Summary
A preprint analysing Bangladesh’s 2025 Multiple Indicator Cluster Survey estimates that 38.5% of children aged 12–59 months had elevated blood lead. Prevalence was higher in wealthier and urban households, though it remained substantial in the poorest group.
A medRxiv preprint analysing Bangladesh’s 2025 Multiple Indicator Cluster Survey (MICS7) estimates that 38.5% of children aged 12–59 months had elevated blood lead, defined in the analysis as at least 5 micrograms per decilitre (µg/dL). The nationally representative survey analysis found higher prevalence among wealthier and urban households, while elevated levels were also common among children in the poorest households.
Lead is a toxic metal, and exposure during childhood is a public-health concern because it can harm brain development. The study examined how blood lead results varied with household wealth, maternal education, residence and geography; it did not identify a particular source of exposure.
What the analysis found
The author analysed 10,622 children with valid blood lead results. Regression models included 10,458 children with complete data for the other variables. Prevalence estimates accounted for the survey design, and the author used survey-weighted logistic regression to examine associations with socioeconomic characteristics.
The estimated prevalence rose from 30.2% in the poorest wealth quintile to 51.9% in the richest. In the adjusted model, each step up the wealth quintiles was associated with 23% higher odds of elevated blood lead (adjusted odds ratio, or AOR, 1.23; 95% confidence interval [CI] 1.16–1.30). Each level of maternal education was associated with 20% lower odds (AOR 0.80; 95% CI 0.76–0.84), while urban residence was associated with 37% higher odds than rural residence (AOR 1.37; 95% CI 1.18–1.59).
These odds ratios describe associations after adjustment; they are not changes in prevalence or proof that a household characteristic caused exposure. The analysis also found geographic differences: adjusted odds relative to Barishal ranged from 0.39 in Rajshahi to 3.29 in Dhaka.
Implications and limits
The contrast across wealth groups challenges the assumption that elevated blood lead is concentrated only among poorer households. The author recommends that prevention and efforts to identify exposure sources should not be limited to poor communities. At the same time, the estimated 30.2% prevalence in the poorest quintile indicates that the burden was substantial there too.
This was a cross-sectional analysis, which can show patterns and associations but cannot establish their causes. The author notes substantial missing blood lead results and coding uncertainty as limitations. The findings are reported in a medRxiv preprint, so they should be read as preliminary research.