Risk factors for iron deficiency anaemia in preschool children in northern Ethiopia.

OBJECTIVE To determine risk factors for anaemia in preschool children. DESIGN A cross-sectional study. SETTING Tigray province, northern Ethiopia. SUBJECTS 2080 of 2373 children aged 6-60 months provided blood to assess anaemia. RESULTS Anaemia was highly prevalent (42%) and constituted an important nutritional problem in the region. In a sub-sample of 230 anaemic children, 56% had a low red blood cell (RBC) count, and 43% had a serum ferritin of less than 12 microgl(-1) indicating that the anaemia was largely due to iron deficiency. Unlike other regions in developing countries, hookworm (0.4%) and malaria (0.0%) were rare and contributed little to the anaemia. Even though their diet lacked variety, the amount of iron consumed through cereal-based staple foods was adequate. However, the iron in these foods was not readily available and their diets were probably high in iron absorption inhibitors and low in enhancers. Dietary factors associated with anaemia included frequent consumption of inhibitors, such as fenugreek and coffee, and poor health in the child such as diarrhoea and stunting. CONCLUSIONS Underlying causes of anaemia were lack of safe water and inadequate human waste management, maternal illiteracy and mother being ill, and having no food reserves. The root cause of these factors was poverty. The optimal control strategy for iron deficiency anaemia should have a holistic approach which includes the alleviation of poverty, the empowerment of women and the provision of a safe environment.