Prevalence of Undernutrition and Anemia in 6–24-Month-Old Children in Rural South India: Assessing the Target Population for a Multiple Biofortified Crops Feeding Trial

Abstract Objectives To characterize anemia and anthropometry in children in rural South India:1.Report the prevalence of undernutrition and anemia2.Examine associations with demographic, socio-economic, and clinical characteristics among 6–24-month-old children screened for participation in a randomized controlled feeding trial. Methods This cross-sectional assessment included 339 children screened for participation in a randomized controlled feeding trial from March – September 2019. Complete blood counts were performed immediately after blood and anthropometric measurements were collected. Sociodemographic data were collected from mothers. We assessed the outcomes hemoglobin (Hb, g/dL), anemia (Hb < 11 g/dL), stunting (LAZ < −2), wasting (WLZ < −2) and underweight (WAZ < −2) with correlates at the individual (child age, sex, birthweight), maternal (maternal age, maternal education) and household (family income) level. Covariates were included based on previous literature and biological plausibility. Linear regression (ß, SE) was used to determine covariates for continuous outcomes (such as Hb) and binomial and Poisson regressions (RR, 95% CI) were used in the case of categorical outcomes (Hb < 11 g/dL, LAZ < −2, WLZ < −2, WAZ < −2). All multivariate models included a priori determined covariates age and sex and covariates with univariate p-values ≤ 0.20. Variables with a p-value of ≤ 0.05 were retained in the final multivariate models (SAS 9.4). Results Almost half (46.9%) of this population was ≤ 12 months of age at the time of assessment. Over half (52.7%) of participants were female. Anemia was present in 72.6% of children. 15.1% of children were stunted, 14.2% underweight and 8.2% were wasted based on the corresponding WHO Z-scores. A higher birth weight of 1 kg was associated with a lower risk of later underweight [0.47 (0.29, 0.79); P = 0.01] and wasting [0.42 (0.21, 0.85); P = 0.02]. Children with families whose monthly income was ≤ 5000 INR (∼USD 70) per month were more likely to be stunted [2.32 (1.17, 4.59); P = 0.01] and underweight [2.07 (1.05, 4.06); P = 0.03]. Conclusions In these 6–24-month-old children, anemia and poor growth are widely prevalent. The results from this analysis provide evidence of a potential to benefit from nutritional interventions targeted at children in this population. Funding Sources Cornell Division of Nutritional Sciences Harvest Plus.