Skip to main content
Top
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Prevalence and factors associated with anaemia among children aged 6 to 59 months in Namutumba district, Uganda: a cross- sectional study

Authors: Fiona Kuziga, Yeka Adoke, Rhoda K. Wanyenze

Published in: BMC Pediatrics | Issue 1/2017

Login to get access

Abstract

Background

Anaemia is one of the major causes of death among children under five years in Africa, with a prevalence of 64.6% among pre-school children. In 2014, we conducted a cross-sectional study in Namutumba district in East-central Uganda to determine the prevalence and factors associated with anaemia among children aged 6 to 59 months.

Methods

We conducted a household survey in 376 randomly selected households. One child aged 6 to 59 months was randomly sampled from each selected household. A structured questionnaire administered to an adult caregiver was used to collect household data. Blood was collected by finger or heel prick to estimate the haemoglobin level using a portable haemocue analyser. Anthropometric data including age, weight and height was collected for each child. A modified poisson regression model was used to determine the correlates of anaemia, prevalence ratios and their 95% confidence intervals (CI).

Results

The prevalence of anaemia was high (58.8%) and was highest among children aged 12 to 23 months (68.5%) and males (61.3%). About 27.7% children were stunted. Children aged 6–11 and 12–23 months were more likely to be anaemic (APR = 1.12; 95% CI: 1.05–1.19 and APR = 1.12; 95% CI: 1.00–1.24 respectively), Resident of Magada and Namutumba (urban areas) were less likely to be anaemic (APR = 0.89; 95% CI: 0.87–0.91and APR = 0.86; 95% CI: 0. 85–0.88 respectively). Children of caretakers of a big family size (seven or more children) and with any formal education were less likely to be anaemic (APR = 0.94; 95% CI: 0.89–0.99 and APR = 0.93; 95% CI: 0.87–0.99). Stunting (HAZ scores) was a predictor of anaemia (APR = 1.07; 95% CI: 1.02–1.12).

