title: Decline in the prevalence of anaemia among children of pre-school age after implementation of wheat flour fortification with multiple micronutrients in Jordan.
abstract: To examine changes in the prevalence of anaemia and its correlates among children of pre-school age after implementation of wheat flour fortification with multiple micronutrients in Jordan.
  
  
  
  Retrospective analysis of the data from two repeated national cross-sectional panels of pre-school children.
  
  
  
  The two surveys were conducted in 2007 and 2009, 16-20 months and 34-36 months, respectively, after implementation of wheat flour fortification with multiple micronutrients in Jordan. Anaemia was considered if Hb level was <11 g/dl. An anaemia prevalence of ≥40 % was considered a severe public health problem, while that of 20-39·9 % was considered a moderate public health problem.
  
  
  
  A total of 3789 and 3447 children aged 6-59 months tested in 2007 and 2009, respectively.
  
  
  
  The prevalence of anaemia in pre-school children declined from 40·4 % in 2007 to 33·9 % in 2009 (adjusted OR=0·74; P24 months (-13·7 points), children living in urban areas (-8·0 points), children from rich households (-9·0 points), children who had never been breast-fed (-17·0 points) and well-nourished children (-6·8 points). In both surveys, presence of childhood anaemia was strongly associated with child age ≤24 months, living in poor households, breast-feeding for ≥6 months, malnourishment, poor maternal education and maternal anaemia.
  
  
  
  The public health problem of childhood anaemia declined from severe in 2007 to moderate in 2009, after the implementation of wheat flour fortification with multiple micronutrients in Jordan.
authors.affiliation: Department of International Health and Medicine,Division of Public Health,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Bunkyo-ku,Tokyo,Japan.
authors.forename: Rami
authors.initials: R
authors.lastname: Al Rifai
authors.affiliation: Department of International Health and Medicine,Division of Public Health,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Bunkyo-ku,Tokyo,Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of International Health and Medicine,Division of Public Health,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Bunkyo-ku,Tokyo,Japan.
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Seino
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005433:Flour; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007597:Jordan / Q000453:epidemiology; D018977:Micronutrients / Q000008:administration & dosage*; D015995:Prevalence; D012189:Retrospective Studies; D014908:Triticum
chemical_list: D018977:Micronutrients
keywords: Anaemia; Childhood anaemia; Fortification with multiple micronutrients; Wheat flour fortification