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Anaemia in Infancy in Rural Bangladesh: the Contribution of Iron Deficiency (ID), Infections, and Poor Feeding Practices

This study aimed to determine the contribution of ID, infections and feeding practices to anaemia in Bangladeshi infants aged 6–11 months. Baseline data from 1600 infants recruited into a cluster‐randomized trial testing the effectiveness of micronutrient powder sales by frontline health workers on the prevalence of anaemia were used. Multivariate logistic regression was used to identify risk factors for anaemia and ID, and population attributable fractions (PAF) were computed to estimate the proportion of anaemia that might be prevented by the elimination of individual risk factors. Sixty‐eight percent of infants were anaemic, 56 percent iron‐deficient, and one‐third of infants had evidence of sub‐clinical infections. The prevalence of anaemia and ID increased rapidly, until 8 to 9 months of age, while the prevalence of sub‐clinical infections was constant. ID (Adjusted Odds Ratio (AOR): 2.5–2.7; p<0.001) and sub‐clinical infections (AOR: 1.4–1.5; p<0.01) were major risk factors for anaemia, in addition to age, and male sex. Sub‐clinical infections, age, and male sex, were similarly significant risk factors for ID. Previous day consumption of iron‐rich foods was very low and not associated with anaemia or ID. These results suggest a multipronged strategy is needed to prevent anaemia during infancy in Bangladesh that combines improvements in dietary iron intake alongside infection control strategies.