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

<h4>Background</h4>In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed.<h4>Objective</h4>To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban vs. rural areas...

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Main Authors: Ana M Palacios, Jeanne H Freeland-Graves, Sherlie Jean-Louis Dulience, Jacques Raymond Delnatus, Lora L Iannotti
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0247975
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author Ana M Palacios
Jeanne H Freeland-Graves
Sherlie Jean-Louis Dulience
Jacques Raymond Delnatus
Lora L Iannotti
author_facet Ana M Palacios
Jeanne H Freeland-Graves
Sherlie Jean-Louis Dulience
Jacques Raymond Delnatus
Lora L Iannotti
author_sort Ana M Palacios
collection DOAJ
description <h4>Background</h4>In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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, ([Formula: see text] = 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.<h4>Conclusions</h4>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.
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spelling doaj.art-bb2fd5001ef5475cbfe9eef4aa10c97c2022-12-21T19:20:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01164e024797510.1371/journal.pone.0247975Differences in factors associated with anemia in Haitian children from urban and rural areas.Ana M PalaciosJeanne H Freeland-GravesSherlie Jean-Louis DulienceJacques Raymond DelnatusLora L Iannotti<h4>Background</h4>In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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, ([Formula: see text] = 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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0247975
spellingShingle Ana M Palacios
Jeanne H Freeland-Graves
Sherlie Jean-Louis Dulience
Jacques Raymond Delnatus
Lora L Iannotti
Differences in factors associated with anemia in Haitian children from urban and rural areas.
PLoS ONE
title Differences in factors associated with anemia in Haitian children from urban and rural areas.
title_full Differences in factors associated with anemia in Haitian children from urban and rural areas.
title_fullStr Differences in factors associated with anemia in Haitian children from urban and rural areas.
title_full_unstemmed Differences in factors associated with anemia in Haitian children from urban and rural areas.
title_short Differences in factors associated with anemia in Haitian children from urban and rural areas.
title_sort differences in factors associated with anemia in haitian children from urban and rural areas
url https://doi.org/10.1371/journal.pone.0247975
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