Conclusion

Anaemia is highly prevalent among children and there is need to invest in measures to prevent anaemia, especially among children in the rural areas.
Literature
1.
go back to reference Leal LP, Batista Filho M, Lira PIC, Figueiroa JN, Osório MM. Prevalence of anemia and associated factors in children aged 6–59 months in Pernambuco, Northeastern Brazil. Rev Saude Publica. 2011;45(3):457–66.CrossRefPubMed Leal LP, Batista Filho M, Lira PIC, Figueiroa JN, Osório MM. Prevalence of anemia and associated factors in children aged 6–59 months in Pernambuco, Northeastern Brazil. Rev Saude Publica. 2011;45(3):457–66.CrossRefPubMed
2.
go back to reference Cardoso MA, Scopel KK, Muniz PT, Villamor E, Ferreira MU. Underlying factors associated with anemia in Amazonian children: a population-based, cross-sectional study. PLoS One. 2012;7(5):e36341.CrossRefPubMedPubMedCentral Cardoso MA, Scopel KK, Muniz PT, Villamor E, Ferreira MU. Underlying factors associated with anemia in Amazonian children: a population-based, cross-sectional study. PLoS One. 2012;7(5):e36341.CrossRefPubMedPubMedCentral
3.
go back to reference Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
4.
go back to reference McLean E, de Benoist B, Egli I, Cogswell M, Wojdyla D. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005: Global database on anaemia. Public Health Nutr. 2008;12(4):444–54.CrossRefPubMed McLean E, de Benoist B, Egli I, Cogswell M, Wojdyla D. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005: Global database on anaemia. Public Health Nutr. 2008;12(4):444–54.CrossRefPubMed
5.
go back to reference Schellenberg D, Schellenberg JR, Mushi A, Savigny D, Mgalula L, Mbuya C, Victora CG. The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Org. 2003;81(8):581–90.PubMedPubMedCentral Schellenberg D, Schellenberg JR, Mushi A, Savigny D, Mgalula L, Mbuya C, Victora CG. The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Org. 2003;81(8):581–90.PubMedPubMedCentral
6.
go back to reference Shaw JG, Friedman JF. Iron deficiency anemia: focus on infectious diseases in lesser developed countries. Anemia. 2011;2011:10.CrossRef Shaw JG, Friedman JF. Iron deficiency anemia: focus on infectious diseases in lesser developed countries. Anemia. 2011;2011:10.CrossRef
7.
go back to reference Kiguli S, Maitland K, George EC, Olupot-Olupot P, Opoka RO, Engoru C, Akech SO, Nyeko R, Mtove G, Reyburn H, et al. Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness. BMC Med. 2015;13:21.CrossRefPubMedPubMedCentral Kiguli S, Maitland K, George EC, Olupot-Olupot P, Opoka RO, Engoru C, Akech SO, Nyeko R, Mtove G, Reyburn H, et al. Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness. BMC Med. 2015;13:21.CrossRefPubMedPubMedCentral
8.
go back to reference Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369(9556):145–57.CrossRefPubMed Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369(9556):145–57.CrossRefPubMed
9.
go back to reference Kikafunda JK, Lukwago FB, Turyashemererwa F. Anaemia and associated factors among under-fives and their mothers in Bushenyi district, Western Uganda. Public Health Nutr. 2009;12(12):2302.CrossRefPubMed Kikafunda JK, Lukwago FB, Turyashemererwa F. Anaemia and associated factors among under-fives and their mothers in Bushenyi district, Western Uganda. Public Health Nutr. 2009;12(12):2302.CrossRefPubMed
10.
go back to reference Crawley J. Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. Am J Trop Med Hyg. 2004;71(2 Suppl):25–34.PubMed Crawley J. Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. Am J Trop Med Hyg. 2004;71(2 Suppl):25–34.PubMed
11.
go back to reference Uganda Bureau of Statistics (UBOS), ICF. I. Uganda demographic and health survey 2011. Kampala: UBOS and Calverton, Maryland ICF International Inc; 2012. Uganda Bureau of Statistics (UBOS), ICF. I. Uganda demographic and health survey 2011. Kampala: UBOS and Calverton, Maryland ICF International Inc; 2012.
