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

Abstract

ObjectiveIn 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 664 and 478 %, prevalence of IDA was 522 and 421 %, prevalence of IDNA was 222 and 298 %, prevalence of anaemia without Fe deficiency was 142 and 57 %. Among infants, anaemia was positively associated with maternal anaemia (OR=331; 95 % CI 210, 523; P<0001), and sTfR/log ferritin index (OR=221; 95 % CI 139, 354; P=0001). Among pre-schoolers, anaemia was positively associated with maternal anaemia (OR=377; 95 % CI 194, 730; P<0001), sTfR/log ferritin index (OR=529; 95 % CI 267, 1050; P<0001), high C-reactive protein (OR=439; 95 % CI 191, 1006, P<0001) and young age (29-35 months: OR=192; 05 % CI 118, 313, P=0009).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.