Burden and clustering of anaemia among children aged 6-59 months in Uttar Pradesh, India: a district-level spatial analysis
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243662Keywords:
Anaemia, Uttar Pradesh, Children aged 6-59 months, IndiaAbstract
Background: In the previous decade, India held the position of being the foremost contributor to childhood anemia among developing nations. In India, 89 million children aged 6-59 months suffer from anaemia. The study attempts to examine the spatial prevalence and detect the clustering of anaemia in Uttar Pradesh and also tries to identify the determinants of anaemia among children aged 6-59 months.
Methods: The study utilized secondary data from the national family health survey-5 conducted in 2019-2021. It employed spatial analysis software, including ArcGIS 10.8 and GeoDa 1.22, incorporating Moran's index. The assessment of factors predicting the prevalence of anemia among children involved the application of a logistic regression model using STATA-17, considering socio-economic, demographic, maternal, and child characteristics.
Results: The anaemia prevalence is highest in Kanshiram Nagar and lowest in Allahabad districts. A total of 38 districts of Uttar Pradesh have more than national level average (67.1%-NFHS-5) of anaemia. Results also shows that 66.7% and 65.3% children 6-59 months age group were anaemic in urban and rural areas respectively. Around 70.7 % of children belonging to poorest wealth status and 69.4% of children who lived in rural areas were anaemic. Increase of mothers age, education, receipt of full ANC and richer wealth status reduce the risk of childhood anaemia.
Conclusions: The correlation between anemia in preschool-aged children and various socioeconomic factors was significant. The research proposes directing efforts towards districts in Uttar Pradesh identified as hot-spots with a higher prevalence of anemia.
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References
Kassebaum NJ. The Global Burden of Anemia. Hematol Oncol Clin N Am. 2016;30(2):247-308.
Gardner WM, Razo C, McHugh TA, Hagins H, Vilchis-Tella VM, Hennessy C, et al. Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(9):e713-34.
World Health Organization. Anaemia Factsheet. 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/anaemia. Accessed on 25 September 2024.
Global Health Metrics. Anaemia-Level 1 impairment. Lancet. 2019;393.
Development Initiatives. Global Nutrition Report 2017: Nourishing the SDGs. Bristol, UK: Development Initiatives. 2017.
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16-25.
World Health Organization. WHO Global Nutrition Targets 2025: Anaemia Policy Brief. 2014. Available at: https://www.who.int/nutrition/topics/ globaltargets_anaemia_policybrief.pdf. Accessed on 25 September 2024.
Lokeshwar MR, Mehta M, Mehta N, Shelke P, Babar N. Prevention of Iron Deficiency Anemia (IDA): How Far Have We Reached? Indian J Pediatr. 2011;78(5):593-602.
Pasricha SR, Black J, Muthayya S, Shet A, Bhat V, Nagaraj S, et al. Determinants of Anemia Among Young Children in Rural India. Pediatrics. 2010;126(1):e140-9.
Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:f3443.
Mireku MO, Davidson LL, Koura GK, Ouédraogo S, Boivin MJ, Xiong X, et al. Prenatal Hemoglobin Levels and Early Cognitive and Motor Functions of One-Year-Old Children. Pediatrics. 2015;136(1):e76-83.
Daru J, Zamora J, Fernández-Félix BM, Vogel J, Oladapo OT, Morisaki N, et al. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. The Lancet Global Health. 2018;6(5):e548-54.
World Health Organization. Worldwide prevalence of anaemia 1993-2005 : WHO global database on anaemia. / Edited by Bruno de Benoist, Erin McLean, Ines Egli and Mary Cogswell. 2008;40.
Singh RK, Patra S. Extent of Anaemia among Preschool Children in EAG States, India: A Challenge to Policy Makers. Anemia. 2014;2014:e868752.
Dey S, Goswami S, Dey T. Identifying predictors of childhood anaemia in North-East India. J Heal Population Nutrit. 2013;31(4):462-70.
National Family Health Survey (NFHS-5), 2019-21: India: Volume1. Mumbai: IIPS; 2021.
International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4),2015-16, India. Mumbai: IIPS; 2017.
Goswmai S, Das KK. Socio-economic and demographic determinants of childhood anemia. J Pediatr. 2015;91(5):471-7.
Goswami S, Acharjee R, Dey S. Determinants of anaemia among children aged under five years in Assam, India. Int J Contemp Pediatr. 2020;7(11):2157.
Anselin L. Thirty years of spatial econometrics. Papers Regional Sci. 2010;89(1):3-25.
Anselin L. Exploring spatial data with GeoDaTM: a workbook. Center for spatially integrated social science. 1963;157:2005.
Zhang Q, Qin G, Liu Z, Li Z, Li J, Varma DS, et al. Dietary Balance Index-07 and the Risk of Anemia in Middle Aged and Elderly People in Southwest China: A Cross Sectional Study. Nutrients. 2018;10(2):10.
Tariq H, Kamal MU, Reddy P, Bajantri B, Niazi M, Matela A, et al. Anemia, intractable vomiting, chronic diarrhea, and syndrome of inappropriate antidiuretic secretion: a diagnostic dilemma. Medicine (Baltimore). 2017;96(52):e9229.
Seidelman J, Zuo R, Udayakumar K, Gellad ZF. Caught on Capsule: Iron-deficiency Anemia Due to Hookworm Infection. Am J Med. 2016;129(2):167-9.
Okam MM, Koch TA, Tran MH. Iron Supplementation, Response in Iron-Deficiency Anemia: Analysis of Five Trials. Am J Med. 2017;130(8):991.e1-8.
Bharati S, Pal M, Bharati P. Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4. J Biosocial Sci. 2020;52(1):97-107.
Onyeneho NG, Ozumba BC, Subramanian SV. Determinants of Childhood Anemia in India. Sci Rep. 2019;9(1):16540.
Larson LM, Thomas T, Kurpad AV, Martorell R, Hoddinott J, Adebiyi VO, et al. Predictors of anaemia in mothers and children in Uttar Pradesh, India. Public Health Nutr. 2010;27(1):e30.
Sharma H, Singh SK, Srivastava S. Socio-economic inequality and spatial heterogeneity in anaemia among children in India: Evidence from NFHS-4 (2015-16). Clin Epidemiol Global Heal. 2020;8(4):1158-71.
Dutta M, Bhise M, Prashad L, Chaurasia H, Debnath P. Prevalence and risk factors of anemia among children 6-59 months in India: A multilevel analysis. Clin Epidemiol Global Heal. 2020;8(3):868-78.
Fotso JC, Kuate-Defo B. Socioeconomic inequalities in early childhood malnutrition and morbidity: modification of the household-level effects by the community SES. Health Place. 2005 Sep;11(3):205–25.
Nair KM, Fernandez-Rao S, Nagalla B, Kankipati RV, Punjal R, Augustine LF, et al. Characterisation of anaemia and associated factors among infants and pre-schoolers from rural India. Public Health Nutr. 2016;19(5):861-71.
Patel KK, Vijay J, Mangal A, Mangal DK, Gupta SD. Burden of anaemia among children aged 6-59 months and its associated risk factors in India-Are there gender differences? Children Youth Serv Rev. 2021;122(C):12.
