<p>Hematological Abnormalities and Associated Factors Among Undernourished Under-Five Children Attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia</p>

Abstract

Introduction The hematopoietic system is one of the systems which can be affected by malnutrition, leading to impaired production of all blood cell lines. Undernourished children with hematological abnormalities like anemia are at higher risk of mortality. Therefore, this study aimed at determining the magnitude and associated factors of hematological abnormalities among undernourished under-five children attending at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia. Methods and Materials An institution-based cross-sectional study was conducted on a total of 251 undernourished under-five children at University of Gondar Specialized Referral Hospital from January to May 2020. A convenient sampling technique was employed to select study participants. Data were collected using a pretested structured questionnaire. Blood samples were collected for complete blood count which were determined by Sysmex KX-21N analyzer. Stool sample was processed via direct wet mount. Thin and thick blood films were examined to assess malaria parasite. The data were entered to EpiData version 4.6.0.0 and analyzed using SPSS version 23 software. Bi-variable and multi-variable binary logistic regression model were fitted to identify factors associated with hematological abnormalities. A p-value <0.05 in the multivariable analysis was considered as statistically significant. Results The overall magnitude of anemia, leukocytosis, thrombocytosis, thrombocytopenia, and leukopenia was 53.4%, 26.7%, 23.9%, 8%, and 2.8%, respectively. Being male, age 6–23 months, high birth order, intestinal parasite infection, edema, not eating vegetables and fruits, and paternal occupation were found to be associated with anemia. Only the age of a child was associated with leukocytosis in undernourished children. Conclusion The current study demonstrated the predominant existence of anemia, leukocytosis, and thrombocytosis among undernourished under-five children. Therefore, early diagnosis, monitoring and setting intervention strategies for anemia especially among children under two years old are required to prevent further complication.

Impact of Therapeutic Foods on Hematological Parameters of Malnourished Children Admitted at the Intensive Nutritional Recovery Center of Tessaoua, Maradi, Niger Republic

“…In the present study, 83.3% children with severe acute malnutrition were found to be anemic, out of which 66.6% were severely anemic and 16.6% were at moderate stage. This study shows increased burden of anemia in severely acutely malnourished children as compared to other studies done in Ethiopia (53.4%) [41], Sri Lanka (55.5%) [42], Bangladesh (56.5%) [43], Guinea-Bissau (80.2%) [44]. Arya et al (2017) in his study conducted in a tertiary care Centre of Kampur in India, found that 95% of the children with severe acute malnutrition had anemia, out of which 52% were severely anemic and 28% were moderately anemic [45].…”

“…The other common hematological abnormalities found in the present study were the elevated leucocyte count or leukocytosis, which was observed in 36(60%) children. Leukocytosis was reported by many researchers to be a common feature in malnourished children [41,45]. Getawa et al (2020) in his study conducted in Ethiopia reported a prevalence of leukocytosis of 26.7% among malnourished children [41].…”

“…Leukocytosis was reported by many researchers to be a common feature in malnourished children [41,45]. Getawa et al (2020) in his study conducted in Ethiopia reported a prevalence of leukocytosis of 26.7% among malnourished children [41]. Leukocytosis in these children may be as a result of opportunistic infections which appear due to compromised immune system.…”

“…Hematopoietic tissues which are essential for cell renewal and proliferation are extremely influenced by the availability of nutrients [36]. Thus, a deficiency of nutrients in the system could lead to impaired production of cellular blood components [37] and further development of pathological conditions such as anemia, changes in leucocytes count, changes in reticulocyte count, and changes in the hematopoietic microenvironment of the bone marrow [38][39][40][41]. In the present study, 83.3% children with severe acute malnutrition were found to be anemic, out of which 66.6% were severely anemic and 16.6% were at moderate stage.…”

Association between severe acute malnutrition in childhood and hematological disorders in adulthood: the Lwiro follow-up study in the Eastern Democratic Republic of the Congo

“…This is not supported by the results obtained in our study. In fact, Aparecida et al and Borelli et al have shown that SAM leads to a reduction of hematopoietic stem cells and pluripotent cells not by apoptosis but by cell cycle arrest (24,25,44). This is explained by a marked reduction in the expression of genes coding for cell differentiation and maturation (44).…”