The changing importance of key factors associated with anaemia in 6- to 59-month-old children in a sub-Saharan African setting where malaria is on the decline: analysis of the Rwanda Demographic and Health Survey 2010


Nkulikiyinka, Richard; Binagwaho, Agnes; Palmer, Katie; (2015) The changing importance of key factors associated with anaemia in 6- to 59-month-old children in a sub-Saharan African setting where malaria is on the decline: analysis of the Rwanda Demographic and Health Survey 2010. Tropical Medicine & International Health, 20 (12). pp. 1722-1732. ISSN 13602276 DOI: https://doi.org/10.1111/tmi.12604

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Abstract

objective To estimate the relative contribution of malaria and other potential determinants tocurrent anaemia prevalence in Rwanda.methods The database for this study was the Rwanda Demographic and Health Survey 2010.Haemoglobin and malaria test results, and additional exposures ascertained through mothers’interviews, were analysed for all eligible children age 6–59 months (n = 4068), in addition to dietdata available for the youngest under 5-year-old per household. We examined anaemia-exposureassociations through forward logistic regression, first for the overall population (n = 3685), andsecond, for the subpopulation with diet data (n = 1934).results In the overall study population, malaria was strongly associated with anaemia (OR = 6.83,95% CI: 2.90–16.05), but population impact was modest (population-attributable fraction = 2.5%).Factors associated with lower odds of anaemia were recent de-worming medication (six months;OR = 0.60, 95% CI: 0.49–0.74), female sex (OR = 0.76, 95% CI: 0.66–0.87), increasing age,residence in North Province and educated mother. Being underweight and recent fever (two weeks)were associated with higher odds. In the subpopulation with diet data, odds were lower withconsumption of vitamin A-rich foods (OR = 0.66, 95% CI: 0.50–0.88); and higher in householdswith many young children.conclusions Malaria remains a strong determinant of anaemia for the individual child:transmission control efforts must be maintained. At population level, to further reduce anaemiaprevalence, promoting regular vitamin A intake from natural sources and reducing intestinalhelminths burden appear the most promising strategies to explore; exploring potential hithertounidentified sex-linked factors is warranted.

Item Type: Article
Faculty and Department: Distance Learning
Academic Services & Administration > Distance Learning
Funders: Bayer Healthcare
PubMed ID: 26425794
URI: http://researchonline.lshtm.ac.uk/id/eprint/2528136

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