Prevalance of anemia and its associated individual, household and community level factors among children aged 1-5 years in two peri-urban communities of Karachi, Pakistan

Iron Deficiency Anemia (IDA) among children is considered to be the principal nutritional cause which impedes national growth due to its devastating impacts on health and economics. About 50% of young children in developing world suffer from anemia with Asia and Africa as the most affected regions. To broaden the understanding of its determinants, this study intends to explore the individual, household and community level factors associated with IDA among children aged 1-5 years in two peri-urban communities of Karachi, Pakistan. Methods: From March-June 2014, a community based cross-sectional study was conducted in two peri-urban communities of Karachi among children aged 1-5 years. A structured questionnaire was used to obtain information on individual, household and community level factors. Systematic sampling method was employed to enhance community representation. Binary multilevel logistic regression was applied to evaluate the association of covariates at two levels. Results: The overall prevalence of mild, moderate and severe anemia in children aged 1-5 year was found to be 17.61%, 57.7% and 14.8%, respectively in the two selected communities. The individual and household factors found to be positively associated with childhood anemia were younger age (AOR=2.0, 95% CI: 1.3-3.1), not being vaccinated (AOR=1.9, 95% CI: 1.0-3.6) and having 4-6 alive children(AOR=1.9, 95% CI:1.2-3.1). And the community level factors which had a negative association with anemia included living in neighborhoods with high availability of fruits (AOR\u270.3, 95% CI: 0.1-0.6), and living in neighborhoods with high number of food and vegetable shops (AOR=0.4, 95% CI: 0.2-0.9). Conclusion: We found a high prevalence of anemia among children aged 1-5 years in the two peri-urban communities of Karachi. Younger age, not being vaccinated, having a higher number of alive children and living in neighborhoods with availability of foods, vegetables and fruits were found to be strong determinants of anemia. The study findings underscore the need for taking practical initiatives to understand the individual, household and community level determinants of anemia. The overall development in terms of nutritional facilities and infrastructure of peri-urban communities need to be enhanced to mitigate the burden of anemia in children under-five years