Prevalence of Inherited Hemoglobin Disorders and Relationships with Anemia and Micronutrient Status among Children in Yaoundé and Douala, Cameroon

Abstract

Information on the etiology of anemia is necessary to design effective anemia control programs. Our objective was to measure the prevalence of inherited hemoglobin disorders (IHD) in a representative sample of children in urban Cameroon, and examine the relationships between IHD and anemia. In a cluster survey of children 12–59 months of age (n = 291) in Yaoundé and Douala, we assessed hemoglobin (Hb), malaria infection, and plasma indicators of inflammation and micronutrient status. Hb S was detected by HPLC, and α+thalassemia (3.7 kb deletions) by PCR. Anemia (Hb < 110 g/L), inflammation, and malaria were present in 45%, 46%, and 8% of children. A total of 13.7% of children had HbAS, 1.6% had HbSS, and 30.6% and 3.1% had heterozygous and homozygous α+thalassemia. The prevalence of anemia was greater among HbAS compared to HbAA children (60.3 vs. 42.0%, p = 0.038), although mean Hb concentrations did not differ, p = 0.38). Hb and anemia prevalence did not differ among children with or without single gene deletion α+thalassemia. In multi-variable models, anemia was independently predicted by HbAS, HbSS, malaria, iron deficiency (ID; inflammation-adjusted ferritin <12 µg/L), higher C-reactive protein, lower plasma folate, and younger age. Elevated soluble transferrin receptor concentration (>8.3 mg/L) was associated with younger age, malaria, greater mean reticulocyte counts, inflammation, HbSS genotype, and ID. IHD are prevalent but contribute modestly to anemia among children in urban Cameroon.

Soya, maize and sorghum ready-to-use therapeutic foods are more effective in correcting anaemia and iron deficiency than the standard ready-to-use therapeutic food: randomized controlled trial

“…This finding was in accordance with findings from other teams showing that serum ferritin is less accurate in assessing ID in Malawian children even after adjustment for inflammation as malaria infection may lead to long lasting ferritin elevation [42, 100]. The second limitation is the absence of screening for malaria and any inherited disorders known to influence the markers of iron status or the biological regulation of iron homeostasis [16, 101–103]. This may have resulted in overestimating the prevalence of ID and IDA.…”

Micronutrient Deficiencies, Nutritional Status and the Determinants of Anemia in Children 0–59 Months of Age and Non-Pregnant Women of Reproductive Age in The Gambia

“…Anemia of infection, which has been identified to largely contribute to anemia in Sub-Saharan Africa [2] is of minor importance in The Gambia. About 35% of the children had increased inflammation markers at the time of the survey, which is at the lower end of the range compared to other countries in Western Africa [32,33,35,47]. Further, although malaria has been identified as one of the main risk factors of anemia in Sub-Saharan Africa [33], it was almost nonexistent among study participants at the time of the survey.…”

“…Further, although malaria has been identified as one of the main risk factors of anemia in Sub-Saharan Africa [33], it was almost nonexistent among study participants at the time of the survey. In other countries in West Africa, the malaria prevalence measured using RDT found a prevalence of 5%–50% [32,33,35,47]. However, some of the surveys were conducted shortly after the rainy season where malaria is more prevalent and the GMNS was conducted in the middle of the dry season; thus, malaria infection and consequently anemia prevalence might be higher during or shortly after the rainy season.…”

Prevalence and causes of anaemia in children aged 6–23 months in rural Qinghai, China: findings from a cross-sectional study

“…Vitamin B12 deficiency was defined as <197 pg/mL. Cut-offs for elevated sTfR and HCY were 8.327 and 14 umol/L, respectively 28…”