{
  "abstract": "Objectives To describe the prevalence and spatial distribution of anaemia among children aged 6–59 months in Madagascar and to explore individual-level and community-level correlates using data from the 2021 Madagascar Demographic and Health Survey.Design A population-based cross-sectional study using secondary data from the 2021 Madagascar Demographic and Health Survey. Spatial statistical methods were used to assess geographic clustering and hotspot areas of anaemia.Setting The study was conducted across community and household levels throughout Madagascar, covering both rural and urban populations within the primary and secondary healthcare delivery contexts.Participants A weighted sample of 10 683 children aged 6–59 months was included. Sampling followed demographic health survey procedures, and only children with complete haemoglobin data were analysed.Interventions No interventions were applied.Primary and secondary outcome measures The primary outcome was anaemia, defined as haemoglobin <11 g/dL. Spatial autocorrelation and hotspot analyses identified geographical clustering patterns.Results The overall point prevalence of anaemia was 47% (95% CI 45.60 to 48.36), showing significant spatial clustering (Global Moran’s I=0.136, p<0.001), with hotspots mainly in the central and southeastern regions. Differences in anaemia prevalence were observed across population subgroups, including child age, maternal education, household wealth, place of residence and nutritional status.Conclusions Anaemia among Malagasy children remains a major public health concern and shows clear geographic variation. The findings describe important differences in prevalence across regions and population subgroups, providing useful evidence for public health planning and for generating hypotheses for future analytical research.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Promotion and Health Behavior, School of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia"
      ],
      "name": "Gebeyehu Lakew"
    },
    {
      "affiliations": [
        "Department of Pediatric and Child Health Nursing, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Mathewos Mekonnen Gemmechu"
    },
    {
      "affiliations": [
        "Department of Pediatric and Child Health Nursing, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Tiruye Menshaw Tiruneh"
    },
    {
      "affiliations": [
        "Department of Pediatric and Child Health Nursing, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Yibeltal Assefa Atalay"
    },
    {
      "affiliations": [
        "Department of Health Promotion and Health Behavior, School of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia"
      ],
      "name": "Amlaku Nigusie Yirsaw"
    },
    {
      "affiliations": [
        "Health Promotion and Behavioral Science Department, School of Public Health, Bahir Dar University College of Medical and Health Sciences, Bahirdar, Ethiopia"
      ],
      "name": "Eyob Ketema Bogale"
    },
    {
      "affiliations": [
        "Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia"
      ],
      "name": "Natnael Atnafu Gebeyehu"
    },
    {
      "affiliations": [
        "Department of Anesthesia, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Tewodros Shitemaw Tekoye"
    },
    {
      "affiliations": [
        "Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Genanew Kassie Getahun"
    },
    {
      "affiliations": [
        "Bati Primary Hospital, North Shoa, Ethiopia"
      ],
      "name": "Kedir Seid"
    },
    {
      "affiliations": [
        "Department of Nursing, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Abel Tibebu Goshu"
    },
    {
      "affiliations": [
        "Department of Anesthesia, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia"
      ],
      "name": "Sintayehu Samuel Lorato"
    },
    {
      "affiliations": [
        "Department of Anesthesia, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia"
      ],
      "name": "Mitiku Desalegn"
    },
    {
      "affiliations": [
        "Department of Midwifery, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Kelemu Abebe Gelaw"
    },
    {
      "affiliations": [
        "Department of Neonatal Nursing, MII Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Yohannes Godie Ashebir"
    },
    {
      "affiliations": [
        "Public Health Nutrition, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia"
      ],
      "name": "Olyad Kuma Getahun"
    }
  ],
  "title": "Spatial variation and distribution of anaemia among children aged 6–59 months in Madagascar: a population-based cross-sectional study",
  "uid": "b82a8823-be16-58cf-ac6c-7f17382c1ce8"
}