Anemia in Early Childhood and Associated Factors in Ecuador: An Analysis From a Health Social Determinants Model

Abstract

Anemia is a problem highly prevalent in children associated with multiple factors. This study aims to identify factors associated with anemia in children under 5 years of age in Ecuador, based on the social determinants of health model. A secondary database study was conducted with information from 18,688 children aged 6–59 months included in the National Survey of Child Malnutrition 2022–2023. Anemia was defined by hemoglobin levels adjusted for age and height at sea level. Bivariate and multivariable Poisson regression for complex samples were used to calculate prevalence ratios with 95% confidence intervals. Anemia was found in 46.4% (95% CI 44.5–48.4) of children aged 6–23 months and 39.8% (95% CI 38.2–41.5) of those aged 24–59 months. For the 6–23-month age group, the prevalence of anemia was higher in the lowest economic quintiles 1 and 2 (PR 1.26; 95% CI 1.05–1.51; PR 1.31; 95% CI 1.09–1.56), in those with latrines compared with toilets (PR 1.37; 95% CI 1.05–1.77), in children of adolescent or younger mothers (PR 1.29; 95% CI 1.08–1.53; PR 1.19; 95% CI 1.08–1.31), and in those with recent infectious diseases (PR 1.13; 95% CI 1.03–1.24). For the 24- to 59-month-old group, the prevalence of anemia was higher in males than in females (PR 1.10, 95% CI 1.03–1.18), in indigenous people and Afro-Ecuadorians compared to mestizos or whites (PR 1.11, 95% CI 1.01–1.23; PR 1.35, 95% CI 1.19–1.53). Children of mothers with no education or only primary education had a 15% higher prevalence of anemia (PR 1.15, 95% CI 1.03–1.29) compared with children of mothers with a university education. In conclusion, gaps were found by gender, ethnicity, and socioeconomic status associated with the prevalence of anemia in children. A comprehensive approach is needed to reduce the prevalence of anemia in childhood.