Anaemia in early childhood among Aboriginal and Torres Strait Islander children of Far North Queensland: a retrospective cohort study

Leonard, Dympna; Büttner, Petra; Thompson, Fintan; Makrides, Maria; McDermott, Robyn

doi:10.1111/1753-6405.12911

Cited by 11 publications

(14 citation statements)

References 40 publications

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“…While the model analysis in this study showed no determination role of gender on anaemia, the role of gender as an anaemia determinant was well documented in many other studies in under 2 years old children which showed a higher risk among boys [3,5,28,29].…”

Section: Discussioncontrasting

confidence: 42%

Anaemia prevalence and determinants in under 5 years children: findings of a cross-sectional population-based study in Sudan

et al. 2020

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Background Early childhood is an age at risk of anaemia and its deleterious consequences. In Sudan, there is limited evidence on the prevalence and determinant of anaemia in under-five children. This study was conducted in Sudan to assess the prevalence of anaemia in children and to identify its determinants. Methods We conducted a household survey involving children aged 6 months to 5 years in November 2016. A representative population was sampled across rural, urban and camps settlements across 18 states in Sudan. We used a pre-designed questionnaire data collection. Haemoglobin (Hb) level and malaria infection were checked. In this cross-sectional study, we dichotomized the outcome variable and performed logistic regression analyses. Results A total of 3094 children under 5 years enrolled in the study, 1566 (50.6%) of them were female and 690 (22.3%) of them were under 2 years old. Anaemia prevalence in the whole cohort (6 months - < 5 years) was 49.4% and the mean haemoglobin concentration was 108.1 (standard deviation (SD): 15.4) g/L. The prevalence in younger (6 months - < 2 years) children (61.9%) was higher than in older (2 - < 5 years) children (45.6%) (p < 0.001). Severe anaemia (Hb < 70 g/L) prevalence in the whole population was 1.6%. Age (Odds ratio (OR) 2.25, 95% confidence interval (95%CI) 1.75–2.90, p < 0.001), type of place of residence (OR 0.37, 95%CI 0.18–0.74, p = 0.005), maternal anaemia (OR 1.74, 95%CI 1.39–2.17, p < 0.001), and malaria infection (OR 2.82, 95%CI 1.56–5.11, p < 0.001) were the identified predictors of anaemia in the whole cohort. In younger children, only the economic class was an anaemia predictor, with a lower anaemia risk among the rich wealth class (OR 2.70, 95%CI 1.29–5.62, p = 0.008). However, in older children, three anaemia predictors were identified. These are maternal anaemia (OR 1.79, 95%CI 1.40–2.28, < 0.001), malaria infection (OR 2.77, 95%CI 1.48–5.21, p = 0.002), and type of residency (where camps’ residents were less likely affected with anaemia than rural children (OR 0.38, 95%CI 0.17–0.87, p = 0.022)). Conclusions About half of the under-5 children in Sudan are anaemic, with worse prevalence in younger children. Efforts targeted at improving socio-economic status, decreasing maternal anaemia and childhood malaria infection may mitigate this alarming trend.

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Section: Discussioncontrasting

confidence: 42%

Anaemia prevalence and determinants in under 5 years children: findings of a cross-sectional population-based study in Sudan

et al. 2020

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“…In settings where the prevalence of early childhood anaemia exceeds 20%, such as Far North Queensland and elsewhere in northern Australia, the World Health Organization recommends interventions that combine nutrition promotion with provision of multi‐micronutrient preparations that include iron, for fortification of complementary food . These interventions have been shown to be safe and effective .…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Anaemia-defined as low haemoglobin-among Aboriginal and Torres Strait Islander women in pregnancy and their children in early life, is prevalent in Far North Queensland and elsewhere in remote northern Australia. [7][8][9][10][11] There are various causes of anaemia including nutrition-related causes (deficiency of iron and/or folate and/or vitamin B12), chronic infections and genetic conditions. 12 Anaemia in the first thousand days is usually caused by iron deficiency due to high iron requirements for the rapidly increasing blood volume and tissue growth of pregnancy and early childhood.…”

Section: Introductionmentioning

confidence: 99%

“…Anaemia—defined as low haemoglobin—among Aboriginal and Torres Strait Islander women in pregnancy and their children in early life, is prevalent in Far North Queensland and elsewhere in remote northern Australia . There are various causes of anaemia including nutrition‐related causes (deficiency of iron and/or folate and/or vitamin B12), chronic infections and genetic conditions…”

