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The Silent Anaemia Epidemic in Children
The Silent Anaemia Epidemic in Children
ISSN No:-2456-2165
Didas Mushabe
Medical Research Council,
Uganda Virus Research Institute, LSHTM, Uganda.
Abstract:- Anaemia (haemoglobin level < 11 g/dl) is a the prevalence was at 22% amongst adolescents and adults
silent epidemic that affects about 293.1 million children aged 16years and over (Akwale et al, 2004). Presently,
aged <5 years worldwide with 28.5% of those located in Global estimate of childhood Anaemia is at 293.1 million
sub-Sahara Africa. Child hood Anaemia is associated children aged <5 years with 28.5% of those located in Sub-
with poor cognition, reduced growth, problems with Sahara Africa. Child hood Anaemia is associated with
immune function and ultimately decreased survival. increased risk of death, impairment of the cognitive and
Uganda’s childhood Anaemia is insidious, multifactorial motor development, growth, immune function and physical
and undefined. The objectives of the study were to work capacity and ultimately decreased survival (Soares,
determine the prevalence, severity and leading cause of 2011).
Anaemia amongst children ≤ 12 years attending Virika
hospital. The cross-sectional study employed both Anaemia is usually multifactorial in origin with
qualitative and semi-quantitative methods. Participants malaria playing a key aetiologic role in endemic countries
were sampled by convenience and simple random like tropical regions. Infants are vulnerable to malaria from
techniques. Parents were given short interviews to the age of approximately three months, when the immunity
obtain participants demographic and necessary acquired from the mothers starts to wear off. Hospital series
information. Blood, stool and anthropometric show that in the areas of intense transmission, most cases of
measurements were obtained from the participants and severe malarial Anaemia, blood transfusions, and deaths
tested for complete blood count, malaria, HIV, sickle occur in infants and children less than five years old
cell disease, helminthes and malnutrition respectively. (Biemba et al, 2000). Malaria causes Anaemia through
Data was analyzed using Excel computer program. haemolysis and increased splenic clearance of red blood
cells and cytokine- induced dyserythropoesis (Mendez,
Results show that Prevalence of Anaemia in 2000, Nagel, 2002 & Ekvall, 2003). Severe malarial
children is high, presenting mostly in moderate form. Anaemia is presumed to account for more than half of all
Malnutrition plays a major role in the development of childhood deaths in Africa with case fatality rates in
Anaemia. Nutritional support and awareness are key hospitals ranging between 8% and 18% (Slutcher et al,
aspects in prevention of Anaemia development and 1994). Case fatality from severe Anaemia in the community
progression. Other control interventions may include is likely to be much higher, since the majority of the
provision of improved diagnostic tests, optimizing hospital cases will have received a lifesaving blood
compliance, appropriating referral practices, transfusion.
implementation of standard treatment guidelines and
research. HIV/AIDS is another factor that has been linked to
childhood Anaemia. HIV causes cytokine-mediated
Keywords:- Anaemia, Prevalence, Severity and Etiology. inflammation, resulting into iron sequestration in
macrophages and decreased iron absorption in the small
I. INTRODUCTION intestines. A number of studies carried out in high HIV
prevalence areas concur that there is a strong association
Anaemia (haemoglobin level < 11 g/dl) remains one between HIV/AIDS and Anaemia (Mukaya (2009, Calis et
of the most intractable public health problems affecting al, 2008 & Lewis et al, 2005). School age children are fond
more than half of all pregnant women and children less of harboring the greatest number of worms, with children
than 5 years old (Demaeyer et al, 1995 & Cheesbrough, below 24 months having intestinal helminthes infection rate
2006). In 1993-2005, nearly 300 million children ranging from 2% to 80% (Montresor et al, 2000). This puts
worldwide had Anaemia while in Sub Saharan Africa, two children at risk of Anaemia since worms are associated to
thirds (83.5 million children) were Anaemic (Soares, 2011). iron deficiency (Tatale et al, 1998). Out of more than 10
In West Africa, the numbers of childhood Anaemia cases million deaths that occur each year in children less than
were highest in Burkina Faso, followed by Ghana and Mali five years old in developing countries, malnutrition
with malnutrition playing a central causative role in attributes half of the deaths directly or indirectly (Black et
preschool children (Soares, 2011). In Tanzania, the al, 2003). Poor nutrition and micronutrient deficiencies
prevalence of Anaemia amongst people aged 15-65 years exacerbate severity of infectious diseases resulting into
was estimated at 43.4% (Tatala et al, 1998) while in Kenya Anaemia. Many African children live in a state of
C. Quality control
Every respondent was given a number and allowed to
participate only once in the study to avoid repetition of test
results. Both positive and negative controls were included
in every days testing of participants samples. All laboratory
analyses followed the standard operating procedures.
D. Ethical consideration
Fig 1:- Shows frequency and percentage distribution of
Written ethical approval was obtained from the
mild, moderate and severe degrees of Anaemia amongst the
Faculty of Research and Ethics Committee (FREC)
subjects
department of Mbarara University of Science and
Technology. Permission was also sought from Virika
C. Aetiology of Anaemia
hospital administration who allowed the study to take place.
Out of 102 Anaemic clients, 38 (37%) were associated
Informed consent was sought from all the subjects who
with malnutrition, 35 (34.3%) had malaria, 9 (8.8%) had
participated in the study. All information obtained from the
helminthes, 8 (7.8%) had sickle cell disorder, 2 (1.7%) had
study was kept confidential.
HIV/AIDS and 10 (10.4%) had unknown aetiology.
Malnutrition contributed to highest number of anaemia
E. Data analysis
cases
Data was cleaned, entered into excel for analysis and
presented in form of frequency tables and figures.
III. RESULTS
A. Prevalence of Anaemia
The number of children with Anaemia was 102 (44%)
while those without Anaemia were 128 (56%). In the study,
prevalence meant the percentage of children diagnosed with
Anaemia, therefore prevalence was 44%.