Poor complementary feeding practices and high anaemia prevalence among infants and young children in rural central and western China

Hipgrave, David; Fu, Xulan; Zhou, Hong; Jin, Yan; Wang, X; Chang, Suying; Scherpbier, Robert; Wang, Y; Guo, Sufang

doi:10.1038/ejcn.2014.98

Cited by 57 publications

(54 citation statements)

References 39 publications

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“…This is consistent with previous studies [52–54], revealing that low frequency of child complementary feeding practice increased the risk of anemia. After six months, the introduction of complementary feeding is a recommended practice to adequately support the daily nutritional requirement of children.…”

Section: Discussionsupporting

confidence: 93%

Anemia severity among children aged 6–59 months in Gondar town, Ethiopia: a community-based cross-sectional study

et al. 2018

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BackgroundAnemia is a public health problem affecting both developed and developing countries. Childhood anemia is associated with serious consequences including growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Hence, this study aimed at assessing the prevalence and factors associated with severity of anemia among children aged 6–59 months in Gondar town, northwest Ethiopia.MethodA community-based cross-sectional study was conducted. A multi-stage sampling technique was employed to select study participants. Socio demographic and socioeconomic data were collected using a pre-tested structured questionnaire. Anthropometric measurements were taken as per WHO recommendation. Hemoglobin (Hb) concentration was measured using a portable HemoCue301 instrument (A Quest Diagnostic Company, Sweden). Mild anemia corresponds to a level of adjusted Hb of 10.0–10.9 g/dl; moderate anemia corresponds to a level of 7.0–9.9 g/dl, while severe anemia corresponds to a level less than 7.0 g/dl. Descriptive statistics were used to describe the study participants. Both bivariable and multivariable ordinal logistic regression were done, and proportional odds ratio (POR) with a 95% confidence interval (CI) was reported to show the strength of association. A p-value < 0.05 was considered statistically significant.ResultOut of the total of 707 children included in this study, more than half (53.5%) of them were male. The median age of children was 30 months. Two hundred two (28.6%) of children were anemic: 124(17.5%) were mildly anemic, 73(10.3%) were moderately anemic, and 5 (0.7%) were severely anemic. The young age of the child, low frequency of child complementary feeding per day, primary maternal educational status, unmarried maternal marital status, and home delivery were factors associated with severity of childhood anemia.ConclusionAnemia among children aged 6–59 months in Gondar Town was a moderate public health problem. Improving access to education, providing regular health education about childcare and child feeding practices, strengthening the socioeconomic support for single-parent families and conducting regular community-based screening are recommended to reduce childhood anemia.

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Section: Discussionsupporting

confidence: 93%

Anemia severity among children aged 6–59 months in Gondar town, Ethiopia: a community-based cross-sectional study

et al. 2018

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“…It is possible that the structural equation model used in the present study, which involved only three continuous variables that could not be treated as one latent variable due to their poor correlations, may have played a role in this discrepancy. The incidence of anaemia among children was alarmingly high in the present sample, as in a previous study 47. This issue constitutes a severe public health problem,48 and likely has a significant impact on child growth and development 4 5 49.…”

Section: Discussionsupporting

confidence: 63%

Factors influencing developmental delay among young children in poor rural China: a latent variable approach

Zhang

Guo²,

Liu

et al. 2018

BMJ Open

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ObjectivesThe aims of the study were to determine the prevalence of suspected developmental delay in children living in poor areas of rural China and to investigate factors influencing child developmental delay.DesignA community-based, cross-sectional survey was conducted.Eighty-three villages in Shanxi and Guizhou Provinces, China.ParticipantsA total of 2514 children aged 6–35 months and their primary caregivers.Outcome measuresSuspected child developmental delay was evaluated using the Ages & Stages Questionnaires-Chinese version. Caregivers’ education and age, wealth index, child feeding index, parent-child interaction, number of books and Zung Self-Rating Depression Scale were reported by the primary caregivers. Haemoglobin levels were measured using a calibrated, automated analyser. Birth weight was obtained from medical records.ResultsOverall, 35.7% of the surveyed children aged 6–35 months demonstrated suspected developmental delay. The prevalence of suspected developmental delay was inversely associated with age, with the prevalence among young children aged 6–11 months being almost double that of children aged 30–35 months (48.0% and 22.8%, respectively). Using a structural equation model, it was demonstrated that caregiver’s care and stimulus factors and child’s haemoglobin level were directly correlated, while caregiver’s sociodemographic factors were indirectly associated with suspected developmental delay.ConclusionsThe prevalence of suspected developmental delay is high in poor rural areas of China, and appropriate interventions to improve child development are needed.

