title: Anemia among children aged 2-5 years in the Gaza Strip- Palestinian: a cross sectional study.
abstract: BACKGROUND
  Anemia is a major public health problem worldwide, with adverse consequences on child growth, development, and survival. This deficiency has affected approximately a quarter of the world population. This study aimed to determine the prevalence of anemia and the associated factors among preschool children in the Gaza Strip.
  
  
  METHODS
  A cross-sectional study was conducted between May and September 2012. A total of 357 preschool children were selected using multistage sampling method from Jabalya refugee camp, El Remal urban area, and Al Qarara rural area. Hemoglobin level was measured, and anemia diagnosis was confirmed at a level <11.0 g/dL. In this study, we utilized a pretested questionnaire for face to face interview with mothers. Anthropometric indicators for children were measured using the WHO guideline. Descriptive and multivariate analyses were conducted to determine the prevalence and associated factors of anemia.
  
  
  RESULTS
  The overall prevalence of anemia was 59.7% among preschool children in the Gaza Strip, 46.5% and 13.5% of which are mild and moderate, respectively. The mean hemoglobin level was 10.83 ± 0.86 g/dl. Children living in Jabalya refugee camp have a high risk of anemia [adjusted b= -0.55; 95% confidence interval (CI;-0.72,-0.39); p < 0.001]. Boys were more susceptible to this deficiency than girls [adjusted b = 0.17; 95% CI (0.0.01, 0.33); p = 0.031]. Hemoglobin level increased with age [adjusted b = 0.02; 95% CI (0.01, 0.03); p < 0.001]. Hemoglobin level decreased in children living in poor households [adjusted b = -0.24; 95%CI (-0.41,-0.06); p = 0.006]. Underweight children were more susceptible to anemia than normal weight children [adjusted b = - 0.22; 95% CI (-0.41, -0.03); p = 0.025].
  
  
  CONCLUSIONS
  The prevalence of anemia among preschool children in the Gaza Strip was higher than those reported in previous local studies, indicating that anemia is a major public health problem. In this study, we also observed mild and moderate cases among children, whereas severe anemia was not observed. Independent predictors of anemia were geographic location, sex, age, monthly income, and malnutrition. Results provided the baseline information on anemia, therefore, especial attention should be given on intervention of anemia.
authors: School of Public Health, Al Quds University, Gaza City, Gaza Strip, Palestine. rimaa2_us@yahoo.com.
authors: Rima Rafiq
authors: RR
authors: El Kishawi
authors: Department of Nutrition, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia. sookl@usm.my.
authors: Kah Leng
authors: KL
authors: Soo
authors: School of Public Health, Al Quds University, Gaza City, Gaza Strip, Palestine. Yabed333@yahoo.com.
authors: Yehia Awad
authors: YA
authors: Abed
authors: Department of Nutrition, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia. wanmanan@usm.my.
authors: Wan Abdul Manan
authors: WA
authors: Wan Muda
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000453:epidemiology*; D000886:Anthropometry; D018912:Arabs / Q000706:statistics & numerical data*; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008877:Middle East / Q000453:epidemiology; D009035:Mothers; D015995:Prevalence; D011634:Public Health; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology
chemical_list: D006454:Hemoglobins