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

Abstract

AbstractObjectiveIn 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.DesignMultivariate 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.SettingTwenty-six villages of Nalgonda district, Telangana, India. Data were collected in community sites.ParticipantsFour hundred and seventy-six infants (aged 6–12 months), 316 pre-schoolers (aged 29–56 months) and their mothers.ResultsPrevalence 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).ConclusionsAnaemia 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.