Factors associated with anemia in young children in Brazil

• Published in: PloS one 2018-09, Vol.13 (9), p.e0204504-e0204504
• Main Authors: da Silva, Lara Livia Santos, Fawzi, Wafaie Wahib, Cardoso, Marly Augusto
• Format: Article
• Language: English
• Subjects: Age; Anemia; Anemia - blood; Anemia - epidemiology; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - epidemiology; Bioavailability; Biology and Life Sciences; Brazil - epidemiology; Child, Preschool; Children; Confidence intervals; Cross-Sectional Studies; Demographic aspects; Diet; Feeding; Female; Folic acid; Fruit; Health care; Hemoglobin; Humans; Independent variables; Infant; Infant Food; Infant Nutritional Physiological Phenomena; Infections; Iron; Iron - blood; Iron Deficiencies; Low income groups; Male; Maternal & child health; Medicine and Health Sciences; Morbidity; Nutrition; Pediatric anemia; Pediatrics; People and places; Physical sciences; Poisson density functions; Population; Preschool children; Prevalence; Prevention; Primary care; Public health; Regression analysis; Regression models; Risk Factors; Statistical analysis; Studies; Tropical diseases; Vegetables; Working groups
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0204504

Anemia is recognized as a major public health problem in childhood, especially in children under 24 months of age. Despite improvements in public health strategies to prevent and control anemia in Brazilian young children in the last decade, few studies have assessed the predictors for this condition in primary health care. Thus, this study aimed to assess the associated factors of anemia in young children who visited primary public health care facilities in Brazil. A cross-sectional study was conducted with 520 children aged 11 to 15 months who visited the primary health care in four Brazilian cities. Anemia was defined as hemoglobin concentration < 110 g/L in venous blood samples. Multilevel Poisson regression models were used to describe the associations between anemia and independent variables. The frequency of anemia was 23.1%. A higher frequency was observed in children who live with more than one other child younger than 5 years in the house (Prevalence Ratio [PR] 1.47; 95% Confidence Interval [CI] 1.01-2.14), who started to receive fruits and vegetables after 8 months of age (PR 1.92; 95% CI 1.19-3.10), who were stunted (PR 2.44; 95% CI 1.32-4.50), who were hospitalized at least once in their life (PR 1.55; 95% CI 1.03-2.33) and who were in the lower tertile of serum folate concentration (PR 2.24; 95% CI 1.30-3.85). Inadequate complementary feeding practices and morbidity were the main predictors for anemia in early childhood in this population. Improvements in current strategies to promote healthy complementary feeding along with better control of morbidities are recommended to reduce anemia in Brazilian young children.