 2016/5/13/entrez PY - 2016/5/14/pubmed PY - 2017/7/14/medline SP - e0155051 EP - e0155051 JF - PloS one JO - PLoS One VL - 11 IS - 5 N2 - BACKGROUND: Iron deficiency Anemia (IDA) in children is a recognized public health problem that impacts adversely on child morbidity, mortality and impairs cognitive development. In Pakistan information on the true prevalence and predictors of IDA is limited. This study sought to investigate IDA in children under five years of age using data from a nationally representative stratified cross-sectional survey. METHODS: Secondary analysis was performed on the National Nutrition Survey in Pakistan 2011-2012. We used a pre-structured instrument to collect socio demographic and nutritional data on mothers and children. We also collected Anthropometric measurements and blood samples for micronutrient deficiencies. IDA was defined as having both haemoglobin levels of <110 g/L and ferritin levels of < 12 μg/L. Data analysis was performed by applying univariate and multivariate techniques using logistic regression through SPSS. FINDINGS: A total of 7138 children aged between 6-59 months were included in the analysis. The prevalence of IDA was 33.2%. In multivariate regression analysis adjusted odds ratios (AOR) were calculated. Age < 24 months (AOR 1.40, 95% CI 1.18-1.55 p <0.05), stunting (AOR 1.42 CI 1.23-1.63 p<0.05), presence of clinical anemia (AOR 5.69 CI 4.93-6.56 p<0.05), having a mother with IDA (AOR 1.72 CI 1.47-2.01 p<0.05) and household food insecurity (AOR 1.20 CI 1.10-1.40 P<0.05) were associated with IDA. Living in a rural area (AOR 0.77 CI 0.65-0.90 p<0.05) and being a female child (AOR 0.87 CI 0.76-0.98 p<0.05) were associated with reduced odds of IDA. CONCLUSION: The prevalence of IDA amongst Pakistani children represents a moderate burden that disproportionately affects the youngest, growth retarded children, affected children are more likely to have mothers with IDA and live in areas where food security is lacking. National efforts to alleviate the burden of IDA should involve both short term vertical programs such as iron supplementation and long term horizontal programs including wheat flour fortification. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27171139/Prevalence_and_Predictors_of_Iron_Deficiency_Anemia_in_Children_under_Five_Years_of_Age_in_Pakistan_A_Secondary_Analysis_of_National_Nutrition_Survey_Data_2011_2012_ L2 - https://dx.plos.org/10.1371/journal.pone.0155051 DB - PRIME DP - Unbound Medicine ER -