Spatial Patterns and Determinants of Childhood Anemia in the Democratic Republic of Congo: Evidence From the 2023/2024 DHS
Zelalem Meraf Wolde, Nigussie Adam Birhan, Kefale Tilahun Getahun, Kahsay Kiros Hailu, Batholomew Chibuike James, Roy Rillera Marzo, Wegayehu Enbeyle Sheferaw, Endale Alemayehu Ali, Denekew Bitew BelayBackground
Anemia in children is a serious public health issue in low‐income settings, particularly sub‐Saharan Africa. In the Democratic Republic of Congo (DRC), evidence on the geographic distribution and multilevel determinants of childhood anemia remains limited. This study aimed to examine the spatial pattern and identify individual, household, and community‐level determinants of anemia among children aged 6–59 months in the DRC.
Methods
A secondary analysis was conducted using data from the 2023/2024 DRC‐DHS. A weighted sample of 9449 children aged 6–59 months was included. Spatial analyses were performed using Global Moran’s I, Getis‐Ord Gi∗, and Kriging interpolation techniques to assess geographic clustering and spatial patterns of childhood anemia. Multilevel binary logistic regression models were fitted to identify factors associated with childhood anemia, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported.
Results
Of the 9449 children, 6092 (64.5%) were anemic. Spatial analysis showed significant geographic clustering of anemia in the DRC (Moran’s I = 0.516, p = 0.0078), with hotspot regions in western‐central and cold spots in eastern provinces. Our findings showed that several factors were associated with lower odds of childhood anemia. Specifically, we observed reduced odds among children aged 24–35 months (AOR = 0.48; 95% CI: 0.34–0.68), females (AOR = 0.89; 95% CI: 0.81–0.98), and those from households in the middle wealth index (AOR = 0.86; 95% CI: 0.75–0.98). In contrast, higher odds of childhood anemia were observed among children with severe stunting (AOR = 1.19; 95% CI: 1.04–1.37), severe underweight (AOR = 1.58; 95% CI: 1.31–1.92), fever (AOR = 1.24; 95% CI: 1.10–1.40), those born to anemic mothers (AOR = 1.39; 95% CI: 1.26–1.53), children from households with female household head (AOR = 1.21; 95% CI: 1.08–1.35), and those residing in communities with higher levels of poverty (AOR = 1.24; 95% CI: 1.05–1.47).
Conclusion
Childhood anemia in the DRC remains highly prevalent and spatially clustered, with western and northern provinces particularly affected. Individual, household, and community factors were identified as significant determinants of anemia risk. Targeted interventions focusing on high‐risk regions, nutritional support, maternal health, and socioeconomic improvements are critical to reducing childhood anemia in the DRC.