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

      research-article
      , ,
      BMC Pediatrics
      BioMed Central
      Anaemia, Children, Namutumba district, Uganda

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          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.

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          Most cited references28

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms.

            This systematic review of 58 observational studies identified hypothetical causal mechanisms explaining the effects of short and long intervals between pregnancies on maternal, perinatal, infant, and child health, and critically examined the scientific evidence for each causal mechanism hypothesized. The following hypothetical causal mechanisms for explaining the association between short intervals and adverse outcomes were identified: maternal nutritional depletion, folate depletion, cervical insufficiency, vertical transmission of infections, suboptimal lactation related to breastfeeding-pregnancy overlap, sibling competition, transmission of infectious diseases among siblings, incomplete healing of uterine scar from previous cesarean delivery, and abnormal remodeling of endometrial blood vessels. Women's physiological regression is the only hypothetical causal mechanism that has been proposed to explain the association between long intervals and adverse outcomes. We found growing evidence supporting most of these hypotheses.
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              Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done?

              To review the appropriateness of the prevalence odds ratio (POR) and the prevalence ratio (PR) as effect measures in the analysis of cross sectional data and to evaluate different models for the multivariate estimation of the PR. A system of linear differential equations corresponding to a dynamic model of a cohort with a chronic disease was developed. At any point in time, a cross sectional analysis of the people then in the cohort provided a prevalence based measure of the effect of exposure on disease. This formed the basis for exploring the relations between the POR, the PR, and the incidence rate ratio (IRR). Examples illustrate relations for various IRRs, prevalences, and differential exodus rates. Multivariate point and interval estimation of the PR by logistic regression is illustrated and compared with the results from proportional hazards regression (PH) and generalised linear modelling (GLM). The POR is difficult to interpret without making restrictive assumptions and the POR and PR may lead to different conclusions with regard to confounding and effect modification. The PR is always conservative relative to the IRR and, if PR > 1, the POR is always > PR. In a fixed cohort and with an adverse exposure, the POR is always > or = IRR, but in a dynamic cohort with sufficient underlying follow up the POR may overestimate or underestimate the IRR, depending on the duration of follow up. Logistic regression models provide point and interval estimates of the PR (and POR) but may be intractable in the presence of many covariates. Proportional hazards and generalised linear models provide statistical methods directed specifically at the PR, but the interval estimation in the case of PH is conservative and the GLM procedure may require constrained estimation. The PR is conservative, consistent, and interpretable relative to the IRR and should be used in preference to the POR. Multivariate estimation of the PR should be executed by means of generalised linear models or, conservatively, by proportional hazards regression.
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                Author and article information

                Contributors
                +256782312713 , fiona.kuziga@gmail.com
                yadoke@musph.ac.ug
                rwanyenze@musph.ac.ug
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                18 January 2017
                18 January 2017
                2017
                : 17
                : 25
                Affiliations
                ISNI 0000 0004 0620 0548, GRID grid.11194.3c, , Makerere University School of Public Health, College of Health Sciences, Makerere University, ; P.O. Box 7062, Kampala, Uganda
                Article
                782
                10.1186/s12887-017-0782-3
                5242053
                28100200
                5273eefa-dc7b-4f64-a91a-8d7187989a08
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 August 2015
                : 3 January 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Pediatrics
                anaemia,children,namutumba district,uganda
                Pediatrics
                anaemia, children, namutumba district, uganda

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