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Journal of Tropical Pediatrics Advance Access originally published online on April 25, 2007
Journal of Tropical Pediatrics 2007 53(4):238-244; doi:10.1093/tropej/fmm011
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© The Author [2007]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Association of diarrhea with anemia among children under age five living in rural areas of Indonesia

Caitlin T. Howarda, Saskia de Peeb, Mayang Saric, Martin W. Bloema,d and Richard D. Sembaa

aThe Johns Hopkins Medical Institutions, Baltimore, MD, USA
bHelen Keller International Asia Pacific, Singapore
cHelen Keller International, Jakarta, Indonesia
dNutrition Service, Policy, Strategy and Programme Support Division, World Food Program, Rome, Italy

Correspondence: Caitlin T. Howard, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 700, Baltimore, MD 21205, USA. Tel.: 1-410-955-3571; Fax: 1-410-955-1332. E-mail <chowar17{at}jhmi.edu>.


  Abstract

The high incidence of anemia of infection among children in developing countries is not well characterized. We investigated the relationship between diarrhea, fever and other risk factors for anemia in young children in the community. The relationship between risk factors for anemia was examined in a cross-sectional study of 85 229 children, aged 6–59 months, from impoverished families in rural areas of Indonesia. The prevalence of anemia was 56.1% among the study subjects. Those considered anemic were more likely to be younger, male, stunted, underweight, wasted, to have low maternal and paternal education and to have current diarrhea or history of diarrhea in the previous 7 days compared with children without anemia (all P < 0.0001). In separate multivariate models adjusted for age, sex, stunting, maternal age and education, and weekly per capita household expenditure, current diarrhea (OR 1.15, 95% CI 1.07–1.325, P < 0.0001) and a history of diarrhea in the previous 7 days (OR 1.16, 95% CI 1.09–1.25, P < 0.0001) were associated with an increased risk of anemia. In similar models, current fever had a borderline association with anemia (OR 1.14, 95% CI 0.98–1.32, P = 0.09). We conclude that diarrhea is a contributing factor of anemia among young children living in rural areas in Indonesia.

Key Words: anemia • children • diarrhea • fever • hemoglobin • Indonesia


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