Risk factors associated with anaemia among children under five years of age in Uganda

Abstract

Background Anaemia remains a public health challenge, especially in developing countries because of its relationship to neurocognitive delays, especially among children under five. According to the World Health Organization (WHO) report for 1993-2005, 293.1 million children were affected by anaemia globally. Risk factors for anaemia that need to be examined in children include socio-demographic characteristics, infection with the Human Immunodeficiency virus (HIV), malnutrition and malaria. Objectives The objectives of the study were to estimate the prevalence of anaemia and identify the potential risk factors (including socio-demographic factors) among children under five years of age who participated in a cross-sectional survey in Uganda in 2011. Methods Data that were collected in a cross-sectional survey during 2011 in Uganda (N = 1 808) were analysed. Children were defined as being anaemic if their haemoglobin levels were below 11.0 g/dl, as per the WHO definition. Cross tabulations, and ordinary and ordinal logistic regression analysis were the primary methods used. Results The main finding was that the prevalence of anaemia in children under five years of age was high, at 50.3% (95% CI: 46% - 54%). Of those with anaemia 1.6% had severe anaemia, 26.2% had moderate anaemia, and 22.6% had mild anaemia. From the multiple ordinary and ordinal logistic regression analyses, age group of the child, region, breastfeeding status of the mother, v

use of antenatal health care facilities, household wealth index, household age group, marital status of household head, and literacy level of the household head were associated with childhood anaemia. Children with anaemia were more likely to be younger than 24 months old, have had malaria, have poor nutritional status, and live in rural areas. The children were also more likely to be anaemic if their mothers had a high education, and were young , and if they lived with a household head aged 79-95 years. They were less likely to be anaemic if they had a household head in one of the relatively higher wealth indices, a household head with a literacy level of ‘medium’, and a household head who was divorced. Conclusion Anaemia was highly prevalent among children under five years of age in Uganda in 2011. Several child- maternal- and household head-related risk factors were identified. Modifiable risk factors should be targeted in Uganda to reduce anaemia in children. Malaria and nutrition programmes (including iron supplementation) should be stepped up, and pregnant women and mothers of new born children should be encouraged to attend health care centres, including antenatal care facilities. Children with un-modifiable risk factors, such as living in rural or low GDP areas should be closely monitored for risk factors that predispose them to anaemia.