Persistence of anaemia among Samoan preschool age children: a longitudinal study

Objective: To characterise the prevalence and persistence of anaemia among Samoan children over a 2-3-year period. Design: Data were from two consecutive waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study. Anaemia (Hb < 11 center dot 0 or 11 center dot 5 g/dl for 2-4 and >= 5 years old, respectively) was considered 'transient' when it occurred at only one wave or 'persistent' if it was present at two consecutive waves. Child, maternal and household correlates of anaemia were examined using log-binomial and modified Poisson regressions. Setting: Eleven Samoan villages. Participants: Mother-child pairs (n 257) recruited in 2015 and reassessed in 2017-2018. Results: Anaemia prevalence was 33 center dot 9 % in 2015 and 28 center dot 0 % in 2017-2018; 35 center dot 6 % of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 v. 2 years, adjusted relative risk (aRR) = 0 center dot 54, (95 % CI 0 center dot 35, 0 center dot 84), P = 0 center dot 007), had older mothers (>= 40 v. 18-29 years, aRR = 0 center dot 61, (95 % CI 0 center dot 39, 0 center dot 95), P = 0 center dot 029) and had higher daily sodium intake (for every 100 mg/d, aRR = 0 center dot 97, (95 % CI 0 center dot 95, 0 center dot 99), P = 0 center dot 003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR = 2 center dot 13, (95 % CI 1 center dot 17, 3 center dot 89), P = 0 center dot 013) and had higher daily dietary iron intake (for every 10 mg/d, aRR = 4 center dot 69, (95 % CI 1 center dot 33, 16 center dot 49), P = 0 center dot 016) than those with no anaemia. Conclusions: Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.