Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study
Abstract Pediatric anemia remains a significant public health challenge in Northeast Thailand, where hemoglobinopathies and nutritional deficiencies coexist. Early identification of children at risk of anemia is crucial to prevent developmental and health consequences. This study assessed the preval...
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Nature Portfolio
2025-07-01
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| author | Suchaorn Saengnipanthkul Prapassara Sirikarn Sasupang Musikaboonleart Ly Cong Tran Maneerat Puwanant |
| author_facet | Suchaorn Saengnipanthkul Prapassara Sirikarn Sasupang Musikaboonleart Ly Cong Tran Maneerat Puwanant |
| author_sort | Suchaorn Saengnipanthkul |
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| description | Abstract Pediatric anemia remains a significant public health challenge in Northeast Thailand, where hemoglobinopathies and nutritional deficiencies coexist. Early identification of children at risk of anemia is crucial to prevent developmental and health consequences. This study assessed the prevalence of children under five being at risk of anemia using Masimo Rad-67® with Rainbow DCI-mini Sensor, while evaluating the association between caregivers’ knowledge, attitudes, and practices on complementary feeding and childhood anemia. A clustered randomized cross-sectional study was conducted involving 2,000 child-caregiver pairs (aged 6 months to 5 years) in Northeast Thailand from September 2022 to March 2023. Non-invasive hemoglobin measurement was used, with anemia risk defined as spectrophotometry hemoglobin (SpHb) < 13.0 g/dL. Data collection included demographic characteristics, natal history, and feeding practices. Additionally, a survey was conducted to assess associated factors of anemia and caregivers’ attitudes, knowledge, and practices regarding complementary feeding. The study found a 36.9% prevalence of at-risk anemia. Key predictors included age under 24 months (adjusted OR 2.1, 95%CI 1.7–2.6), maternal thalassemia trait (adjusted OR 1.8, 95%CI 1.4–2.3), and wasting (adjusted OR 1.6, 95%CI 1.2–2.1). Iron supplementation was a protective factor. Despite 48.2% of children receiving iron supplementation per government policy, only 24.6% met the daily iron intake according to the Thai dietary reference intake. Gap in caregiver knowledge persisted, with 68.1% of caregivers having received education on iron deficiency anemia, and only 32% able to name iron-rich foods. Public health strategies should combine nutritional education targeting iron-rich complementary feeding, implementation of a thalassemia-integrated screening protocol, and proactive community surveillance programs to improve iron intake. Thai clinical trial registration: TCTR20221024002. |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-664e1f599f9f45b29b03d9d0ea24c0e92025-08-20T03:45:28ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-05550-8Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional studySuchaorn Saengnipanthkul0Prapassara Sirikarn1Sasupang Musikaboonleart2Ly Cong Tran3Maneerat Puwanant4Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Khon Kaen UniversityDepartment of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen UniversityDepartment of Nutrition, Srinagarind Hospital, Faculty of Medicine, Khon Kaen UniversityDoctor of Philosophy Program in Clinical Sciences, Khon Kaen UniversityDepartment of Pediatrics, Faculty of Medicine, Prince of Songkla UniversityAbstract Pediatric anemia remains a significant public health challenge in Northeast Thailand, where hemoglobinopathies and nutritional deficiencies coexist. Early identification of children at risk of anemia is crucial to prevent developmental and health consequences. This study assessed the prevalence of children under five being at risk of anemia using Masimo Rad-67® with Rainbow DCI-mini Sensor, while evaluating the association between caregivers’ knowledge, attitudes, and practices on complementary feeding and childhood anemia. A clustered randomized cross-sectional study was conducted involving 2,000 child-caregiver pairs (aged 6 months to 5 years) in Northeast Thailand from September 2022 to March 2023. Non-invasive hemoglobin measurement was used, with anemia risk defined as spectrophotometry hemoglobin (SpHb) < 13.0 g/dL. Data collection included demographic characteristics, natal history, and feeding practices. Additionally, a survey was conducted to assess associated factors of anemia and caregivers’ attitudes, knowledge, and practices regarding complementary feeding. The study found a 36.9% prevalence of at-risk anemia. Key predictors included age under 24 months (adjusted OR 2.1, 95%CI 1.7–2.6), maternal thalassemia trait (adjusted OR 1.8, 95%CI 1.4–2.3), and wasting (adjusted OR 1.6, 95%CI 1.2–2.1). Iron supplementation was a protective factor. Despite 48.2% of children receiving iron supplementation per government policy, only 24.6% met the daily iron intake according to the Thai dietary reference intake. Gap in caregiver knowledge persisted, with 68.1% of caregivers having received education on iron deficiency anemia, and only 32% able to name iron-rich foods. Public health strategies should combine nutritional education targeting iron-rich complementary feeding, implementation of a thalassemia-integrated screening protocol, and proactive community surveillance programs to improve iron intake. Thai clinical trial registration: TCTR20221024002.https://doi.org/10.1038/s41598-025-05550-8AnemiaUnder-five childrenNutritional statusRisk factorsHealth knowledge, attitudes, practiceNon-invasive hemoglobin |
| spellingShingle | Suchaorn Saengnipanthkul Prapassara Sirikarn Sasupang Musikaboonleart Ly Cong Tran Maneerat Puwanant Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study Scientific Reports Anemia Under-five children Nutritional status Risk factors Health knowledge, attitudes, practice Non-invasive hemoglobin |
| title | Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study |
| title_full | Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study |
| title_fullStr | Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study |
| title_full_unstemmed | Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study |
| title_short | Prevalence and associated factors of at risk of anemia among children under five in Northeast Thailand using noninvasive hemoglobin screening in a cross sectional study |
| title_sort | prevalence and associated factors of at risk of anemia among children under five in northeast thailand using noninvasive hemoglobin screening in a cross sectional study |
| topic | Anemia Under-five children Nutritional status Risk factors Health knowledge, attitudes, practice Non-invasive hemoglobin |
| url | https://doi.org/10.1038/s41598-025-05550-8 |
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