title: Prenatal anemia control and anemia in children aged 6-23 months in sub-Saharan Africa.
abstract: It is unclear whether routine prenatal anemia control interventions can reduce anemia risk in young children. This study examines the associations between prenatal iron supplementation and/or deworming and anemia in children aged 6-23 months in sub-Saharan Africa (SSA). We analyzed data from Demographic and Health Surveys conducted between 2003 and 2014 in 25 SSA countries. The surveys collected data on prenatal iron supplementation and deworming and determined children's hemoglobin levels through blood testing. We assessed the associations between prenatal iron supplementation and/or deworming and anemia using multinomial logistic regression. The study included 31,815 mother-child pairs: 25.0%, 41.4%, and 4.8% of children had mild, moderate, and severe anemia, respectively. Compared with children whose mothers did not take iron and deworming drugs prenatally, the risk of moderate/severe anemia was reduced among children whose mothers took only iron supplements for ≥6 months (odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.45-0.76); only deworming drugs (OR: 0.73; 95% CI: 0.56-0.93); deworming drugs plus iron for <6 months (OR: 0.79; 95% CI: 0.67-0.93); and deworming drugs plus iron for ≥6 months (OR: 0.77; 95% CI: 0.59-0.99). Prenatal use of only iron for <6 months was not associated with moderate/severe anemia. Prenatal iron and/or deworming drugs had no effect on mild anemia. Prenatal anemia control interventions are associated with reduced risk of moderate/severe anemia but not with mild anemia in young children in SSA. Iron supplements should be taken for ≥6 months or with deworming drugs prenatally to reduce moderate/severe anemia risk in children.
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Calistus
authors.initials: C
authors.lastname: Wilunda
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Child Health and Paediatrics, School of Medicine, Moi University, Eldoret, Kenya.
authors.forename: Fabian
authors.initials: F
authors.lastname: Esamai
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawakami
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D007501:Iron / Q000008:administration & dosage* / Q000097:blood; D016015:Logistic Models; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008875:Middle Aged; D009035:Mothers; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007501:Iron
keywords: anemia control; child nutrition; deworming; iron supplementation; low-income countries