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Italian Journal of Pediatrics
Published in: Italian Journal of Pediatrics 1/2018

Open Access 01-12-2018 | Review

Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis

Authors: Mulugeta Melku, Wubet Worku Takele, Degefaye Zelalem Anlay, Daniale Tekelia Ekubagewargies, Zegeye Getaneh, Molla Abebe, Zegeye Abebe

Published in: Italian Journal of Pediatrics | Issue 1/2018

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Abstract

Background

Anemia is one of the global public health problems affecting more than one-third of the world population. It has been strongly associated with limited psychomotor development; and poor growth and performance in cognitive, social, and emotional function in children. Despite published data revealed that anemia is a public health problem among children in Ethiopia, there is no a pooled national estimate on the prevalence and associated risk factors of anemia.

Methods

Published articles until December 31, 2017, were searched using comprehensive search strings through PubMed/Medline, EMBASE, SCOPUS, HINARI, Web of Science, Google Scholar and Google. Reference probing of published articles and hand searching were employed for grey literature. Two groups of review authors independently appraised the studies for eligibility and extracted the data. The quality of articles was assessed using Joana Brigg’s institute critical appraisal checklist for prevalence and analytical studies. The pooled estimates were determined using random effect model. Heterogeneity between the included studies was assessed using the I2 statistics. Subgroup analysis was employed in the evidence of heterogeneity. Publication bias was assessed by visual inspection of the funnel plot and Egger’s regression test statistic.

Results

Of the total 871 articles retrieved, 34 articles which involved 61,748 children were eligible for meta-analysis. The overall pooled prevalence of anemia using random effect model was 31.14% (95% CI: 24.62, 37.66%). In subgroup analysis, the pooled prevalence of anemia was higher among preschool-aged children (44.17%; 95% CI: 37.19, 51.15%) than school-aged children (22.19%; 95% CI: 17.54, 26.83%). Furthermore, the odds of anemia was higher among children who were male (OR = 1.11; 95% CI: 1.03, 1.19), stunted (OR = 1.95; 95% CI: 1.52, 2.51), and wasted (OR = 2.05; 95% CI: 1.36, 3.10).

