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Persistence of anaemia among Samoan preschool age children: a longitudinal study
Bohao Wu1, Courtney C Choy2, Anna C Rivara1
1Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT06510, USA.
Insights
Anaemia affects over a third of Samoan children, with many cases persisting over time. Mothers with anaemia and higher iron intake are linked to persistent childhood anaemia.
Area of Science:
- Public Health
- Pediatrics
- Nutritional Epidemiology
Background:
- Anaemia remains a significant public health concern globally, particularly in low-income countries.
- Persistent anaemia in children can lead to long-term developmental and health consequences.
- Understanding the prevalence and risk factors for anaemia in specific populations is crucial for effective intervention.
Purpose of the Study:
- To determine the prevalence and persistence of anaemia in Samoan children over a 2-3 year period.
- To identify child, maternal, and household factors associated with transient and persistent anaemia.
- To inform targeted prevention strategies for childhood anaemia in Samoa.
Main Methods:
- Longitudinal study design using data from two waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study.
- Inclusion of 257 mother-child pairs from eleven Samoan villages.
- Statistical analysis using log-binomial and modified Poisson regressions to examine correlates of anaemia.
Main Results:
- Overall anaemia prevalence was 33.9% in 2015 and 28.0% in 2017-2018.
- 35.6% of anaemia cases identified in 2015 persisted in 2017-2018.
- Risk factors for persistent anaemia included maternal anaemia and higher dietary iron intake; older age, older mothers, and higher sodium intake were associated with transient anaemia.
Conclusions:
- Moderate-to-high anaemia prevalence necessitates broad prevention efforts in Samoa.
- Children with persistent anaemia risk factors require specific attention.
- Routine screening for anaemia in children whose mothers have anaemia is recommended.
Objective:
To characterise the prevalence and persistence of anaemia among Samoan children over a 2-3-year period.
Design:
Data were from two consecutive waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study. Anaemia (Hb < 11·0 or 11·5 g/dl for 2-4 and ≥ 5 years old, respectively) was considered 'transient' when it occurred at only one wave or 'persistent' if it was present at two consecutive waves. Child, maternal and household correlates of anaemia were examined using log-binomial and modified Poisson regressions.
Setting:
Eleven Samoan villages.
Participants:
Mother-child pairs (n 257) recruited in 2015 and reassessed in 2017-2018.
Results:
Anaemia prevalence was 33·9 % in 2015 and 28·0 % in 2017-2018; 35·6 % of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 v. 2 years, adjusted relative risk (aRR) = 0·54, (95 % CI 0·35, 0·84), P = 0·007), had older mothers (≥ 40 v. 18-29 years, aRR = 0·61, (95 % CI 0·39, 0·95), P = 0·029) and had higher daily sodium intake (for every 100 mg/d, aRR = 0·97, (95 % CI 0·95, 0·99), P = 0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR = 2·13, (95 % CI 1·17, 3·89), P = 0·013) and had higher daily dietary iron intake (for every 10 mg/d, aRR = 4·69, (95 % CI 1·33, 16·49), P = 0·016) than those with no anaemia.
Conclusions:
Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.
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