https://doi.org/10.4081/gh.2021.1036
Geospatial inequality of anaemia among children in Ethiopia
Submitted: 7 July 2021
Accepted: 13 September 2021
Published: 28 October 2021
Accepted: 13 September 2021
Abstract Views: 2461
PDF: 795
HTML: 45
HTML: 45
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Anaemia remains a severe public health problem among children in Ethiopia and targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. An analysis was performed using Ethiopia Demographic and Health Survey 2016 data. Blood specimens for anaemia testing were collected from 9268 children aged 6-59 months. A child was considered as anaemic if the bloodhaemoglobin count was less than 11.0 g/dL. We applied Kulldorf's spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran the local indicator of spatial association and the Getis-Ord Gi* statistics to detect and locate hotspots and multilevel multivariable analysis to identify risk factors for anaemia clustering. More than half of children aged 6-59 months (57%) were found to be anaemic in Ethiopia. We found significant geospatial inequality of anaemia among children and identified clusters (hotspots) in the eastern part of Ethiopia. The odds of anaemia among children found within the identified cluster was 1.5 times higher than children found outside the cluster. Women anaemia, stunting and high fertility were associated with anaemia clustering.
Adamu AY, Abebaw Y, 2013. Diversity in Ethiopia: a historical overview of political challenges. Int J Community Divers 12:17-27.
DOI: https://doi.org/10.18848/2327-0004/CGP/v12i03/39924
Alemu A, Shiferaw Y, Ambachew A, Hamid H, 2012. Malaria helminth co–infections and their contribution for anaemia in febrile patients attending Azzezo health center, Gondar, Northwest Ethiopia: a cross sectional study. Asian Pac J Trop Med 5:803-9.
DOI: https://doi.org/10.1016/S1995-7645(12)60147-3
Anselin L, 1995. Local indicators of spatial association - LISA. Geograph Anal 27:93-115.
DOI: https://doi.org/10.1111/j.1538-4632.1995.tb00338.x
Assefa A, Ahmed AA, Deressa W, Sime H, Mohammed H, Kebede A, Solomon H, Teka H, Gurrala K, Matei B, Wakeman B, 2019. Multiplex serology demonstrate cumulative prevalence and spatial distribution of malaria in Ethiopia. Malar J 18:1-14.
DOI: https://doi.org/10.1186/s12936-019-2874-z
Baye K, 2014. Teff: nutrient composition and health benefits. Intl Food Policy Res Inst 67:1-18.
Berhane G, McBride L, Hirfrfot KT, Tamiru S, 2012. Chapter 7: Patterns in foodgrain consumption and calorie intake. pp. 190-216 in P.A. Dorosha S.Rashid (Eds.), Food and Agriculture in Ethiopia. University of Pennsylvania Press, PA, USA.
Brooker S, Akhwale W, Pullan R, Estambale B, Clarke SE, Snow RW, Hotez PJ, 2007. Epidemiology of plasmodium-helminth co-infection in Africa: populations at risk, potential impact on anemia, and prospects for combining control. Am J Trop Med Hyg 77:88-98.
DOI: https://doi.org/10.4269/ajtmh.2007.77.88
CSA Ethiopia, 2016. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia in collaboration with ICF, Rockville, MD, USA.
Degarege A, Animut A, Medhin G, Legesse M, Erko, B, 2014. The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from Dore Bafeno, southern Ethiopia. J Helminthol 88:152-9.
DOI: https://doi.org/10.1017/S0022149X12000855
De la Cruz-Góngora V, Villalpando S, Rebollar R, Shamah-Levy T, Humarán IMG, 2012. Nutritional causes of anemia in Mexican children under 5 years. Results from the 2006 National Health and Nutrition Survey. Salud Publica Mex 54:108-15.
DOI: https://doi.org/10.1590/S0036-36342012000200006
Deribew K, Tekeste Z, Petros B, 2013. Urinary schistosomiasis and malaria associated anaemia in Ethiopia. Asian Pac J Trop Med 3:307-10.
DOI: https://doi.org/10.1016/S2221-1691(13)60068-4
Ejigu BA, Wencheko E, Berhane K, 2018. Spatial pattern and determinants of anaemia in Ethiopia. PLoS One 13:e0197171.
DOI: https://doi.org/10.1371/journal.pone.0197171
EPHI, 2013. Ethiopia National Food Consumption Survey Report. Ethiopian Public Health Institute, Addis Ababa. Available from: www.ephi.gov.et
EPHI, 2015. Ethiopia National Malaria Indicator Survey 2015. Ethiopian Public Health Institute, Addis Ababa. Available from: www.ephi.gov.et
Gayawan E, Arogundade ED, Adebayo SB., 2014. Possible determinants and spatial patterns of anaemia among young children in Nigeria: a Bayesian semi-parametric modelling. Int Health 6:35-45.
DOI: https://doi.org/10.1093/inthealth/iht034
Getis A, Ord JK, 2010. The analysis of spatial association by use of distance statistics. In: L. Anselin and S.J. Rey (Eds.), Perspectives on spatial data analysis. Springer, Berlin, Germany, pp. 127-45.
DOI: https://doi.org/10.1007/978-3-642-01976-0_10
Habyarimana F, Zewotir T, Ramroop S, 2018. Spatial distribution and analysis of risk factors associated with anaemia among women of reproductive age: case of 2014 Rwanda Demographic and Health Survey Data. Open Public Health J 11:425-37.
DOI: https://doi.org/10.2174/1874944501811010425
Horton S, Ross J, 2003. The economics of iron deficiency. Food Policy 28:51-75.
