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The Burden of Childhood Anemia in Bangladesh: Does Socioeconomic Status Matter?

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03126253
Recruitment Status : Completed
First Posted : April 24, 2017
Last Update Posted : April 24, 2017
Information provided by (Responsible Party):
G.M. Rabiul Islam, Shahjalal University of Science and Technology

Brief Summary:
Childhood anemia is a global public health problem that is associated with life-threatening consequences such as growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Anemia can be caused by a variety of factors such as nutritional deficiencies (i.e., iron, folic acid, vitamin B12, and vitamin A), infections (i.e., helminth), and blood disorders (i.e., hemoglobinopathies). The World Health Organization (WHO) estimates that approximately 50% of anemia cases can be attributed to iron deficiency. This is an estimated global average that varies widely depending upon the location in question. The World Bank estimates for 2011 claim that approximately 55.60% of all Bangladeshi children under five years of age are suffering from anemia. The relationship between socioeconomic status (SES) inequality and anemia among the children has never been conclusively and it is unclear if the children of the age group of 6-59 months have uniformly high levels of anemia during all the stages of development, e.g., during the infant, toddler, and preschool stages. In addition, there is a dearth of evidence from Bangladesh, where the meaning of sociodemographic characteristics may be different from that in other countries. Therefore, this study attempts to fill the above-mentioned lacuna by investigating and evaluating the association of SES inequality, among other explanatory variables, on the development of childhood anemia during different stages of child development and to answer the questions: (a) Is SES a factor impeding childhood anemia along with other explanatory variables? (b) In which stage of child development, the chance of disparaging with childhood anemia is highest? (c) Is there evidence of between child development stages differences in the strength and form of association disparities between having childhood anemia and SES? (c) What are the predictive margins for SES-associated anemia in the case of infants, toddlers, and preschool children? The results of this analysis will be reported for elucidating the potential effects of SES and the stages of child development that are usually neglected in the conventional scientific literature. Moreover, as anemia is one of the current key health issues in Bangladesh, it is also expected that the findings of this study would contribute significantly toward shaping the health policy strategy of the country.

Condition or disease Intervention/treatment
Anemia Diagnostic Test: Anemia

Detailed Description:
The data collected by the 2011 Bangladesh Demographic Health Survey (BDHS), conducted by the National Institute for Population Research and Training (Ministry of Health and Family Welfare, Bangladesh), will be used for the purpose of this study. in the BDHS 2011, A nationally representative household-based sample was created through a stratified, multistage cluster sampling strategy in which 600 primary sampling units were constructed (207 in urban areas and 393 in rural areas). The primary sampling units were derived from a sampling frame created for the 2001 Bangladeshi census from seven divisions of Bangladesh. Households were selected randomly from each primary sampling unit. The data pertaining to the socioeconomic and sociodemographic factors were collected using a structured open-ended interview. The questionnaire used for this purpose was modeled on the MEASURE DHS questionnaires. Prior to the use, these questionnaires were adapted for the use in Bangladesh through a series of meetings with a Technical Working Group (TWG) that comprised of representatives from the National Institute of Population Research and Training (NIPORT,) Mitra and Associates, the International Centre for Diarrheal Diseases and Control in Bangladesh (ICDDR, B), USAID/Bangladesh, and MEASURE DH. The questionnaires were drafted in English and then translated into Bangla which is the national language of Bangladesh. The translations were reviewed by the experts as well as by the volunteers and a pilot study was conducted to validate the same. Of the total of 17,964 selected households, face-to-face interviews were successfully completed for 17,141 corresponding to a household response rate of 98%. The subjects for the examination of anemia were 2320 children aged 6-59 months, were raised from every third household of the BDHS sample. After excluding subjects with missing data, a total of 2068 individuals were selected for this analysis.

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Study Type : Observational
Actual Enrollment : 2320 participants
Observational Model: Ecologic or Community
Time Perspective: Cross-Sectional
Official Title: The Burden of Childhood Anemia in Bangladesh:
Actual Study Start Date : May 11, 2011
Actual Primary Completion Date : July 8, 2011
Actual Study Completion Date : January 18, 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anemia

Intervention Details:
  • Diagnostic Test: Anemia
    Hemoglobin level will be used as the parameter for diagnosing anemia. The HemoCue system was used to estimate the concentration of hemoglobin in capillary blood. WHO guidelines for the diagnosis of anemia that were adopted by the Demographic Health Surveys will be used in this study. Briefly, a hemoglobin concentration of less than 70 g/L will be consider to define severe anemia, 70-99 g/L for moderate anemia, and 100-109 g/L will be presumed to correspond to mild anemia. The above-mentioned classification of anemia as "severe" "moderate" and "mild" categories is based on blood hemoglobin cutoffs (will be adjusted for altitude and smoking) recommended by the Center for Disease Prevention of United States; this classification has also been adopted by the World Health Organization.

Primary Outcome Measures :
  1. Anemia [ Time Frame: Baseline ]
    Blood hemoglobin level will be used as the parameter for diagnosing anemia.

Information from the National Library of Medicine

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Ages Eligible for Study:   6 Months to 59 Months   (Child)
Sexes Eligible for Study:   All
Sampling Method:   Non-Probability Sample
Study Population
children 6-59 month of age in Bangladesh

Inclusion Criteria:

  • Infant: Less than or equal to 12 months old
  • Toddler: between 13-36 months
  • Preschool children: between 37-59 month

Exclusion Criteria:

  • Child 0-5 months

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03126253

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Data analysis
Sylhet, Bangladesh, 3114
Sponsors and Collaborators
Shahjalal University of Science and Technology
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Principal Investigator: GM MI Islam, PhD Shahjalal University of Science and Technology
Additional Information:
Study Data/Documents: Report of the survey along with sampling plan  This link exits the site

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: G.M. Rabiul Islam, Associate Professor, Shahjalal University of Science and Technology Identifier: NCT03126253    
Other Study ID Numbers: FET-CA
First Posted: April 24, 2017    Key Record Dates
Last Update Posted: April 24, 2017
Last Verified: April 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by G.M. Rabiul Islam, Shahjalal University of Science and Technology:
childhood anemia, socioeconomic status
Additional relevant MeSH terms:
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Hematologic Diseases