12.
go back to reference MOH U, ACF. Nutrition survey report namutumba district, Uganda. Kampala: Ministry of Health Uganda; 2011. MOH U, ACF. Nutrition survey report namutumba district, Uganda. Kampala: Ministry of Health Uganda; 2011.
13.
go back to reference Bhaskaram P, Balakrishna N, Radhakrishna KV, Krishnaswamy K. Validation of hemoglobin estimation using hemocue. Indian J Pediatr. 2003;70(1):25–8.CrossRefPubMed Bhaskaram P, Balakrishna N, Radhakrishna KV, Krishnaswamy K. Validation of hemoglobin estimation using hemocue. Indian J Pediatr. 2003;70(1):25–8.CrossRefPubMed
14.
go back to reference WHO, UNICEF, UNU. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. Geneva: World Health Organization; 2001. WHO, UNICEF, UNU. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. Geneva: World Health Organization; 2001.
15.
go back to reference Group WMGRS. WHO child growth standards:length/height-for-Age, weight-for-Age, weight-for-length, weight-for-height and body mass index-for-Age: methods and development. Geneva: Group WMGRS; 2006. Group WMGRS. WHO child growth standards:length/height-for-Age, weight-for-Age, weight-for-length, weight-for-height and body mass index-for-Age: methods and development. Geneva: Group WMGRS; 2006.
16.
go back to reference Thompson ML, Myers JE, Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med. 1998;55(4):272–7.CrossRefPubMedPubMedCentral Thompson ML, Myers JE, Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med. 1998;55(4):272–7.CrossRefPubMedPubMedCentral
17.
go back to reference Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRefPubMedPubMedCentral Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRefPubMedPubMedCentral
18.
go back to reference WFP: Food Consumption Analysis: Calculation and use of the food consumption score in food security analysis, in Strengthening Emergency Needs Assessment Capacity, V. unit,.In. Rome: Editor World Food Programme; 2008. WFP: Food Consumption Analysis: Calculation and use of the food consumption score in food security analysis, in Strengthening Emergency Needs Assessment Capacity, V. unit,.In. Rome: Editor World Food Programme; 2008.
19.
go back to reference Crawley J. Reducing the burden of anaemia in infants and young children in malaria- endemic countries of Africa: From evidence to action. Am J Trop Med Hyg. 2004;71(2):25–34.PubMed Crawley J. Reducing the burden of anaemia in infants and young children in malaria- endemic countries of Africa: From evidence to action. Am J Trop Med Hyg. 2004;71(2):25–34.PubMed
20.
go back to reference Habte D, Asrat K, Magafu MG, Ali IM, Benti T, Abtew W, Tegegne G, Abera D, Shiferaw S. Maternal risk factors for childhood anaemia in Ethiopia. Afr J Reprod Health. 2013;17(3):110–8.PubMed Habte D, Asrat K, Magafu MG, Ali IM, Benti T, Abtew W, Tegegne G, Abera D, Shiferaw S. Maternal risk factors for childhood anaemia in Ethiopia. Afr J Reprod Health. 2013;17(3):110–8.PubMed
21.
go back to reference Ngnie-Teta I, Receveur O, Kuate-Defo B. Risk factors for moderate to severe anemia among children in Benin and Mali: insights from a multilevel analysis. Food Nutr Bull. 2007;28(1):76–89.CrossRefPubMed Ngnie-Teta I, Receveur O, Kuate-Defo B. Risk factors for moderate to severe anemia among children in Benin and Mali: insights from a multilevel analysis. Food Nutr Bull. 2007;28(1):76–89.CrossRefPubMed
22.
go back to reference Rawat R, Saha KK, Kennedy A, Rohner F, Ruel M, Menon P. Anaemia in infancy in rural Bangladesh: contribution of iron deficiency, infections and poor feeding practices. Br J Nutr. 2014;111(1):172–81.CrossRefPubMed Rawat R, Saha KK, Kennedy A, Rohner F, Ruel M, Menon P. Anaemia in infancy in rural Bangladesh: contribution of iron deficiency, infections and poor feeding practices. Br J Nutr. 2014;111(1):172–81.CrossRefPubMed
