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LETTER TO EDITOR
Year : 2022  |  Volume : 66  |  Issue : 3  |  Page : 378-379  

Prevalence of anemia and its associated factors among children under 5 years of age attending a comprehensive healthcare facility in Kandahar City, Afghanistan


1 Assistant Professor, Department of Public Health, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
2 Master, Department of Public Health, Master of Public Health Program, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
3 Associate Professor, Department of Radiology, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
4 Associate Professor, Department of Pediatrics, Kandahar University, Kandahar, Afghanistan

Date of Submission25-Dec-2021
Date of Decision30-Apr-2022
Date of Acceptance08-Jun-2022
Date of Web Publication22-Sep-2022

Correspondence Address:
Muhammad Haroon Stanikzai
Medical Faculty, Near Ayno Mena, 10th District, Kandahar
Afghanistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.ijph_2202_21

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How to cite this article:
Stanikzai MH, Zakir S, Ishaq N, Rahimi BA. Prevalence of anemia and its associated factors among children under 5 years of age attending a comprehensive healthcare facility in Kandahar City, Afghanistan. Indian J Public Health 2022;66:378-9

How to cite this URL:
Stanikzai MH, Zakir S, Ishaq N, Rahimi BA. Prevalence of anemia and its associated factors among children under 5 years of age attending a comprehensive healthcare facility in Kandahar City, Afghanistan. Indian J Public Health [serial online] 2022 [cited 2022 Sep 28];66:378-9. Available from: https://www.ijph.in/text.asp?2022/66/3/378/356605



Dear Editor,

Children affected by anemia endure a variety of bio-psycho-social deficits that impact their health and well-being.[1],[2] Our study aimed to assess the prevalence of anemia and its associated factors among children under 5 years of age attending a comprehensive healthcare facility in Kandahar city, Afghanistan.

This was a cross-sectional study of children attending Adam Darmal Comprehensive Healthcare Center (CHC) carried out between December 2021 and January 2022. We consecutively (nonprobability sampling technique) invited children to participate if the children met the inclusion criteria (male and female children aged 6–59 months attending the designated outpatient clinic). The questionnaire, which consisted of socioeconomic characteristics of the parents and other related information of the study participants, was originally drafted in English language and translated into local languages (Pashtu/Dari) for the ease of interview. Hemoglobin (Hb) measurements were performed by a portable hemoglobinometer (Sahli, Germany) following a standardized procedure recommended by the WHO. Hb level remaining below 11 g/dL was used to define anemia.[3] Ethical clearance was obtained from the Research and Ethics Committee “The committee approved the proposal from ethics point of view,” Kandahar University (Letter No. 20 dated July 15, 2020).

In this study, a total of 512 children with a response rate of 98.4% were included. The mean and standard deviation (SD) value for the ages of children was 14 (months) ± 4.3, with 60% of them being >1 year of age. Of the total children, 299 (58.4%) were exclusively breastfed, 264 (51.6%) were given complementary foods around 6 months of age, and 214 (41.8%) were malnourished. Only 5% of children had received iron supplements. Of the mothers included in the study, about 65% (335) of the mothers had no formal education, and majority (90.6%, 464) of the mothers were homemakers. About 22% (113) of the children's fathers attended primary education, and 191 (37.3%) were formal or governmental employees. More than half, 309 (60.4%), of the children were living in a household with an unimproved sanitation facility, and the majority (372, 72.7%) of households had a protected water source.

Of the 512 children, 285 (55.6%, 95% confidence interval; 51.24%–60.02%) were anemic. The mean (±SD) Hb level of the study participants was 10.76 (±1.12). Among children with anemia, 139 (48.8%) had mild and 146 (51.2%) had moderate anemia. The prevalence of severe anemia was 0%. The multivariable logistic regression showed that being a young age child (<1 year), the mother being homemaker, not exclusively breastfeed, and availability of unimproved sanitation facility in the household were the factors associated with anemia among children under 5 years of age [Table 1].
Table 1: Factors associated with anemia among children aged 6-59 months attending a comprehensive healthcare facility in Kandahar city, Afghanistan, January 2021; crude and adjusted odds ratio

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The high prevalence of anemia among children under 5 years of age constitutes a severe public health problem in the study area. There are few reliable prevalence estimates of anemia among children in Afghanistan; however, the WHO estimated a 46.4% prevalence of anemia in children.[3] Similar hospital-based studies conducted in other developing countries observed lower prevalence rates in their samples.[4],[5] These gaps may now increase manifold due to the series of political and administrative changes.[6] Hence, healthcare deliverers should play a vital role in policy advocacy and health service delivery, promoting anemia prevention and treatment in this resource-constraint setting.

Acknowledgments

We thank Adam Darmal CHC administration for their invaluable support. Our special gratitude goes to the data collectors, mothers/legal guardians of the study participants, and children whose work made this study possible.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Pivina L, Semenova Y, Doşa MD, Dauletyarova M, Bjørklund G. Iron deficiency, cognitive functions, and neurobehavioral disorders in children. J Mol Neurosci 2019;68:1-10.  Back to cited text no. 1
    
2.
Anwary Z, Stanikzai MH, Wyar WM, Wasiq AW, Farooqi K. Anemia among women who visit Bost Hospital for delivery in Helmand province, Afghanistan. Anemia 2021;2021:9358464.  Back to cited text no. 2
    
3.
McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr 2008;12:444.  Back to cited text no. 3
    
4.
Onyeneho NG, Ozumba BC, Subramanian SV. Determinants of childhood anemia in India. Sci Rep 2019;9:16540.  Back to cited text no. 4
    
5.
Chandran V, Kirby RS. An analysis of maternal, social and household factors associated with childhood anemia. Int J Environ Res Public Health 2021;18:3105.  Back to cited text no. 5
    
6.
Britten S, Amer M. Preventing collapse of the Afghan health service. Lancet 2021;398:1481.  Back to cited text no. 6
    



 
 
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