Section: Introductionmentioning

confidence: 99%

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Early childhood anaemia more than doubles the risk of developmental vulnerability at school‐age among Aboriginal and Torres Strait Islander children of remote Far North Queensland: Findings of a retrospective cohort study

Leonard

Buettner

Thompson

et al. 2020

Nutrition & Dietetics

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Aims: Early childhood anaemia, usually attributed to iron deficiency, is associated with persistent detrimental effects on child development. This study investigates the association of anaemia between age six and 23 months with indicators of childhood development at school-age among children of remote Aboriginal and Torres Strait Islander communities of Far North Queensland. Methods:The triennial Australian Early Development Census (AEDC) encompasses five domains of early childhood development-physical health and wellbeing, social competence, emotional maturity, language and cognitive skills (school-based), communication skills and general knowledge. AEDC 2012 and 2015 assessments were linked with health information for children and their mothers from remote Aboriginal and Torres Strait Islander communities of Far North Queensland.Results: AEDC assessments were available for 250 children who had measurements of haemoglobin recorded at age 6 to 23 months. More children who had had early childhood anaemia (n = 66/143, 46.2%, [37.9%, 54.4%]) were developmentally vulnerable on two or more domains compared to those who had not been anaemic (n = 25/107, 23.4% [15.2%, 31.5%], P < .001). Multivariable analysis confirmed that early childhood anaemia more than doubled the risk of developmental vulnerability (OR 2.2 [1.1,4.3] P = .020) at school age. Conclusions: Early childhood anaemia is a risk factor for developmental vulnerability at school-age in this setting. Interventions combining nutrition promotion and multi-micronutrient food fortification, are effective in prevention of early childhood anaemia. Such interventions could also improve early childhood development and subsequent educational achievement.

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“…Among children, anaemia can be associated with persistent developmental disadvantage 3,4 . Recent reports from remote settings confirm the continuing high prevalence of anaemia (42%‐61%) among infants and young children during the complementary feeding period (6‐23 months) especially among infants aged 6 to 11 months (57%‐68%) 5‐8 …”

Section: Introductionmentioning

confidence: 97%

The iron content of healthy diets for one day for breastfed babies and young children

Leonard

Buettner

McDermott

et al. 2021

Nutrition & Dietetics

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Aims Early childhood anaemia due to iron deficiency is widespread in remote communities across northern Australia. Current recommendations for healthy food to complement breastfeeding at age 6 to 23 months include iron‐rich and iron‐enriched foods. An electronic nutrient analysis was undertaken to assess the iron content of hypothetical healthy diets for breastfed babies and young children aged 6 to 23 months in Australia, in comparison with their estimated requirements. Methods Hypothetical diets for 1 day were developed that were consistent with the Foundation Diets for breastfed infants 6 to 12 months and for toddlers 13 to 23 months. Nutrient content was derived using the Australian Food Composition database in FoodWorks 10. The iron content of these two diets were compared with Estimated Average Requirements (EARs) and Recommended Dietary Intakes (RDIs) for iron for infants aged 7 to 12 months and children aged 1 to 3 years. Results The iron content of the hypothetical diet for breastfed infants aged 6 to 12 months (5.8 mg) was less than the EAR (7 mg, 83%) and the RDI (11 mg, 53%). For young breastfed children aged 13 to 23 months, the iron content of the hypothetical diet was 4.4 mg; above the EAR (4 mg, 110%) but less than RDI (9 mg, 49%). Conclusions Breastfeeding has health and neurodevelopmental benefits for infants and young children that are particularly important in remote Australia where food insecurity and poor nutrition compromise health and wellbeing. Adequate iron intake is also important for neurodevelopment in early life but healthy diets for breastfed babies and young children may have insufficient iron content to meet requirements. The upcoming revision of the Australian Dietary Guidelines provides an opportunity to consider this issue.

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Anaemia in early childhood among Aboriginal and Torres Strait Islander children of Far North Queensland: a retrospective cohort study

Cited by 11 publications

References 40 publications

Anaemia prevalence and determinants in under 5 years children: findings of a cross-sectional population-based study in Sudan

Anaemia prevalence and determinants in under 5 years children: findings of a cross-sectional population-based study in Sudan

Early childhood anaemia more than doubles the risk of developmental vulnerability at school‐age among Aboriginal and Torres Strait Islander children of remote Far North Queensland: Findings of a retrospective cohort study

The iron content of healthy diets for one day for breastfed babies and young children

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