23.
go back to reference Tine RCK, Faye B, Ndour CT, Sylla K, Sow D, Ndiaye M, Ndiaye JL, Magnussen P, Alifrangis M, Bygbjerg IC, et al. Parasitic infections among children under five years in Senegal: prevalence and effect on anaemia and nutritional status. ISRN Parasitol. 2013;2013:6.CrossRef Tine RCK, Faye B, Ndour CT, Sylla K, Sow D, Ndiaye M, Ndiaye JL, Magnussen P, Alifrangis M, Bygbjerg IC, et al. Parasitic infections among children under five years in Senegal: prevalence and effect on anaemia and nutritional status. ISRN Parasitol. 2013;2013:6.CrossRef
24.
go back to reference Ekiz C, Agaoglu L, Karakas Z, Gurel N, Yalcin I. The effect of iron deficiency anemia on the function of the immune system. Hematol J. 2005;5(7):579–83.CrossRefPubMed Ekiz C, Agaoglu L, Karakas Z, Gurel N, Yalcin I. The effect of iron deficiency anemia on the function of the immune system. Hematol J. 2005;5(7):579–83.CrossRefPubMed
25.
go back to reference Xiaoliang Y, Rongwei Y, Junchi Z, Lei J, Jianmeng L, Ren A. The relationship between anemia and physical development among children at the ages of 3–6 years in 21 counties of China. Wei Sheng Yan Jiu. 2009;38(6):688–91.PubMed Xiaoliang Y, Rongwei Y, Junchi Z, Lei J, Jianmeng L, Ren A. The relationship between anemia and physical development among children at the ages of 3–6 years in 21 counties of China. Wei Sheng Yan Jiu. 2009;38(6):688–91.PubMed
26.
go back to reference Ayoya MA, Ngnie-Teta I, Raphin MN, Mamadoultaibou A, Boldon E, Saint-Fleur JE, Koo L, Bernard S. Prevalence and risk factors of anemia among children 6 to 59 months Old in Haiti. Anemia. 2013;2013:3.CrossRef Ayoya MA, Ngnie-Teta I, Raphin MN, Mamadoultaibou A, Boldon E, Saint-Fleur JE, Koo L, Bernard S. Prevalence and risk factors of anemia among children 6 to 59 months Old in Haiti. Anemia. 2013;2013:3.CrossRef
27.
go back to reference Leite M, Cardoso A, Coimbra C, Welch J, Gugelmin S, Lira PC, Horta B, Santos R, Escobar A. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People’s Health and Nutrition. Nutr J. 2013;12(1):69.CrossRefPubMedPubMedCentral Leite M, Cardoso A, Coimbra C, Welch J, Gugelmin S, Lira PC, Horta B, Santos R, Escobar A. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People’s Health and Nutrition. Nutr J. 2013;12(1):69.CrossRefPubMedPubMedCentral
28.
go back to reference Paudel R, Pradhan B, Wagle RR, Pahari DP, Onta SR. Risk factors for stunting among children: a community based case control study in Nepal. Kathmandu Univ Med J. 2012;10(39):18–24. Paudel R, Pradhan B, Wagle RR, Pahari DP, Onta SR. Risk factors for stunting among children: a community based case control study in Nepal. Kathmandu Univ Med J. 2012;10(39):18–24.
29.
go back to reference Branca F, Ferrari M. Impact of micronutrient deficiencies on growth: the stunting syndrome. Ann Nutr Metab. 2002;46 Suppl 1:8–17.CrossRefPubMed Branca F, Ferrari M. Impact of micronutrient deficiencies on growth: the stunting syndrome. Ann Nutr Metab. 2002;46 Suppl 1:8–17.CrossRefPubMed
30.
go back to reference Santos RF, Gonzalez ESC, Albuquerque EC, Arruda IKG, Diniz AS, Figueroa JN, Pereira APC. Prevalence of anemia in under five-year-old children in a children’s hospital in Recife, Brazil. Rev Bras Hematol Hemoter. 2011;33(2):100–4.CrossRefPubMedPubMedCentral Santos RF, Gonzalez ESC, Albuquerque EC, Arruda IKG, Diniz AS, Figueroa JN, Pereira APC. Prevalence of anemia in under five-year-old children in a children’s hospital in Recife, Brazil. Rev Bras Hematol Hemoter. 2011;33(2):100–4.CrossRefPubMedPubMedCentral
31.