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“…Among Latin American countries in a recent review, Bolivia has the highest national prevalence of anemia among preschoolers (6–59-month-olds; 61%; Mujica-Coopman et al, 2015), and so it is perhaps not surprising that our study also showed an extremely high prevalence of anemia in infants, despite our adjustment for the high altitude of the study setting. Comparably high anemia prevalence has also been previously shown in low-resource Chinese infants and toddlers (51–60% of 6–17-month olds (Hipgrave et al, 2014; Luo et al, 2014)), whereas high IDA has also been found in Saudi Arabian infants (49% at 6–24 months of age; Al Hawsawi et al, 2015). Overall, these comparisons suggest that our population showed a high prevalence of ID, IDA, and anemia even among other low-resource populations.…”

Section: Discussionmentioning

confidence: 50%

Early deterioration of iron status among a cohort of Bolivian infants

Burke

Rebolledo

Aceituno

et al. 2016

Maternal & Child Nutrition

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Iron deficiency (ID) and iron deficiency anemia (IDA) are major contributors to infant and maternal morbidity worldwide. There is limited longitudinal data on iron status in young infants and on methods to adjust iron biomarkers for inflammation. We aimed to quantify the prevalence of inflammation-adjusted ID, anemia, and IDA over the first year in a cohort of Bolivian infants and their mothers. Healthy mother-infant dyads were recruited from two peri-urban hospitals. Infants provided three blood draws (2, 6-8, and 12-18 months; N = 160); mothers provided two blood draws (1 and 6-8 months postpartum [plus third anemia measurement at 12-18 months]; N = 250). Blood was analyzed for hemoglobin, ferritin, soluble transferrin receptor, C-reactive protein (CRP), and alpha(1)-acid glycoprotein (AGP). Iron biomarkers were adjusted for inflammation using CRP and AGP; hemoglobin cutoffs were adjusted for altitude. Inflammation (elevated CRP or AGP) was 17% among toddlers 12-18 months of age. ID (inflammation-adjusted ferritin) increased with age (<1%, 56%, and 79% at each blood draw), as did anemia and IDA Correspondence: Rachel M. Burke, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Claudia Nance Rollins Building, 1518 Clifton Rd. NE Atlanta, GA, 30322, USA. rachel.m.burke@gmail.com. CONFLICTS OF INTERESTBurke, Rebolledo, Fabiszewski de Aceituno, Revollo, Iñiguez, Klein, Drews-Botsch, Leon, Suchdev: no conflicts of interest. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. CONTRIBUTIONS PS, JL, CDB, MK, VI, AFdA, PAR, and RMB designed the research. PS, JS, AFdA, PAR, RR, VI, and RMB conducted the research. RMB analyzed the data. RMB, PS, and JS wrote the paper and had primary responsibility for final content. All authors have read and approved the final manuscript. SUPPORTING INFORMATIONAdditional Supporting Information may be found online in the supporting information tab for this article. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript (anemia: 70%, 76%, and 81%; IDA: <1%, 46%, and 68%). Maternal ID declined from the first to second assessment (39% vs. 27%). Inflammation-adjusted ID prevalence was up to 15 percentage points higher than unadjusted estimates. The high prevalence of ID, anemia, and IDA in this cohort of Bolivian infants beginning at 6-8 months of age suggests that early interventions may be necessary in vulnerable populations. Keywordsanemia; global micronutrient malnutrition; infant nutrition; iron deficiency; iron deficiency anemia; micronutrient deficiencies | INTRODUCTIONIron deficiency (ID), which can progress into iron deficiency anemia (IDA) if uncorrected, is one of the most common micronutrient deficiencies globally: an estimated 40% of children under 5% and 38% of pregnant women worldwide suffer from ID (Camaschella, 2015). ID and IDA can have especially severe consequences in youn...

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Poor complementary feeding practices and high anaemia prevalence among infants and young children in rural central and western China

Cited by 57 publications

References 39 publications

Anemia severity among children aged 6–59 months in Gondar town, Ethiopia: a community-based cross-sectional study

Anemia severity among children aged 6–59 months in Gondar town, Ethiopia: a community-based cross-sectional study

Factors influencing developmental delay among young children in poor rural China: a latent variable approach

Early deterioration of iron status among a cohort of Bolivian infants

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