Gastrointestinal Parasitosis and Anemia Monitoring in the Child Population of Villa Clarín, Colombia

BackgroundThere is limited non-anecdotal literature on the effectiveness of health policies and the prevalence of childhood anemia in rural communities in the Colombian Caribbean region. The objective of the following study is to report a parasitological and hematological episode of 94 children belonging to the child population of Villa Clarín, Colombia, and reinforce the disposable literature of local care reports.Case presentationThis article studies an event of intestinal parasitosis prevalence and anemia in 94 children between 1 and 11 years of age, grouped into three age ranges of 1 to 3 years, 4 to 6 years, and 7 to 11 years of age respectively, from the rural community of Villa Clarín, Colombia. Blood samples were obtained by venipuncture and processed through a complete blood count. The feces were collected by spontaneous evacuation and analyzed using a spontaneous sedimentation technique. The prevalence of intestinal parasitosis was 96.81%. ConclusionsEight of the 91 children in whom intestinal parasites were detected had anemia while 29 were above the normal levels of hemoglobin. An association was found with E. histolytica / dispar, but not with A. lumbricoides, T. trichiura, S. stercolaris, Uncinaria, Taenia sp, H. nana, H. diminuta, G. lamblia, T. hominis or B. hominis. The high prevalence of intestinal parasitosis and the anemia levels indicate deficiencies in environmental sanitation and hygienic-sanitary measures.

Prevalence and Determinants of Anemia among Children in Zanzibar, Tanzania: Analysis of Cross-Sectional Population Representative Surveys

The aim of this study was to assess the prevalence of anemia and its determinants among children aged 6–59 months in Zanzibar, Tanzania, from 2005 to 2015. We used secondary data from the Tanzania Demographic and Health Surveys from three different periods: 2005, 2010, and 2015. A sample of 3502 child-mother pairs from three survey datasets was used to analyze the overall prevalence of anemia and reveal its determinants. Hierarchical logistic regression was used to demonstrate the prevalence odds ratio of factors, both from the mothers and children, for anemia prevalence. The study indicated a significant decrease in anemia prevalence from 76.1% in 2005 to 65.4% in 2015 (p < 0.001). Hierarchical logistic regression between variables and anemia showed a significant association (p = 0.02) with households that improperly disposed of stool, children with minimum dietary diversity (p = 0.041), children in low age quartiles (p = < 0.001), and underweight children (p = 0.025). Maternal, household characteristics, and child factors were associated with childhood anemia in Zanzibar, Tanzania. Despite the significant decrease of anemia in Zanzibar, the overall prevalence rate is still a significant public health concern. Designing and strengthening comprehensive interventions to address anemia in the general population and different categories should be given special consideration.

Anemia Among Children Under 5 Years in India: A District-Level Spatial Analysis Using NFHS-5 Data

The 2015/2016 National Family Health Survey (NFHS-4) revealed that the prevalence of anemia among children under 5 years is 58% in India. Lack of nutritional supplementation and lack of health care facilities are found to be important influential factors of anemia among children. We aimed to examine district-level spatial heterogeneity and clustering of associated factors with childhood anemia in India. Geographically weighted regression was applied on the NFHS-5 data for 335 districts. Factors such as prevalence of nutritional supplementation in children and mothers, birth order, antenatal care, diarrhea in children, and stunting were found to be significantly associated. Spatial scan statistics technique identified 3 significant local spatial clusters of anemia. This study provides findings based on the latest available data which can further assist in the design and execution of tailor-made policies.

A simulation study for evaluating the performance of clustering measures in multilevel logistic regression

Background Multilevel logistic regression models are widely used in health sciences research to account for clustering in multilevel data when estimating effects on subject binary outcomes of individual-level and cluster-level covariates. Several measures for quantifying between-cluster heterogeneity have been proposed. This study compared the performance of between-cluster variance based heterogeneity measures (the Intra-class Correlation Coefficient (ICC) and the Median Odds Ratio (MOR)), and cluster-level covariate based heterogeneity measures (the 80% Interval Odds Ratio (IOR-80) and the Sorting Out Index (SOI)). Methods We used several simulation datasets of a two-level logistic regression model to assess the performance of the four clustering measures for a multilevel logistic regression model. We also empirically compared the four measures of cluster variation with an analysis of childhood anemia to investigate the importance of unexplained heterogeneity between communities and community geographic type (rural vs urban) effect in Malawi. Results Our findings showed that the estimates of SOI and ICC were generally unbiased with at least 10 clusters and a cluster size of at least 20. On the other hand, estimates of MOR and IOR-80 were less accurate with 50 or fewer clusters regardless of the cluster size. The performance of the four clustering measures improved with increased clusters and cluster size at all cluster variances. In the analysis of childhood anemia, the estimate of the between-community variance was 0.455, and the effect of community geographic type (rural vs urban) had an odds ratio (OR)=1.21 (95% CI: 0.97, 1.52). The resulting estimates of ICC, MOR, IOR-80 and SOI were 0.122 (indicative of low homogeneity of childhood anemia in the same community); 1.898 (indicative of large unexplained heterogeneity); 0.345-3.978 and 56.7% (implying that the between community heterogeneity was more significant in explaining the variations in childhood anemia than the estimated effect of community geographic type (rural vs urban)), respectively. Conclusion At least 300 clusters with sizes of at least 50 would be adequate to estimate the strength of clustering in multilevel logistic regression with negligible bias. We recommend using the SOI to assess unexplained heterogeneity between clusters when the interest also involves the effect of cluster-level covariates, otherwise, the usual intra-cluster correlation coefficient would suffice in multilevel logistic regression analyses.

