Associations Between Early Childhood Caries and Malnutrition and Anemia: A Global Perspective
Abstract Background: To determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children. Methods: Matched country level ECC, malnutrition and anemia prevalence information were generated from databases covering the period from 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for Gross National Income per capita. Adjusted regression coefficients (B) and partial eta squared were computed. Results: The mean (standard deviation (SD)) ECC prevalence for 0-2 year-olds was 23.8 (14.8)% and 57.3 (22.4)% for 3-5 year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight was 7.2 (4.9)%, stunting was 24.3 (13.5)%, and anemia was 37.8 (18.1)%. For 0-2-year-olds, the strongest and only significant association observed was between the prevalence of ECC and overweight (η2= 0.21): one percent higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B= 0.12, P= 0.03). In 3-5-year-olds, the strongest and only significant association was observed between the prevalence of ECC and anemia (η2= 0.08): one percent higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B= -0.14, P= 0.048). Conclusion: Age-related disparities in the relationship between country-level prevalence of ECC, malnutrition and anemia were observed. The relationship between ECC and overweight may be due to intake of sugars. The relationship between ECC and anemia needs further investigations.