Prevalence of and risk factors for anemia in young children in southern Cameroon.

Abstract

Abstract. Anemia during childhood remains a major public health challenge in sub-Saharan Africa. To determine the prevalence of and the main risk factors for anemia in young children, we conducted a longitudinal survey in Ebolowa in southern Cameroon. Children were enrolled in two cohorts and followed during a three-year period: the first cohort was composed of 122 children from 0 to 36 months of age and the second cohort was composed of 84 children from 24 to 60 months of age. The two cohorts were followed weekly for symptomatic malaria, monthly for both symptomatic and asymptomatic malaria, and every six months for hematologic data; the children were grouped into six-month age groups. The prevalence of anemia (hemoglobin [Hb] level Ͻ 11 g/dl) was the highest in the sixmonth-old age group (47%) and the age-related evolution clearly showed a decrease in the prevalence from three years of age. Thus, 42% of the children less than three years of age were anemic, while 21% of the children between three and five years of age were anemic. The lowest mean Ϯ SD Hb content (10.7 Ϯ 2.1 g/dl) was observed in the six-month-old children and a regular improvement in the Hb level occurred from six months to three years of age. A stabilization was observed at a level of approximately 12 g/dl. At any age, there was no difference in mean Hb levels between children with AS and AA Hb genotypes. Hookworm infection was diagnosed in two children in the study population. Results of a multivariate analysis showed that placental malaria infection was the strongest risk factor for anemia in the six-month-old children (odds ratio [OR] ϭ 3.6; 95% confidence interval [CI] ϭ 1.1-12.3) and was independent of the frequency of parasitemia, parasitemia at the time of Hb measurement, or microcytosis. In the one-year-old age group, microcytosis was a significant factor related to anemia (OR ϭ 2.8, 95% CI ϭ 1-7.8) pointing out the role of iron deficiency at this age. Parasitemia at the time of Hb measurement was significantly associated with anemia in all age groups (except in 54-and 60-month-old groups). Strategies to decrease the prevalence of anemia in young children in southern Cameroon should include chemoprophylaxis for pregnant women, prevention of acquired malaria infection in both pregnancy and infancy, and prevention of nutritional iron deficiency.Anemia impairs normal development in children and it constitutes a major public health problem in young children in the developing world with wide social and economic implications. Thus, decreased physical exercise tolerance and intellectual performance have been associated with mild anemia, which may lead to a slowdown of growth in children. 1, 2In sub-Saharan Africa in children less than five years of age, the prevalence of anemia varies from 43% in Zaire to 74% in Tanzania. 3, 4 Its etiology in tropical countries is multifactorial: thus, the most important risk factors need to be identified for prevention strategy. Anemia is commonly associated with nutritional deficiencies such as iron defic...

Relationship between vitamin A status and anaemia among school age children in Benin

“…16 The prevalence of vitamin A deficiency of 29.6% in this study, which is of public health significance, 17 is similar to the 28.1% reported by Ajaiyeoba in Nigeria. 15 The mean (±SD) haemoglobin concentration of 10.5 (±1.1) g/dl found in this study is similar to 10.7 (±2.1) g/ dl reported by Cornet et al 18 in Southern Cameroon. This is however, lower than 11.9 (±2.3) g/dl reported by Adewuyi 19 in the middle belt of Nigeria.…”

A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria

“…This effect disappeared in the multivariate analysis. The existence of a direct and causal relationship cannot be proven in this observational study, but others have also reported the effect of placental malaria infection on increased risk of infant anaemia (Redd et al, 1994;Cornet et al, 1998). It is uncertain whether this association was owing to comparable malaria exposure in mothers during pregnancy and their infants after birth, or whether it is related to recrudescent infant malaria or immune sensitization occurring as a consequence of congenital infection.…”

Effect of daily iron supplementation on iron status, cell-mediated immunity, and incidence of infections in 6–36 month old Togolese children

“…Before intervention, 62% of children hosted malarial parasites, mainly Plasmodium falciparum, and one-third had a high parasitemia rate known to affect hemoglobin concentration (Brabin, 1992;Cornet et al, 1998). Forty-two percent of the children had intestinal parasites such as Necator americanus and Ascaris lumbricoides, leading to iron de®ciency anemia (Stoltzfus et al, 1997).…”