Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 603

P12-126 - Determinants of anemia among women and children in rural Bangladesh: a comparison between households with high and low groundwater iron levels

Sunday, Jun 10
8:00 AM – 6:00 PM


We aim to identify determinants of anemia among women and children, separately for households reporting groundwater iron consumption and those not.


We analyzed data from the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial 2015 baseline survey in Sylhet, Bangladesh on 1757 women and their 889 children aged 6-37 months. Determinants of anemia were assessed using multivariable logistic regression with robust standard errors to adjust for village-level clustering. Groundwater iron was assessed by asking women about iron content in their drinking water.


Women and children in households with reported groundwater iron were less likely to be anemic than those with none (Any: 31% and 46%; None: 37% and 56%, respectively). In both groundwater iron groups, recent pregnancy and lower educational attainment in women and lower child age were associated with higher levels of anemia.

Among women reporting no groundwater iron, heme-iron food or iron supplement consumption was significantly associated with reduced anemia (OR: 0.64; 95% CI (0.42, 0.97)). Among children in these households, no dietary factors were associated with anemia. However, children of underweight mothers (BMI<18.5) were more likely to be anemic (OR: 1.95; 95% CI (1.26, 3.00)).

Among women reporting groundwater iron, consumption of coffee or tea increased the likelihood of anemia (OR: 1.55; 95% CI (1.10, 2.18)). Among their children, consumption of Vitamin C-rich vegetables or fruit was associated with less anemia (OR: 0.57; 95% CI (0.34, 0.94)).


The influence of dietary factors on anemia seem to differ depending on the presence of groundwater iron in household drinking water. Among women without groundwater iron, increasing dietary iron remains a key strategy. In areas with groundwater iron, making this iron source accessible for intestinal absorption may reduce anemia even without additional dietary iron sources. Furthermore, there is still a large proportion of anemia among both women and children consuming iron from water or dietary sources, which is likely due to causes other than iron deficiency.

Funding Source: This trial is funded by the German Federal Ministry for Education and Research (BMBF). This analysis was done with the support of the Alexander von Humboldt Foundation and Thrasher Research Fund.

CoAuthors: Jillian Waid, MSW – Helen Keller International; Sabine Gabrysch, MD PhD – University of Heidelberg

Amanda S. Wendt

AvH Postdoctoral Fellow
Institute of Public Health, University of Heidelberg
Heidelberg, Baden-Wurttemberg, Germany