Moderate-to-Severe Anaemia due to Afebrile Plasmodium falciparum Infection in Children aged 6-23 Months from the Rural District of Kongoussi, Burkina Faso

Abstract

A population-based cross-sectional study was conducted to investigate the association of haemoglobin concentration and moderate-to-severe anaemia with afebrile Plasmodium falciparum (PF) infection in 456 rural children aged 6-23 months. Capillary blood was obtained for haemoglobin concentration measurement by HemoCue and malaria detection by blood smear microscopy. Anaemia was noted in 444 (97.4%) children with 194 (42.5%) being moderate-to-severe anaemia. PF infection was noted in 240 (52.6%) children with 117 (25.6%) being afebrile and 123 (27.0%) being febrile. Children with afebrile and those with febrile PF infection were more likely to have moderate-to-severe anaemia than children who were PF-free, with odds ratio (95% confidence interval) of 1.86 (1.07-3.23), p = 0.028 and 2.40 (1.29-4.48), p < 0.001, respectively. These results underline the high burden of both anaemia and PF infection in this population. Strategies aiming at controlling malarial anaemia and based on malaria case-treatment should consider both febrile and afebrile PF infection to allow for a better impact.

Malaria and Macronutrient Deficiency as Correlates of Anemia in Young Children: A Systematic Review of Observational Studies

“…Of the 13 studies that investigated associations between stunting (or lowered HAZ) and anemia, 7 found associations. 4,12,14,15,23,25,28 Although stunting was consistently shown to lower hemoglobin across the studies, the magnitude and precision of the estimates varied substantially. Wasting (or lowered WHZ) was investigated in only 6 studies and was associated with anemia in 3.…”

“…4,[12][13][14][20][21][22][23][24][25][26][27][28] Nutritional status was a less consistent correlate of anemia. Of the 13 studies that investigated associations between stunting (or lowered HAZ) and anemia, 7 found associations.…”

“…There were no systematic differences in level of adjustment or type of covariates in studies that detected associations between undernutrition and anemia, although they were mainly conducted in Kenya 4,12,22,23 and Burkina Faso. 15,25 There were no systematic differences in the prevalence of malaria, stunting, or wasting in these studies (Table 2), but further research might investigate other contextual differences (eg, malaria control programs, other infections, supplementation, or treatment practices) in malaria and undernutrition.…”

“…One study that investigated various levels of malaria parasitemia suggested a dose-response relationship between parasite load and lowered hemoglobin. 25 Two studies 15,29 found no statistically significant associations between malaria and anemia. Whereas, in a Tanzanian population, 29 the prevalence of malaria was found to be 48%, which is similar to other studies, the prevalence of malaria in one study in Burkina Faso was low at 6.25%.…”

Effect of an improved local ingredient-based complementary food fortified or not with iron and selected multiple micronutrients on Hb concentration

“…We calculated the sample size to allow for the detection of a between-group difference of 7 g/l in Hb concentration at 80 % power and 5 % two-side type error, assuming a standard deviation of 13 g/l. These hypotheses were based on published studies (19,23) . We needed to include at least fifty-three children per group to compare endpoint Hb concentration that was the main evaluation criterion.…”