Conclusion

The pooled prevalence of anemia among children was high, indicating that it had been continuing to be a public health problem. Therefore, there is a need to design a comprehensive prevention and control strategies to reduce its burden.
Appendix
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Literature
1.
WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.
2.
3.
Desalegn A, Mossie A, Gedefaw L. Nutritional iron deficiency anemia: magnitude and its predictors among school age children, Southwest Ethiopia: a community based cross-sectional study. PLoS One. 2014;9(12):e114059.CrossRefPubMedPubMedCentral
4.
Harika R, Faber M, Samuel F, Mulugeta A, Kimiywe J, Eilander A. Are low intakes and deficiencies in Iron, vitamin a, zinc, and iodine of public health concern in Ethiopian, Kenyan, Nigerian, and south African children and adolescents. Food Nutr Bull. 2017;
5.
Walter T. Effect of iron-deficiency anemia on cognitive skills and neuromaturation in infancy and childhood. Food Nutr Bull. 2003;24(4)
6.
WHO. Worldwide prevalence of anaemia 1993–2005. Geneva: World Health Organization; 2008.
7.
Santos JN, Rates SPM, Lemos SMA, Lamounier JA. Consequences of anemia on language development of children from a public day care center. Rev Paul Pediatr. 2009;27(1):67–73.CrossRef
8.
Plessow R, Arora NK, Brunner B, Tzogiou C, Eichler K, Brügger U, et al. Social costs of iron deficiency anemia in 6–59-month-old children in India. PLoS One. 2015;10(8):e0136581.CrossRefPubMedPubMedCentral
9.
Kotecha PV. Nutritional anemia in young children with focus on Asia and India. Indian journal of community medicine: official publication of Indian Association of Preventive & social. Medicine. 2011;36(1):8.
10.
Gutema B, Adissu W, Asress Y, Gedefaw L. Anemia and associated factors among school-age children in Filtu town, Somali region, Southeast Ethiopia. BMC hematol. 2014;14(1):13.CrossRefPubMedPubMedCentral
11.
Alelign T, Degarege A, Erko B. Prevalence and factors associated with undernutrition and anaemia among school children in Durbete town, Northwest Ethiopia. Archives of Public Health. 2015;73:34.CrossRefPubMedPubMedCentral
12.
Getaneh Z, Enawgaw B, Engidaye G, Seyoum M, Berhane M, Abebe Z, et al. Prevalence of anemia and associated factors among school children in Gondar town public primary schools,Northwest Ethiopia:a school based cross-sectiona lstudy. PLoS One. 2017;12(12):e0190151.CrossRefPubMedPubMedCentral
13.
Deribew A, Alemseged F, Tessema F, Sena L, Birhanu Z, Zeynudin A, et al. Malaria and under-nutrition: a community based study among under-five children at risk of malaria, south-West Ethiopia. PLoS One. 2010;5(5):e10775.CrossRefPubMedPubMedCentral
14.
Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton. Maryland: Central Statistical Agency and ICF International. p. 2016.
15.
Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647.CrossRefPubMed
16.
Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and incidence data. Int J Evid Based Healthc. 2015;13(3):147–53.CrossRefPubMed
17.
18.
Higgins J, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.CrossRefPubMed
19.
20.
Fentahun K, Gabre-yohannes E. Risk factors of anemia in children aged 6 to 59 months in Ethiopia. J Ethiopian Stat Assoc. 2014;23:17–28.
21.
Habte D, Asrat K, Magafu MG, Ali IM, Benti T, Abtew W, et al. Maternal risk factors for childhood Anaemia in Ethiopia. Afr J Reprod Health. 2013;17(3):110–8.PubMed
22.
23.
Gashu D, Stoecker BJ, Bougma K, Adish A, Haki GD, Marquis GS. Stunting, selenium deficiency and anemia are associated with poor cognitive performance in preschool children from rural Ethiopia. Nutr J. 2016;15:38.CrossRefPubMedPubMedCentral
24.
Degarege A, Animut A, Medhin G, Legesse M, Erko B. The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from dore Bafeno, southern Ethiopia. J Helminthol. 2014;88:152–9.CrossRefPubMed
25.
26.
Kebede SW, Beyene DA, Meshesha AG, Sinishaw MA. Two thirds of hookworm infected children were anemic at the outpatient department in Jimma Health Center, Jimma, Southwest Ethiopia. Asian Pac J Trop Dis. 2016;6(9):691–4.CrossRef
27.
G/Selassie Y, Tsegaye A, Alemu J, B/Selassie M. Magnitude, Severity and Associated Factors of Anemia among underfive Children attending Hawassa University Teaching and Referral Hospital and Adare Hospital in Hawassa, Southern Ethiopia. 2016.
28.
