Peer-reviewed article
Spatial variation and distribution of anaemia among children aged 6-59 months in Madagascar: a population-based cross-sectional study.
Lakew G, Gemmechu MM, Tiruneh TM, Atalay YA, Yirsaw AN et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined anaemia among children aged 6-59 months across Madagascar using data from the 2021 Demographic and Health Survey. Nearly half of children (47%) had anaemia, defined as haemoglobin below 11 g/dL. The study found significant geographic clustering of anaemia, with hotspots concentrated in central and southeastern regions. Anaemia prevalence differed by child age, maternal education, household wealth, place of residence, and nutritional status.
Key points
- Overall anaemia prevalence was 47% (95% CI 45.60–48.36) among children aged 6–59 months
- Significant spatial clustering was identified (Global Moran's I=0.136, p<0.001)
- Anaemia hotspots were mainly located in central and southeastern regions of Madagascar
- Prevalence differences were observed across subgroups including child age, maternal education, household wealth, place of residence, and nutritional status
- Findings provide evidence for public health planning and hypothesis generation for future research
Limitations
This is a descriptive cross-sectional study that identifies associations and geographic patterns but cannot establish causation. The study cannot explain why certain regions have higher anaemia rates or what specific interventions would be effective.
Abstract
Objectives To describe the prevalence and spatial distribution of anaemia among children aged 6-59 months in Madagascar and to explore individual-level and community-level correlates using data from the 2021 Madagascar Demographic and Health Survey. Design A population-based cross-sectional study using secondary data from the 2021 Madagascar Demographic and Health Survey. Spatial statistical methods were used to assess geographic clustering and hotspot areas of anaemia. Setting The study was conducted across community and household levels throughout Madagascar, covering both rural and urban populations within the primary and secondary healthcare delivery contexts. Participants A weighted sample of 10 683 children aged 6-59 months was included. Sampling followed demographic health survey procedures, and only children with complete haemoglobin data were analysed. Interventions No interventions were applied. Primary and secondary outcome measures The primary outcome was anaemia, defined as haemoglobin <11 g/dL. Spatial autocorrelation and hotspot analyses identified geographical clustering patterns. Results The overall point prevalence of anaemia was 47% (95% CI 45.60 to 48.36), showing significant spatial clustering (Global Moran's I=0.136, p<0.001), with hotspots mainly in the central and southeastern regions. Differences in anaemia prevalence were observed across population subgroups, including child age, maternal education, household wealth, place of residence and nutritional status. Conclusions Anaemia among Malagasy children remains a major public health concern and shows clear geographic variation. The findings describe important differences in prevalence across regions and population subgroups, providing useful evidence for public health planning and for generating hypotheses for future analytical research.