go back to reference Ehrhardt S, Burchard G, Mantel C, Cramer J, Kaiser S, Kubo M, Otchwemah R, Bienzle U, Mockenhaupt F. Malaria, anemia, and malnutrition in african children--defining intervention priorities. J Infect Dis. 2006;194:108–14.CrossRefPubMed Ehrhardt S, Burchard G, Mantel C, Cramer J, Kaiser S, Kubo M, Otchwemah R, Bienzle U, Mockenhaupt F. Malaria, anemia, and malnutrition in african children--defining intervention priorities. J Infect Dis. 2006;194:108–14.CrossRefPubMed
32.
go back to reference Uganda Bureau of Statistics (UBOS), ICF. I. Uganda Malaria Indicator Survey 2014–15. Kampala, Uganda, and Rockville, Maryland: UBOS and ICF International; 2015. Uganda Bureau of Statistics (UBOS), ICF. I. Uganda Malaria Indicator Survey 2014–15. Kampala, Uganda, and Rockville, Maryland: UBOS and ICF International; 2015.
33.
go back to reference Thorne CJ, Roberts LM, Edwards DR, Haque MS, Cumbassa A, Last AR. Anaemia and malnutrition in children aged 0–59 months on the Bijagos Archipelago, Guinea-Bissau, West Africa: a cross-sectional, population-based study. Paediatr Int Child Health. 2013;33(3):151–60.CrossRefPubMed Thorne CJ, Roberts LM, Edwards DR, Haque MS, Cumbassa A, Last AR. Anaemia and malnutrition in children aged 0–59 months on the Bijagos Archipelago, Guinea-Bissau, West Africa: a cross-sectional, population-based study. Paediatr Int Child Health. 2013;33(3):151–60.CrossRefPubMed
34.
go back to reference Pita GM, Jimenez S, Basabe B, Garcia RG, Macias C, Selva L, Hernandez C, Cruz M, Herrera R, O’Farrill R, et al. Anemia in children under five years old in Eastern Cuba, 2005–2011. MEDICC Rev. 2014;16(1):16–23.PubMed Pita GM, Jimenez S, Basabe B, Garcia RG, Macias C, Selva L, Hernandez C, Cruz M, Herrera R, O’Farrill R, et al. Anemia in children under five years old in Eastern Cuba, 2005–2011. MEDICC Rev. 2014;16(1):16–23.PubMed
35.
go back to reference Oliveira MA, Osorio MM, Raposo MC. Socioeconomic and dietary risk factors for anemia in children aged 6 to 59 months. J Pediatr. 2007;83(1):39–46.CrossRef Oliveira MA, Osorio MM, Raposo MC. Socioeconomic and dietary risk factors for anemia in children aged 6 to 59 months. J Pediatr. 2007;83(1):39–46.CrossRef
36.
go back to reference Abubakar A, Uriyo J, Msuya SE, Swai M, Stray-Pedersen B. Prevalence and risk factors for poor nutritional status among children in the Kilimanjaro region of Tanzania. Int J Environ Res Public Health. 2012;9(10):3506–18.CrossRefPubMedPubMedCentral Abubakar A, Uriyo J, Msuya SE, Swai M, Stray-Pedersen B. Prevalence and risk factors for poor nutritional status among children in the Kilimanjaro region of Tanzania. Int J Environ Res Public Health. 2012;9(10):3506–18.CrossRefPubMedPubMedCentral
37.
go back to reference Conde-Agudelo A, Rosas-Bermudez A, Castano F, Norton MH. Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms. Stud Fam Plann. 2012;43(2):93–114.CrossRefPubMed Conde-Agudelo A, Rosas-Bermudez A, Castano F, Norton MH. Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms. Stud Fam Plann. 2012;43(2):93–114.CrossRefPubMed
38.
go back to reference Finlay JE, Ozaltin E, Canning D. The association of maternal age with infant mortality, child anthropometric failure, diarrhoea and anaemia for first births: evidence from 55 low- and middle-income countries. BMJ Open. 2011;1(2):e000226.CrossRefPubMedPubMedCentral Finlay JE, Ozaltin E, Canning D. The association of maternal age with infant mortality, child anthropometric failure, diarrhoea and anaemia for first births: evidence from 55 low- and middle-income countries. BMJ Open. 2011;1(2):e000226.CrossRefPubMedPubMedCentral
Metadata
Title
Prevalence and factors associated with anaemia among children aged 6 to 59 months in Namutumba district, Uganda: a cross- sectional study
Authors
Fiona Kuziga
Yeka Adoke
Rhoda K. Wanyenze
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0782-3

Other articles of this Issue 1/2017

BMC Pediatrics 1/2017 Go to the issue