Herrador Z, Sordo L, Gadisa E, Buno A, Go’mez-Rioja R, Iturzaeta JM, et al. micronutrient deficiencies and related factors in school-aged children in Ethiopia: a cross-sectional study in Libo Kemkem and Fogera districts, Amhara regional state. PLoS One. 2014;9(12):e112858.CrossRefPubMedPubMedCentral
29.
30.
Feleke BE, Derbie A, Zenebe Y, Mekonnen D, Hailu T, Tulu B, et al. Burden and determinant factors of Anemia among elementary school children in Northwest Ethiopia: a comparative cross sectional study. Afr, J Infect Dis. 2017;12(1):1–6.
31.
Gashu D, Stoecker BJ, Adish A, Haki GD, Bougma K, Marquis GS. Ethiopian pre-school children consuming a predominantly unrefined plant-based diet have low prevalence of iron-deficiency anaemia. Public Health Nutr. 2016;19(10):1834–41.CrossRefPubMed
32.
Getnet A, Worku S. The association between major helminth infections (soil-transmitted helminthes and schistosomiasis) and Anemia among school children in Shimbit elementary school, Bahir Dar, Northwest Ethiopia. American Journal of Health Research. 2015;3(2):97–104.CrossRef
33.
Tesfaye M, Yemane T, Adisu W, Asres Y, Gedefaw L. Anemia and iron deficiency among school adolescents: burden, severity, and determinant factors in Southwest Ethiopia. Adolescent health, medicine and therapeutics. 2015;6:189.PubMedPubMedCentral
34.
Yimam Y, Degarege A, Erko B. Effect of anthelminthic treatment on helminth infection and related anaemia among school-age children in northwestern Ethiopia. BMC Infect Dis. 2016;16(1):613.CrossRefPubMedPubMedCentral
35.
Birmeka M, Urga K, Petros B. Assessment of Anemia and Iron Status of Primary School children aged 7–19 in Enemore-Ener and Abeshege Districts, Gurage Zone, Ethiopia. EC Nutrition. 2017;10(1):18–25.
36.
Tiku YS, Mekonnen TC, Workie SB, Amare E. Does Anaemia have major public health importance in children aged 6–59 months in the Duggina Fanigo District of Wolaita Zone,Southern Ethiopia? Ann Nutr Metab. 2018;72:3–11.CrossRefPubMed
37.
Grimes JE, Tadesse G, Mekete K, Wuletaw Y, Gebretsadik A, French MD, et al. School water, sanitation, and hygiene, soil-transmitted helminths, and schistosomes: national mapping in Ethiopia. PLoS Negl Trop Dis. 2016;10(3):e0004515.CrossRefPubMedPubMedCentral
38.
39.
Taye B, Enquselassie F, Tsegaye A, Amberbir A, Medhin G, Fogarty A, et al. Effect of early and current helicobacter pylori infection on the risk of anaemia in 6.5-year-old Ethiopian children. BMC Infect Dis. 2015;15(1):270.CrossRefPubMedPubMedCentral
40.
Roba KT, O’Connor TP, Belachew T, O’Brien NM. Anemia and undernutrition among children aged 6-23 months in two agroecological zones of rural Ethiopia. Pediatric Health, Medicine and Therapeutics. 2017;55(140):131–40.
41.
Birhanu Z, Yihdego YY, Emana D, Feyissa D, Kenate S, Kebede E, et al. Relationship between exposure to malaria and haemoglobin level of children 2-9 years old in low malaria transmission settings. Acta Trop. 2017;173:1–10.CrossRefPubMed
42.
43.
Gebreegziabiher G, Etana B, Niggusie D. Determinants of anemia among children aged 6–59 months living in Kilte Awulaelo Woreda, northern Ethiopia. Anemia. 2014;2014
44.
Mahmud MA, Spigt M, Mulugeta Bezabih A, López Pavon I, Dinant G-J, Blanco Velasco R. Risk factors for intestinal parasitosis, anaemia, and malnutrition among school children in Ethiopia. Pathogens and global health. 2013;107(2):58–65.CrossRefPubMedPubMedCentral
45.
Adish A, Esrey S, Gyorkos T, Johns T. Risk factors for iron deficiency anaemia in preschool children in northern Ethiopia. Public Health Nutr. 1999;2(3):243–52.CrossRefPubMed
46.
Reithinger R, Ngondi JM, Graves PM, Hwang J, Getachew A, Jima D. Risk factors for anemia in children under 6 years of age in Ethiopia: analysis of the data from the cross-sectional Malaria Indicator Survey, 2007. Trans R Soc Trop Med Hyg2013. 2013;107:769–76.CrossRef
47.
Muchie KF. Determinants of severity levels of anemia among children aged 6–59 months in Ethiopia: further analysis of the 2011Ethiopian demographic and health survey. MuchieBMC Nutrition. 2016;2(1):51.
48.
Hall A, Kassa T, Demissie T, Degefie T, Lee S. National survey of the health and nutrition of schoolchildren in Ethiopia. Trop Med Int Health. 13(12):1518–26.
49.
Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton. Maryland: Central Statistical Agency and ICF International. p. 2005.
50.
Abdi Guled R, Mamat NM, Balachew T, Bakar MA, Azdie W, Assefa N. Predictors and prevalence of anemia, among children aged 6 to 59 months in shebelle zone, Somali region, eastern Ethiopia: a cross sectional study. International Journal of Development Research. 2017;7(1):11189–96.
