Characterisation of anaemia and associated factors among infants and pre-schoolers from rural India

Public Health Nutr. 2016 Apr;19(5):861-71. doi: 10.1017/S1368980015002050. Epub 2015 Jul 3.

Abstract

Objective: In India, national databases indicate anaemia prevalence of 80 % among 6-35-month-old children and 58 % among 36-59-month-old children. The present study aimed to characterise anaemia and the associated factors among infants and pre-schoolers living in rural India.

Design: Multivariate logistic regression analysis of data collected prior to an intervention trial. Fe-deficiency with anaemia (IDA), Fe deficiency with no anaemia (IDNA) and anaemia without Fe deficiency were defined. Serum ferritin, soluble transferrin receptor (sTfR) and sTfR/log ferritin index were used to indicate Fe status.

Setting: Twenty-six villages of Nalgonda district, Telangana, India. Data were collected in community sites. Participants Four hundred and seventy-six infants (aged 6-12 months), 316 pre-schoolers (aged 29-56 months) and their mothers.

Results: Prevalence of anaemia among infants and pre-schoolers was 66·4 and 47·8 %, prevalence of IDA was 52·2 and 42·1 %, prevalence of IDNA was 22·2 and 29·8 %, prevalence of anaemia without Fe deficiency was 14·2 and 5·7 %. Among infants, anaemia was positively associated with maternal anaemia (OR=3·31; 95 % CI 2·10, 5·23; P<0·001), and sTfR/log ferritin index (OR=2·21; 95 % CI 1·39, 3·54; P=0·001). Among pre-schoolers, anaemia was positively associated with maternal anaemia (OR=3·77; 95 % CI 1·94, 7·30; P<0·001), sTfR/log ferritin index (OR=5·29; 95 % CI 2·67, 10·50; P<0·001), high C-reactive protein (OR=4·39; 95 % CI 1·91, 10·06, P<0·001) and young age (29-35 months: OR=1·92; 05 % CI 1·18, 3·13, P=0·009).

Conclusions: Anaemia prevalence continues to be high among infants and pre-schoolers in rural India. Based on sTfR/ferritin index, Fe deficiency is a major factor associated with anaemia. Anaemia is also associated with inflammation among pre-schoolers and with maternal anaemia among infants and pre-schoolers, illustrating the importance of understanding the aetiology of anaemia in designing effective control strategies.

Keywords: Anaemia; India; Infants; Pre-schoolers; Risk factors; sTfR/log ferritin index.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / blood
  • Anemia / diagnosis*
  • Anemia / epidemiology*
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / epidemiology*
  • Body Mass Index
  • Body Weight
  • C-Reactive Protein / metabolism
  • Child, Preschool
  • Family Characteristics
  • Female
  • Ferritins / blood
  • Folic Acid / blood
  • Food Supply
  • Humans
  • India
  • Infant
  • Iron / blood
  • Iron Deficiencies*
  • Logistic Models
  • Male
  • Micronutrients / administration & dosage
  • Micronutrients / blood
  • Morbidity
  • Multivariate Analysis
  • Nutrition Assessment
  • Prevalence
  • Receptors, Transferrin / blood
  • Risk Factors
  • Rural Population*
  • Socioeconomic Factors
  • Vitamin B 12 / blood

Substances

  • Micronutrients
  • Receptors, Transferrin
  • C-Reactive Protein
  • Ferritins
  • Folic Acid
  • Iron
  • Vitamin B 12