Page 250 - Special Topic Session (STS) - Volume 2

STS489 Danielle J.R. et al.

Spatial heterogeneity of childhood anaemia in
four sub-Saharan African countries
Danielle Jade Roberts, Temesgen Zewotir
University of KwaZulu-Natal, Westville, South Africa.

Abstract
Childhood anaemia is a significant public health problem faced by many
developing countries, particularly in Africa. It contributes to adverse health
problems in children by affecting their cognitive and physical development, as
well as their immune function which can lead to increased susceptibility to
infections. The causes of anaemia are multifactorial and interrelate in a
complex way. Such causes vary from country to country, as well as within a
country. Thus, strategies for anaemia control should be tailored to local
conditions and take into account the specific etiology and prevalence of
anaemia in a given setting and sub-population. In addition, policies and
programmes for anaemia control that do not account for the spatial
heterogeneity of anaemia in children may result in certain sub-populations
being excluded, therefore restricting the effectiveness of the programmes.
This study investigated the demographic and socioeconomic determinants as
well as the spatial variation of anaemia in children aged 6 to 59 months in
Kenya, Malawi, Tanzania and Uganda. The study made use of data collected
from nationally represented Malaria Indicator Surveys (MIS) and Demographic
and Health Surveys (DHS) conducted in all four countries between 2015 and
2017. A Bayesian geoadditive model, which included a structured and
unstructured spatial effect, was used. The study revealed distinct spatial
variation in childhood anaemia across the four countries. However, the spatial
variation was predominantly due to district-specific factors that do not
transcend boundaries. These factors may include a lack of access to good
health care and poor nutrition, among other local factors. Therefore, efforts in
assessing the local district-specific causes of childhood anaemia within each
country should be focused on.

Keywords
Adjusted odds ratio; fully Bayesian approach; Hierarchical geoadditive model;
HemoCue haemoglobin concentration analyser; spatial effect

1. Introduction
Anaemia is defined as a significant reduction in haemoglobin (Hb)
concentration which decreases the amount of oxygen reaching the tissues and
organs of the body. Anaemia contributes to adverse health problems in

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