Dataset Information

Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries.

ABSTRACT:

Importance

Anemia remains a major challenge for women's and children's health in low- and middle-income countries (LMICs).

Objective

To assess the socioeconomic inequalities and prevalence of anemia among children and nonpregnant girls and women in LMICs over time.

Design, setting, and participants

This cross-sectional and repeated cross-sectional analysis used data from the Demographic and Health Surveys collected from January 1, 2000, through December 31, 2014. Initial cross-sectional data sets constructed from the most recent surveys included 163?419 children aged 6 to 59 months and 304?202 nonpregnant girls and women aged 15 to 49 years (hereinafter referred to as nonpregnant women) from 45 LMICs. Repeated cross-sectional data sets from the most recent and the earliest surveys consisted of 322?088 nonpregnant women from 25 LMICs and 182?273 children from 24 LMICs. Analyses were conducted from June 1, 2016, through July 3, 2018.

Main outcomes and measures

Total and severe anemia for children aged 6 to 59 months (hemoglobin level, <11 and <7 g/dL, respectively) and nonpregnant women aged 15 to 49 years (<12 and <8 g/dL, respectively) were defined according to the World Health Organization hemoglobin cutoff levels. The slope index of inequality (SII) and the relative index of inequality (RII) were calculated to determine anemia inequalities.

Results

Among the 163?419 children aged 6 to 59 months and the 304?202 nonpregnant women aged 15 to 49 years in the initial cross-sectional data sets, 34 of 45 countries had anemia prevalence levels for children greater than 40% and 37 of 45 had anemia prevalence levels greater than 20% for nonpregnant women. Among the 182?273 children from 24 LMICs and 322?088 nonpregnant women from 25 LMICs in the repeated cross-sectional data sets, the annualized absolute decreases in the prevalence of anemia ranged from 0.67 to 3.98 percentage points in 16 of the 24 LMICs; for cases of severe anemia, the decrease was 0.03 to 0.82 percentage points in 15 LMICs. Among 322?088 nonpregnant women from 25 LMICs in the repeated cross-sectional data sets, the annualized absolute decreases in the prevalence of anemia ranged from 0.49 to 2.59 percentage points in 17 of 25 LMICs; for severe anemia, the decrease was 0.03 to 0.29 percentage points in 15 LMICs. The SII was significantly negative and the RII was significantly less than 1 in 37 of the 45 LMICs among children and in 26 of the 45 LMICs for nonpregnant women. The annualized changes in the SII approached 0 in 16 of the 24 LMICs among children and in 11 of 25 LMICs among nonpregnant women.

Conclusions and relevance

Most LMICs continue to exhibit a high prevalence of anemia among children and nonpregnant women, although the prevalence of total and severe anemia have decreased in many LMICs. Anemia inequalities among children and nonpregnant women persist in most LMICs.

SUBMITTER: Yang F

PROVIDER: S-EPMC6324516 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries.

Yang Fan F Liu Xueyi X Zha Panpan P

JAMA network open 20180907 5

<h4>Importance</h4>Anemia remains a major challenge for women's and children's health in low- and middle-income countries (LMICs).<h4>Objective</h4>To assess the socioeconomic inequalities and prevalence of anemia among children and nonpregnant girls and women in LMICs over time.<h4>Design, setting, and participants</h4>This cross-sectional and repeated cross-sectional analysis used data from the Demographic and Health Surveys collected from January 1, 2000, through December 31, 2014. Initial cr ...[more]

PMID: 30646183

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Project description:ObjectiveTo analyze socioeconomic inequalities in the prevalence of underweight and overweight or obesity in women from low and middle-income countries (LMICs).MethodsUsing the last available Demographic Health Survey between 2010 and 2016 from 49 LMICs, we estimated the prevalence of underweight (BMI < 18.5 kg/m2) and overweight or obesity combined (BMI ≥ 25 kg/m2) for women aged 20-49 years. We used linear regression to explore the associations between the two outcomes and gross national income (GNI). We assess within-country socioeconomic inequalities using wealth deciles. The slope index of inequality (SII) and the inequality pattern index (IPI) were calculated for each outcome. Negative values of the latter express bottom inequality (when inequality is driven by the poorest deciles) while positive values express top inequality (driven by the richest deciles).ResultsIn total, 931,145 women were studied. The median prevalence of underweight, overweight or obesity combined, and obesity were 7.3% (range 0.2-20.5%), 31.5% (8.8-85.3%), and 10.2% (1.9-48.8%), respectively. Pearson correlation coefficients with log GNI were -0.33 (p = 0.006) for underweight, 0.72 (p < 0.001) for overweight or obesity, and 0.66 (p < 0.001) for obesity. For underweight, the SII was significantly negative in 38 of the 49 countries indicating a higher burden among poor women. There was no evidence of top or bottom inequality. Overweight or obesity increased significantly with wealth in 44 of the 49 countries. Top inequality was observed in low-prevalence countries, and bottom inequality in high-prevalence countries.ConclusionUnderweight remains a problem among the poorest women in poor countries, but overweight and obesity are the prevailing problem as national income increases. In low-prevalence countries, overweight or obesity levels are driven by the higher prevalence among the richest women; as national prevalence increases, only the poorest women are relatively preserved from the epidemic.

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Dataset Information

Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries.

Importance

Objective

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Publications

Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries.

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