DOI: https://doi.org/10.1016/S0306-9192(02)00070-2
Hurni H, 1998. Agroecological belts of Ethiopia. Explanatory notes on three maps at a scale of 1:1,000,000. Published by the Centre for Development and Environment, University of Bern in association with The Ministry of Agriculture, Ethiopia. Available from: https://edepot.wur.nl
Kibret KT, Chojenta C, D’Arcy E, Loxton D., 2019. Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: a multilevel and spatial analysis. BMJ Open 9:e027276.
DOI: https://doi.org/10.1136/bmjopen-2018-027276
Kim JY, Shin S, Han K, Lee KC, Kim JH, Choi YS, Kim DH, Nam GE, Yeo HD, Lee HG and Ko BJ, 2014. Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys. Eur J Clin Nutr 68:253-8.
DOI: https://doi.org/10.1038/ejcn.2013.241
Kulldorff M, 1997. A spatial scan statistic. Commun Statist-Theory Meth 26:1481-96.
DOI: https://doi.org/10.1080/03610929708831995
Kulldorff M, Nagarwalla N, 1995. Spatial disease clusters: detection and inference. Stat Med 14:799-810.
DOI: https://doi.org/10.1002/sim.4780140809
Magalhães RJS, Clements AC, 2011. Spatial heterogeneity of haemoglobin concentration in preschool-age children in sub-Saharan Africa. Bull World Health Organ 89:459-68.
DOI: https://doi.org/10.2471/BLT.10.083568
Mahmud MA, Spigt M, Bezabih AM, Pavon IL, Dinant G-J, Velasco RB., 2015. Efficacy of handwashing with soap and nail clipping on intestinal parasitic infections in school-aged children: a factorial cluster randomized controlled trial. PLoS Med 12:e1001837.
DOI: https://doi.org/10.1371/journal.pmed.1001837
Noronha JA, Al Khasawneh E, Seshan V, Ramasubramaniam S, Raman S, 2012. Anemia in pregnancy-consequences and challenges: a review of literature. J SAFOG 4:64-70.
DOI: https://doi.org/10.5005/jp-journals-10006-1177
Pasricha SR, Black J, Muthayya S, Shet A, Bhat V, Nagaraj S, Prashanth NS, Sudarshan H, Biggs BA, Shet AS, 2010. Determinants of anemia among young children in rural India. Pediatrics 126:e140-9.
DOI: https://doi.org/10.1542/peds.2009-3108
Perez-Heydrich C, Warren JL, Burgert CR, Emch M, 2013. Guidelines on the use of DHS GPS data. ICF International.
Reithinger R, Ngondi JM, Graves PM, Hwang J, Getachew A, Jima D, Ethiopia Malaria Indicator Survey Working Group, Amena M, Bergeron L, Bilak H, Chirwa B, 2013. Risk factors for anemia in children under 6 years of age in Ethiopia: analysis of the data from the cross-sectional Malaria Indicator Survey, 2007. Trans R Soc Trop Med Hyg 107:769-76.
Samuel F, 2015. Status of soil-transmitted helminths infection in Ethiopia. Am J Health Res 3:170-6.
DOI: https://doi.org/10.11648/j.ajhr.20150303.21
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Peña-Rosas JP, Bhutta ZA, Ezzati M, Nutrition Impact Model Study Group, 2013. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health 1:e16-e25.
DOI: https://doi.org/10.1016/S2214-109X(13)70001-9
Taffesse AS, Dorosh P, Gemessa SA, 2012. Chapter 3: Crop production in Ethiopia: regional patterns and trends. pp. 53-83 in P.A. Dorosh and S. Rashid (Eds.), Food and Agriculture in Ethiopia. University of Pennsylvania Press, PA, USA.
Thurnham DI, Northrop-Clewes CA, 2007. Infection and the etiology of anemia. In: K. Kraemer and M. Zimmermann (Eds.), Nutritional anemia. Sight and Life Press, Basel, Switzerland, pp. 231-256.
United Nations Development Programme (UNDP), 2018. Ethiopia: National Human Development Report 2018. Industrialization with a Human Face. UNDP Ethiopia.
Wang J, Wang H, Chang S, Zhao L, Fu P, Yu W, Man Q, Scherpbier R, Pan L, Duan Y, Yin SA, 2015. The influence of malnutrition and micronutrient status on anemic risk in children under 3 years old in poor areas in China. PLoS One 10:e0140840.
DOI: https://doi.org/10.1371/journal.pone.0140840
Waters N, 2017. Tobler’s first law of geography. pp. 1-15 in International encyclopedia of geography: People, the earth, environment and technology. Available from: https://doi.org/10.1002/9781118786352.wbieg1011
DOI: https://doi.org/10.1002/9781118786352.wbieg1011
WHO, ‎2011. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/85839
Yang F, Liu X, Zha P, 2018. Trends in socioeconomic inequalities and prevalence of anemia among children and nonpregnant women in low-and middle-income countries. JAMA Netw Open 1:e182899-e182899.
DOI: https://doi.org/10.1001/jamanetworkopen.2018.2899
Yip R, Dallman PR, 1988. The roles of inflammation and iron deficiency as causes of anemia. Am J Clin Nutr 48:1295-300.
DOI: https://doi.org/10.1093/ajcn/48.5.1295
How to Cite
Endris, B. S., Dinant, G.-J., Gebreyesus, S. H., & Spigt, M. (2021). Geospatial inequality of anaemia among children in Ethiopia. Geospatial Health, 16(2). https://doi.org/10.4081/gh.2021.1036
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
