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Abstract There is little research on anemia and vitamin D deficiency in HIV-exposed uninfected (HEU) children. This study was aimed to describe and compare the prevalence of anemia and vitamin D inadequacy in HEU children and HIV-unexposed uninfected (HUU) children, and to examine the associations of HIV exposure with anemia and vitamin D inadequacy. This was a hospital-based descriptive cross-sectional study nested within the Prevention of Mother-to-Child Transmission (PMTCT) of HIV program in Hunan Province during July and September 2022. The HEU children aged 6 to 24 months were recruited from the PMTCT outpatient clinics located in five Municipal Maternal and Child Health Care Hospitals. The HUU children were recruited from routine child health examination clinics in the same five Hospitals. Questionnaires about children’s characteristics and maternal gestational conditions were collected from children’s caregivers, and blood samples were collected from all children. Descriptive statistics, Chi-square test, non-parametric rank sum test, and logistic regression were used for analysis. The study population included 336 HEU children and 334 HUU children. The overall prevalence of anemia in the HEU and HUU children was 10.4% and 8.1%, respectively. The median hemoglobin concentrations were 120 (115–126) g/L in the HEU children and 122 (116–129) g/L in the HUU children. Neither prevalence of anemia nor hemoglobin concentration was significantly different between the two groups (P > 0.05). The prevalence of vitamin D inadequacy in the HEU children (19.6% for deficiency and 25.0% for insufficiency) was significantly higher than that of the HUU children (11.4% for deficiency and 16.2% for insufficiency) (P

Abstract Fever and diarrhea are key causes of malnutrition, growth and development disorders, and death among children. At present, most studies on the associated factors of fever and diarrhea in children are concentrated in African and South Asian countries, but relevant research in China is very limited. This study was aimed to analyze the two-week prevalence of fever, diarrhea, and coexisting fever and diarrhea among children aged 6–23 months in rural areas of Hunan Province and to explore the associated factors. The survey data of the Nutrition Improvement Program for Children in Poor Areas (NIPCPA) from 2016 to 2023 was used here. NIPCPA is a cross-sectional survey completed annually in Hunan to collect children’s nutrition and health indicators. The two-week prevalence rates of fever, diarrhea, and coexisting fever and diarrhea among children aged 6–23 months were 12.2% (2066/16,985), 9.6% (1634/16,985), and 3.2% (542/16,985), respectively. Multivariate logistic regression analysis showed the risks of fever, diarrhea, and coexisting fever and diarrhea were higher among younger children. The high educational level of caregivers, effective consumption of Yingyangbao (a complementary food supplement containing iron, zinc, calcium, vitamins A, D, B1, B2, B12, folic acid, and other micronutrients), and complementary feeding meeting minimum dietary diversity and meeting minimum acceptable diet were protective factors against fever in children, with adjusted odds ratios (aORs) of 0.87 (95%CI: 0.78–0.98), 0.78 (0.69–0.87), 0.73 (0.65–0.82), and 0.74 (0.66–0.84), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against diarrhea in children, with aORs of 0.72 (95%CI: 0.63–0.83), 0.79 (0.70–0.91), and 0.80 (0.70–0.92), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against coexisting fever and diarrhea among children, with aORs of 0.53 (95%CI: 0.43–0.66), 0.71 (0.58–0.89), and 0.70 (0.56–0.88), respectively. Fever, diarrhea, and the coexisting fever and diarrhea affect one in eight, one in ten, and one in thirty children respectively in rural areas of Hunan. Effective interventions should be actively taken, such as improving the education level of caregivers, enhancing their scientific feeding skills for children, and promoting children’s compliance with Yingyangbao consumption, to further reduce the prevalence of fever and diarrhea in children.

Abstract Background In recent 10 years, with the rapid socioeconomic development and the extensive implementation of children nutrition improvement projects, the previous epidemiological data cannot reflect the actual level of anemia among children in China, especially in rural areas. Therefore, this study analyzed the prevalence, severity and associated factors of anemia among children aged 6–71 months in rural Hunan Province. Methods A community-based cross-sectional study was conducted. Through multistage stratified cluster sampling, 5229 children aged 6 to 71 months and their caregivers were randomly selected from 72 villages across 24 towns in 12 counties from rural Hunan. The demographic characteristics of children and their caregivers, feeding practice, nutritional status of children, caregivers’ anemia-related feeding knowledge, and gestational conditions of mothers were acquired by using a unified questionnaire. Peripheral blood from the left-hand middle fingertip was sampled from each child, and hemoglobin concentration was measured using a HemoCue301 portable hemoglobin analyzer (Sweden). Associated factors analyses involving overall anemia and anemia severities were conducted on multivariate logistic regression models. Results The overall anemia prevalence was 8.8%, and the prevalence of mild, moderate and severe anemia was 6.3, 2.5 and 0.1%, respectively. Children age groups of 6–11 months, 12–23 months and 36–47 months, exclusive breast-feeding within 6 months after birth, and maternal moderate/severe anemia were significantly associated with an increased risk of overall anemia in children. Children age groups of 6–11 months and 12–23 months were significantly associated with an increased risk of mild anemia in children. Children age groups of 6–11 months, 12–23 months and 36–47 months, low caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia were significantly associated with an increased risk of moderate/severe anemia in children. Children who underwent regular physical examination were less likely to have moderate/severe anemia. The common protective factor for overall, mild and moderate/severe anemia in children was high family income. Conclusions The anemia status of preschool children in rural Hunan Province was a mild public health problem and associated with children age group, feeding practice, regular physical examination, family income, caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia.