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Updated: May 11, 2026

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Severity of anemia among children under 36 months old in rural western China
Wenlong Gao1, Hong Yan, Duolao Wang
1Department of Epidemiology and Health Statistics, School of Public Health, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Insights
Anemia affects about 25% of young children in rural China. Key factors include maternal anemia, region, and family size, highlighting the need for targeted health policies.
Area of Science:
- Pediatric Nutrition
- Public Health
- Hematology
Background:
- Childhood anemia is a significant public health concern in developing regions.
- Understanding the determinants of anemia severity is crucial for effective intervention strategies.
- Rural western China faces unique challenges in child health outcomes.
Purpose of the Study:
- To determine the prevalence and severity of anemia in children under 36 months in rural western China.
- To explore the factors influencing childhood anemia severity in this population.
Main Methods:
- A cross-sectional study involving 6711 children under 36 months in rural western China.
- Hemoglobin levels were measured, and family information was collected.
- A generalized estimating equation (GEE) linear model was employed to identify anemia determinants.
Main Results:
- The prevalence of mild, moderate, and severe anemia was 27.4%, 21.9%, and 3.2%, respectively.
- Maternal anemia, province-level region, iron pot usage, family size, ethnicity, child's age, and gender were significant determinants.
- Younger children and boys exhibited more severe anemia.
Conclusions:
- Approximately 25% of children experienced moderate-to-severe anemia.
- Multiple factors including socioeconomic, demographic, and maternal health indicators influence childhood anemia.
- Findings provide critical insights for developing targeted health policies to combat childhood anemia in rural western China.
Objective:
To describe severity of anemia and explore its determinants among children under 36 months old in rural western China.
Study Design:
The family information of 6711 children was collected and their hemoglobin was measured in 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of severity of childhood anemia.
Results:
The prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively. GEE model analysis showed that province-level region and severity of maternal anemia affected the severity of childhood anemia not only in 0-5 months but also beyond 5 months. In addition, children aged 0-5 months in families using iron pot (coefficient = -0.26 95%CI -0.41,-0.12) had seldom more severe anemia, and children aged 6-36 months in families more than 4 members (coefficient = -0.03 95%CI -0.06,-0.01) or of Han ethnicity (coefficient = -0.08 95%CI -0.13,-0.04) seldom had more severe anemia but boys (coefficient = 0.03 95%CI 0.01,0.06) or younger children (6-11 month vs 30-36 month: coefficient = 0.23 95%CI 0.17, 0.28; 12-17 month vs 30-36 month: coefficient = 0.19 95%CI 0.15,0.24; 18-23 vs 30-36 month: coefficient = 0.09 95%CI 0.04,0.13) had more severe anemia.
Conclusion:
The prevalence of moderate-to-severe anemia in these children was about 25%. Province-level region, iron pot use, family size, ethnicity, age and gender of children and severity of maternal anemia were important determinants of the severity of childhood anemia. These findings have some important implications for health policy decision for childhood anemia in rural western China.
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