Iron deficiency anaemia among 6-to-36-month children from northern Angola

Abstract

Background: Angola is one of the southern African countries with the highest prevalence of anaemia. Identifying anaemia determinants is an important step for the design of evidence-based control strategies. In this study, we aim at documenting the factors associated with Iron Deficiency Anaemia (IDA) in 948 children recruited at the Health Research Center of Angola study area during 2015. Methods: Data on demographic, socioeconomic and parental practices regarding water, sanitation, hygiene, malaria infection and infant and young child feeding were collected, as well as parasitological, biochemical and molecular data. Total and age-stratified multivariate multinomial regression models were fitted to estimate the magnitude of associations between anaemia and its determinants. Results: Anaemia was found in 44.4% of children, of which 46.0% had IDA. Overall, regression models associated IDA with age, gender and inflammation and non-IDA with age, zinc deficiency and overload, P. falciparum infection, sickle cell trait/anaemia. Among 6-to-23-month-old children IDA was associated with continued breastfeeding and among 24-to-36-month-old children IDA was associated with stunting. Furthermore, zinc deficiency was associated with non-IDA among both age groups children. Inflammation was associated with IDA and non-IDA in either 6-to-23 and 24-to-36 months old children. Conclusion: The main variables associated with IDA and non-IDA within this geographic setting were commonly reported in Africa, but not specifically associated with anaemia. Additionally, the associations of anaemia with inflammation, zinc deficiency and infections could be suggesting the occurrence of nutritional immunity and should be further investigated. In age groups, zinc overload was observed to protect under 6 months children from Non-IDA, while continued breastfeeding was associated with increased IDA prevalence in 6-to-23 months children, and stunting was suggested to increase the odds of IDA in 24-to-36 month children. This site-specific aetiology profile provides an essential first set of evidences able to inform the planification of preventive and corrective actions/programs. Nevertheless, regional and country representative data is needed.

Iron deficiency anemia among children aged 2–5 years in southern Ethiopia: a community-based cross-sectional study

“…The discrepancy may be due to age differences and because the socio-economic and dietary practices could vary across the regions. Studies from Rwanda showed a similar result with our findings in the age range 6–59 months ( Rutayisire, Nwaike & Marete, 2019 ), whereas in Angola 46% of anemia cases were because of iron deficiency in children 3–36 months of age ( Fancony et al, 2020 ). Furthermore, a recent review finding indicated that 25% of anemia in young children was because of iron deficiency ( Green et al, 2017 ).…”

“…The variation of proportion of iron deficiency anemia with inflammation adjustment could be explained by the high burden of inflammation among children in the study area ( Engle-Stone et al, 2017 ; Merrill et al, 2017 ). Furthermore, the study shows that inflammation is one of the causes of iron deficiency anemia ( Fancony et al, 2020 ).…”

The Burden of Disease and Risk Factors of Iron Deficiency Anemia in Preschool Children Attending the Well-Baby Clinic in the National Guard Primary Health Care Centers in the Western Region of Saudi Arabia

“…A slightly lower prevalence was found in a harmonious study conducted by Zho et al, showing a prevalence of only 6.2% among preschool children [5]. A higher prevalence of anemia was reported by Fançony et al [6], who stated that anemia was found in 44.4% children. Another higher prevalence of anemia was reported in a study conducted in India by John et al [7], who found that anemia was 30%.…”

Risk factors of anaemia and iron deficiency in Somali children and women: Findings from the 2019 Somalia Micronutrient Survey

“…The association between ID and stunting was observed in children and likely captures the fact that both conditions are caused by poor diets and/or malnutrition. Fançony et al ( 2020 ) found an association between stunting and IDA in northern Angola and speculated that ‘long periods of nutritional restriction’ is potentially the main driver of both IDA and stunting.…”