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

Abstract

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.

How Barunga Aboriginal community implemented and sustained an anaemia program – A case study evaluation

“…Similarly, information was not collected on potential adverse outcomes 78,79 or potential child development benefits of iron supplementation for children at risk of anaemia. 10,80,81 These factors should be considered for monitoring and evaluating future Program implementation.…”

“…2,7 Anaemia reduction in Aboriginal and Torres Strait Islander (Aboriginal hereafter acknowledging that there is cultural diversity throughout Australia) children is an important strategy to improve child health and reach Australian Government "Closing the Gap" targets for Aboriginal child health and development. [9][10][11] Before 2000, anaemia prevalence in Aboriginal children in the Northern Territory (NT) aged between 6 months and 6 years of age was estimated between 42% and 52%. 12 While anaemia prevalence steadily declined to 20% in the NT in 2016 for young children under 5 years of age, it remained high in some communities and age groups.…”

“…4,22 A retrospective cohort study analysing Australian Early Development Census data found that an anaemia diagnosis in Aboriginal children aged 6-23 months in remote Queensland was associated with double the risk of developmental vulnerability during the first year of school. 10 Therefore, addressing and preventing anaemia in Aboriginal children are critical to improve early childhood development and later educational achievement.…”

The first 1000 days: A critical period of nutritional opportunity and vulnerability

“…This issue of Nutrition & Dietetics includes a collection of original nutrition research that spans these critical first 1000 days of life and beyond. In addition to papers related to pregnancy, 7‐10 infancy 11‐13 and the preschool years, 14 there are papers related to schoolchildren, 15 adolescents 16 and young adults 17,18 …”

“…Young children are particularly vulnerable because of their rapidly developing brain, and iron deficiency in early childhood can have lifelong consequences 28 . In this issue, Leonard et al 14 report on the association of early childhood anaemia and developmental outcomes at school age among Aboriginal and Torres Strait Islander children of remote Far North Queensland. They show, in this study, that children who experienced anaemia between 6 and 24 months of age had double the risk of adverse developmental outcomes at school age.…”