Analysis of determinants of severity levels of childhood anemia in Bangladesh using a proportional odds model

Background: Anemia is an important risk factor for the health of children as it leads to delayed growth and has long term impacts on neurodevelopment and behavior which causes child morbidity and mortality. Though the rate of severe anemia is almost ignorable in Bangladesh, the overall prevalence of anemia is still very high. Thus this study designed to identify determinants of severity levels of anemia among children aged 6-59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). Method: A total of 2188 children aged 6-59 months with complete information on the selected predictors were finally identified from data of this cross sectional survey. Proportional odds model was applied to assess the impacts of determinant on severity level of anemia. Results: Among 2188 children sampled, 24.8%, 32.3% and 42.9% were severely or moderately anemic, mildly anemic, and non-anemic, respectively. Out of children who resided in urban areas, 27.1% were mildly anemic, and 21.1% were severely or moderately anemic. Stunting, division, wealth index, mother's anemia status, age of child, water facility and mother's body mass index were found to be statistically significant determinants of severity levels of childhood anemia. Test of parallelism showed that the odds ratios were constant across all cutoff points of childhood anemia status at 5% level. Conclusions: In summary, our analysis highlights concerning continuing public health challenge presented by anemia in Bangladesh. This study explores the factors associated with the severity level anemia.