Prevalence and Risk Factors of Anemia in the Mother-Infant Population from Apartadó, Colombia Public

Abstract

Iron deficiency is the most common cause of anemia in developing countries and a major contributor of infant mortality deaths worldwide (WHO, 2017a). In Apartadó, Colombia, there are limited data on anemia status in young children and mothers (ENSIN, 2010). The study aimed to quantify the prevalence and the risk factors of anemia in a cohort of Colombian children and their mothers. 198 healthy mother-infant pairs were recruited from one post-natal health facility in Apartadó. Children were between the ages of 6 to 60 months and the ages of the mothers ranged from 15 to 46 years old. A blood test was performed in 135 children and 102 mothers using HemoCue® to determine the level of hemoglobin, from which anemia was diagnosed in the mother and infant. About 50% of the children and mothers in the study had anemia. Additionally, a health characterization survey was conducted to identify the health conditions of the mother infant pair that included diarrhea diseases, respiratory problems, stunting and wasting in order to determine risk factors associated with anemia. Bivariate correlations between health outcomes and anemia were assessed using logistic regression models. Through a multiple logistic regression model, it was found that age was a significant risk factor of anemia (OR: 0.196; 95% CI: 0.083, 0.463; P = 0.0002). Older children were 80% less likely to develop anemia than younger children. The prevalence of anemia in children and mothers was 15.5 and 17.2 percentage points higher than the Colombian national prevalence accordingly. The high prevalence of anemia in this cohort of Colombian children and mothers suggests an immediate need for interventions in order to address the impact of anemia in Apartadó.

Table of Contents

Table of Contents

Chapter 1: Literature Review…………………………………………………………...………....................1

Global Burden of Iron Deficiency…………………………………………………………..…….......................1

Risk Factors Associated with Iron Deficiency Anemia……………………………………..……..............2

Exclusive Breastfeeding and Iron Deficiency Anemia……………………………………..……..............2

Maternal Anemia and Iron Deficiency Anemia…………………………………………………...................3

Stunting/Wasting & Iron Deficiency Anemia…………………………………………..………….................4

Diseases & Iron Deficiency………………………………….………………………………….........................…4

Body Mass Index (BMI) & Iron Deficiency Anemia……………………………………….…...............….5

Lack of Education & Iron Deficiency Anemia………………………………………………..................……5

Burden of Iron Deficiency Anemia in Colombia………………………………………………….................6

Root Causes of Iron Deficiency Anemia in Colombia……………………………………………..............7

Poverty & Iron Defieincy Anemia……………………………………………………………..…......................7

Internal Armed Conflict & Iron Deficiency Anemia…………………………………………….................8

Uraba, Colombia…………………………………………………………………………………...............................9

Conclusion & Significance……………………………………………………………………..............................9

Chapter 2: Methods…………………….……………………………………………………..........................…11

Study Approval and Location………………………………………..………………………...........................11

Sample Size……………………………………………………………………………………..................................11

Study Design & Study Population……………………………………………………………….......................11

Data Collection Tools & Study Activities……………………………………………………….....................12

Database Design………………………………………………………………………………..............................…14

Data Entry and Data Quality…………………………………………………………………….........................14

Data Analysis……………………………………………………………………………………................................14

Chapter 3: Results……………………………………………………………………………...........................…16

Socio-demographic Characteristics of the Mother-Infant Pair…………………………………...........16

Health Characteristics of Children…………………………………………………………….........................17

Health Characteristics of Children by Age Group and by Gender……………………………….........19

Health Characteristics of Mothers………………………………………………………………........................20

Risk Factors of Anemia………………………………………………………………………….............................21

Complementary Breastfeeding Significant Predictor of Anemia………………………………...........21

Diarrhea Significant Predictor of Anemia……………………………………………………….....................22

Chapter 5: Discussion..........................................................................................23

Introduction and Findings………………………………………………………………………...........................23

Prevalence of Anemia……………………………………………………………………………............................23

Age and Anemia…………………………………………………………………………………...............................24

Complementary Breastfeeding and Anemia……………………………………………………...................24

Diarrhea and Anemia……………………………………………………………………….................................25

Strenghts and Limitations………………………………………………………………………...........................26

Implications……………………………………………………………………………………................................…26

Conclusion………………………………………………………………………………………..................................26

Chapter 6: Public Health Implications………………………………………………………..................28

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Mot-clé	Children Ris Factors Iron Deficiency Age Colombia Anemia Uraba Apartadó
Committee Chair / Thesis Advisor	Leon, Juan, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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