To examine changes in the prevalence of anaemia and its correlates among children of pre-school age after implementation of wheat flour fortification with multiple micronutrients in Jordan.

Retrospective analysis of the data from two repeated national cross-sectional panels of pre-school children.

The two surveys were conducted in 2007 and 2009, 16–20 months and 34–36 months, respectively, after implementation of wheat flour fortification with multiple micronutrients in Jordan. Anaemia was considered if Hb level was <11 g/dl. An anaemia prevalence of ≥40 % was considered a severe public health problem, while that of 20–39·9 % was considered a moderate public health problem.

A total of 3789 and 3447 children aged 6–59 months tested in 2007 and 2009, respectively.

The prevalence of anaemia in pre-school children declined from 40·4 % in 2007 to 33·9 % in 2009 (adjusted OR=0·74; P<0·001). The decline in the prevalence in 2009 as compared with 2007 was more pronounced among children aged >24 months (−13·7 points), children living in urban areas (−8·0 points), children from rich households (−9·0 points), children who had never been breast-fed (−17·0 points) and well-nourished children (−6·8 points). In both surveys, presence of childhood anaemia was strongly associated with child age ≤24 months, living in poor households, breast-feeding for ≥6 months, malnourishment, poor maternal education and maternal anaemia.

The public health problem of childhood anaemia declined from severe in 2007 to moderate in 2009, after the implementation of wheat flour fortification with multiple micronutrients in Jordan.

Despite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.

Blood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.

Talin communities, Aragatsotn Province, Armenia.

Children under 5 years of age in Talin region.

Of the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.

The study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.