Spatial variation and determinants of childhood anemia among children aged 6 to 59 months in Ethiopia: further analysis of Ethiopian demographic and health survey 2016

Background The magnitude of childhood anemia was increased from time to time. Thus, Even if the Ethiopian government applied tremendous efforts, anemia in children continues as a major public health problem. There is limited evidence on the spatial variation of and determinant factors of childhood anemia at the national level. Therefore, this study aimed to explore spatial distribution and determinants of anemia among children aged 6 to 59 months in Ethiopia. Method A stratified two-stage cluster sampling technique was used in Ethiopian Demographic Health Survey 2016 data. In this study 8602 children aged 6–59 months were included. Bernoulli model was used to explore the presence of purely spatial clusters of Anemia in children in age 6–59 months using Sat scan. ArcGIS version 10.3 was used to know the distribution of anemia cases across the country. A mixed-effects Logistic regression model was used to identify determinant factors of anemia. Results The finding indicates that the spatial distribution of childhood anemia was non-random in the country with Moran’s I: 0.65, p < 0.001. The SaT scan analysis identified a total of 180 significant primary clusters located in the Somali and Afar regions (LLR = 14.47, P-value< 0.001, RR = 1.47). Age of child 12–23 months (AOR = 0, 68, 95%CI: 0.55, 0.85), 24–35 months (AOR = 0.38, 95%CI: 0.31, 0.47), and36–47 months (AOR = 0.25, 95%CI, 0.20, 0.31), working mother (AOR = 0.87, 95%CI: 0.76, 0.99), anemic mother (AOR = 1.53, 95%CI, 1.35, 1.73), had fever in the last 2 weeks (AOR = 1.36,95%CI:1.13, 1.65), moderate stunting (AOR = 1.31,95%CI: 1.13, 1.50),Severely stunting (AOR = 1.82,95%CI: 1.54, 2.16), religion, wealth index, and number of under-five children in the household were statistically significant associated with childhood anemia. Conclusion Spatial variation of childhood anemia across the country was non-random. Age of the child, wealth index, stunting, religion, number of under-five children in the household, fever in the last 2 weeks, anemic mother, and working status of the mother were determinants of childhood anemia. Therefore, interventions should be a priority concern for high-risk (hot spot) areas regarding allocation of resources and improved access to health facilities, and to reduce the consequence of anemia among the generation policymakers and concerned bodies should be implemented these specific determinant factors.

Associations of early childhood caries with salivary beta defensin-3 and childhood anemia: a case–control study

Background Human beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia. Methods A total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05. Results The mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002). Conclusion Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

Maternal health status and household food security on determining childhood anemia in Bangladesh -a nationwide cross-sectional study

Background The aim of this study was to examine the effect of household food security on childhood anemia in Bangladesh while controlling for socioeconomic and demographic factors. Methods We used nationally representative Bangladesh Demographic Health Survey (BDHS) 2011 data for this study, the only existing survey including anemia information and household food security. The sample included 2171 children aged 6–59 months and their mothers. Differences between socioeconomic and demographic variables were analyzed using Chi-square test. Univariate and multivariate logistic regression analyses were performed to estimate the effects of different socioeconomic and demographic factors on childhood anemia. We also performed mediation analysis to examine the direct and indirect effect of household food security on childhood anemia. Results In Bangladesh, 53% male (95% CI: 50–56) and 51% female (95% CI: 47–54) children aged 6–59 months were anemic in 2011. The food insecure households have 1.20 times odds (95% CI: 0.97–1.48) of having anemic children comparing to food secure households in the unadjusted model. On the other hand, anemic mothers have 2 times odds (95% CI: 1.67–2.44) of having anemic children comparing to non-anemic mothers. However, household food security is no longer significantly associated with childhood anemia in the adjusted model while mothers’ anemia remained a significant factor (OR 1.87: 95% CI: 1.53–2.29). Age of children is the highest associated factor, and the odds are 4.89 (95% CI: 3.21–7.45) for 6–12 months old children comparing to 49–59 months in the adjusted model. Stunting and household wealth are also a significant factor for childhood anemia. Although food security has no significant direct effect on childhood anemia, maternal anemia and childhood stunting mediated that relationship. Conclusions Future public health policies need to focus on improving mothers’ health with focusing on household food security to eliminate childhood anemia.