51.
Mekasha A, Zerfu M. Prevalence of anemia among school children in Addis Ababa. Ethiop Med J. 2009;47(2):129–33.PubMed
52.
Smith RE Jr. The clinical and economic burden of Anemia. Am J Manag Care. 2010;16:S59–66.PubMed
53.
54.
55.
56.
Hurtado EK, Claussen AH, Scott KG. Early childhood anemia and mild or moderate mental retardation. Am J Clin Nutr. 1999;69:115–9.CrossRefPubMed
57.
Chang S, Wang L, Wang Y, Brouwer ID, Kok FJ, Lozoff B, et al. Iron-deficiency Anemia in infancy and social emotional development in preschool-aged Chinese children. Pediatrics. 2011;127:e927–e33.CrossRefPubMed
58.
Lozoff B, Corapci F, Burden MJ, Kaciroti N, Angulo-Barroso R, Sazawal S, et al. Preschool-aged children with Iron deficiency Anemia show altered affect and behavior. J Nutr. 2007;137(3):683–9.CrossRefPubMedPubMedCentral
59.
60.
61.
Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615–24.CrossRefPubMedPubMedCentral
62.
Gelaye B, Kumie A, Aboset N, Berhane Y, Williams MA. School-based intervention: evaluating the role of water, latrines and hygiene education on trachoma and intestinal parasitic infections in Ethiopia. J Water Sanit Hyg Dev. 2014;4(1):120–30.CrossRefPubMed
63.
Zuffo CR, Osório MM, Taconeli CA, Schmidt ST, da Silva BH. CC4 a. Prevalence and risk factors of anemia in children. J Pediatr. 2016;92(4):53–60.CrossRef
64.
65.
Leung K-C, Johannsson G, Leong GM, HO KKY. Estrogen regulation of growth hormone action. Endocr Rev. 2004;25(5):693–721.CrossRefPubMed
66.
67.
Courant F, Aksglaede L, Antignac J-P, Monteau F, Sorensen K, Andersson A-M, et al. Assessment of circulating sex steroid levels in Prepubertal and pubertal boys and girls by a novel ultrasensitive gas chromatography-tandem mass spectrometry method. J Clin Endocrinol Metab. 2010;95(1):82–92.CrossRefPubMed
68.
Bachman E, Travison TG, Basaria S, Davda MN, Guo W, Li M, et al. Testosterone induces Erythrocytosis via increased erythropoietin and suppressed Hepcidin: evidence for a new erythropoietin/hemoglobin set point. J Gerontol A Biol Sci Med Sci. 2014;69(6):725–35.CrossRefPubMed
69.
Abebe Z, Anlay DZ, Belete Biadgo, Kebede A, Melku T, Enawgaw B, et al. High prevalence of undernutrition among children in Gondar town, Northwest Ethiopia: a community-based cross-sectional study. Int J pediatr 2017; Int J Pediatr(Volume 2017):5367070.
70.
Akombi BJ, Agho KE, Merom D, Renzaho AM, Hall JJ. Child malnutrition in sub-Saharan Africa: a meta-analysis of demographic and health surveys (2006-2016). PLoS One. 2017;12(5):e0177338.CrossRefPubMedPubMedCentral
71.
Degarege D, Degarege A, Animut A. Undernutrition and associated risk factors among school age children in Addis Ababa, Ethiopia. BMC Public Health. 2015;15:375.CrossRefPubMedPubMedCentral
72.
Khan JR, Awan N, Misu F. Determinants of anemia among 6–59 months aged children in Bangladesh: evidence from nationally representative data. BMC Pediatr. 2016;16:3.CrossRefPubMedPubMedCentral
73.
Leite MS, Cardoso AM, Coimbra CE Jr, Welch JR, Gugelmin SA, Lira PCI, et al. 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;12:69.CrossRefPubMedPubMedCentral
74.
Leal LP, Filho MB, deLira PI C, Figueiroa JN, Osório MM. Prevalence of anemia and associated factors in children aged 6–59 months in Pernambuco, Northeastern Brazil. Rev Saúde Pública. 2011;45, 9(3)
75.
Diaz JR, dela Scagigas A, Rodriguez R. Micronutrient deficiencies in developing and affluent countries. Eur J Clin Nutr. 2003;57(Suppl. 1):70–2.CrossRef
76.
Martins VJB, Toledo Florêncio TMM, Grillo LP, Franco MdCP, Martins PA, Clemente APG, et al. Long-lasting effects of undernutrition. Int J Environ Res Public Health 2011, 8, . 2011;8:1817–1846.
77.
Balarajan Y, Ramakrishnan U, OÈ zaltin E, Shankar AH, Subramanian S. Anaemia in low- income and middle-income countries. Lancet. 2012;378(9809):2123–35.CrossRef
78.
Zanin FHC, da Silva CAM, Bonomo É, Teixeira RA, Pereira CAJ, dos Santos KB, et al. Determinants of Iron deficiency Anemia in a cohort of children aged 6-71 months living in the northeast of Minas Gerais, Brazil. PLoS One. 2015;10(10):e0139555.CrossRefPubMedPubMedCentral
Metadata
Title
Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis
Authors
Mulugeta Melku
Wubet Worku Takele
Degefaye Zelalem Anlay
Daniale Tekelia Ekubagewargies
Zegeye Getaneh
Molla Abebe
Zegeye Abebe
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2018
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-018-0513-x

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