Purpose: We aimed to assess the associations between water source and sanitation with anemia in preschool children (PSC; age: 6-59 months) using population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project.
Methods: We analyzed nationally and subnationally representative data from the BRINDA project. Fourteen surveys, representing 13 countries with PSC (N = 32,549) included measures of hemoglobin, household water source and sanitation, type of residence, and socioeconomic status (SES) and were included in analysis. Anemia was defined as hemoglobin concentration < 110 g/L, adjusting for altitude when this information was available. The household water source and sanitation were classified as either “improved” or “unimproved”. Univariable analyses were done using Rao-Scott chi-square test. Multivariable analyses were done using logistic regressions.
Results: The percentage of participants with access to an improved household water source ranged from 44.2% in Laos to 96% in Bangladesh (2012) whereas the percentage of participants with access to improved household sanitation ranged from 0.2% in Kenya (2007) to 94.7% in Philippines. The country-level prevalence of anemia across these 14 surveys ranged from a low of 24.6% in Azerbaijan to a high of 71.7% in Kenya (2010). In the multivariable logistic regression models, access to improved sanitation source was associated with decreased odds of anemia in 5 out of 6 surveys assessed. However, none of these associations was significant at a significance level of 0.05.
Conclusions: Improved household water source and sanitation was not consistently associated with anemia across surveys. Further research is warranted to explore potential links between water source and sanitation with anemia from a clinical perspective.
Table of Contents
Descriptive statistics 9
Univariable associations 10
Multivariable logistic regression models 10
Competing interests 13
Ethical approval 13
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Association between water source and sanitation with anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project ()||2019-04-26 12:00:07 -0400||