Differences in factors associated with anemia in Haitian children from urban and rural areas

Ana M. Palacios; Jeanne H. Freeland-Graves; Sherlie Jean-Louis Dulience; Jacques Raymond Delnatus; Lora L. Iannotti

doi:10.1371/journal.pone.0247975

Differences in factors associated with anemia in Haitian children from urban and rural areas

Ana M. Palacios, Jeanne H. Freeland-Graves, Sherlie Jean-Louis Dulience, Jacques Raymond Delnatus, Lora L. Iannotti

Health Policy & Community Health

Research output: Contribution to journal › Article › peer-review

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Abstract

<div class="line" id="line-5"> Background</div><div class="line" id="line-72"> <br/></div><div class="line" id="line-75"> In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed.</div><div class="line" id="line-77"> <br/></div><div class="line" id="line-80"> Objective</div><div class="line" id="line-82"> <br/></div><div class="line" id="line-85"> To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban  <i> vs </i> . rural areas of Haiti.</div><div class="line" id="line-92"> <br/></div><div class="line" id="line-95"> Methods</div><div class="line" id="line-97"> <br/></div><div class="line" id="line-100"> This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5–13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect.</div><div class="line" id="line-102"> <br/></div><div class="line" id="line-105"> Results</div><div class="line" id="line-107"> <br/></div><div class="line" id="line-110"> In rural areas, stunting was more prevalent in children with anemia  <i> vs </i> . no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults  <i> vs </i> . rural children with no anemia, ( <img src="https://journals.plos.org/plosone/article/file?type=thumbnail&id=info:doi/10.1371/journal.pone.0247975.e001"/>  = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia  <i> vs </i> . no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32–3.18)], age [AOR = 0.89; 95%CI (0.85–0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67–0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed.</div><div class="line" id="line-156"> <br/></div><div class="line" id="line-159"> Conclusions</div><div class="line" id="line-161"> <br/></div><div class="line" id="line-164"> In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.</div><div class="line" id="line-166"> <br/></div><div class="line" id="line-169"> <br/></div>

Original language	American English
Journal	PLoS ONE
Volume	16
DOIs	https://doi.org/10.1371/journal.pone.0247975
State	Published - Apr 6 2021

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@article{a1fcfba5a3b2450ea759faebbff2303c,

title = "Differences in factors associated with anemia in Haitian children from urban and rural areas",

abstract = " Background In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed. Objective To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban  vs . rural areas of Haiti. Methods This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5–13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect. Results In rural areas, stunting was more prevalent in children with anemia  vs . no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults  vs . rural children with no anemia, (  = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia  vs . no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32–3.18)], age [AOR = 0.89; 95%CI (0.85–0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67–0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed. Conclusions In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed. ",

author = "Palacios, {Ana M.} and Freeland-Graves, {Jeanne H.} and {Jean-Louis Dulience}, Sherlie and {Raymond Delnatus}, Jacques and Iannotti, {Lora L.}",

note = "Publisher Copyright: {\textcopyright} 2021 Palacios et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2021",

month = apr,

day = "6",

doi = "10.1371/journal.pone.0247975",

language = "American English",

volume = "16",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

}

TY - JOUR

T1 - Differences in factors associated with anemia in Haitian children from urban and rural areas

AU - Palacios, Ana M.

AU - Freeland-Graves, Jeanne H.

AU - Jean-Louis Dulience, Sherlie

AU - Raymond Delnatus, Jacques

AU - Iannotti, Lora L.

N1 - Publisher Copyright: © 2021 Palacios et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2021/4/6

Y1 - 2021/4/6

N2 - Background In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed. Objective To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban  vs . rural areas of Haiti. Methods This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5–13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect. Results In rural areas, stunting was more prevalent in children with anemia  vs . no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults  vs . rural children with no anemia, (  = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia  vs . no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32–3.18)], age [AOR = 0.89; 95%CI (0.85–0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67–0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed. Conclusions In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.

AB - Background In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed. Objective To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban  vs . rural areas of Haiti. Methods This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5–13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect. Results In rural areas, stunting was more prevalent in children with anemia  vs . no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults  vs . rural children with no anemia, (  = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia  vs . no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32–3.18)], age [AOR = 0.89; 95%CI (0.85–0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67–0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed. Conclusions In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.

U2 - 10.1371/journal.pone.0247975

DO - 10.1371/journal.pone.0247975

M3 - Article

SN - 1932-6203

VL - 16

JO - PLoS ONE

JF - PLoS ONE

ER -

Differences in factors associated with anemia in Haitian children from urban and rural areas

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