Magnitude, Severity, and Morphological Types of Anemia in Hospitalized Children Under the Age of Five in Southern Tanzania

Severity and Morphological Characteristics of Anaemia Among 6 to 59 Months Old Children in Temeke, Dar es Salaam-Tanzania: Clinics Based Cross Sectional Analysis

Background

Anaemia is a global public health indicator of both poor nutrition and poor health. Besides, it stands as a silent signal of mal-aligned health system across the entire human lifespan. Globally, the importance of anaemia is most pronounced among children. This study was conceived to assess severity and morphological characteristics of anaemia among children aged from 6 to 59 months old in Temeke, Dar es Salaam, Tanzania.

Methods

We designed a cross sectional, clinics-based analytical study. Children aged 6 to 59 months with anaemia were the target population. Severity and morphological characteristics of anaemia were the main outcome variables. Data were collected using a pre-designed questionnaire. Data were summarised using median and inter-quartile range (continuous variables) or frequency and proportions (categorical variables). Chi-square tests were applied to assess association between categorical variables. Alpha level of 5% was used as a limit of type 1 error in findings. Written informed consent was sought from mother of each child prior to inclusion into the study.

Results

We successfully recruited and analysed 250 children. Participants median age was 17.5 (IQR: 9 - 34) months (females, n=112, 44.8%). Point prevalence of anaemia (Hb<12 g/dL) was 66.8%. Among anemic children (n=167), about 19%, 63% and 18% had mild, moderate and severe anaemia respectively. A direct linear association between MCV and MCHC was observed among anemic children (n=167, Spearman's rank ´Y= 0.86, P=.000). There was a significant association between prevalence and severity of anaemia among studied children (LR χ2 (corrected) = 229.5, df=3). Majority (n=121, 72%) of the studied children had normocytic normochromic anaemia.

Conclusion

Majority of under-fives in attendance at outpatient clinics in Temeke were anemic. Normochromic normocytic anaemia was the most prevalent variant of anaemia in this study population.

Magnitude, Associated Factors and Morphological Types of Anemia Among Hospitalized 6-59 Months Age Children at Jimma Medical Center, Southwest Ethiopia - A Hospital-Based Cross-Sectional Study

Background

Anemia is among the major public health problems that cause significant morbidity and mortality among children around the world. Anemia in children of age 6 months to 5 years is a major health problem in most developing world countries with estimated prevalence of about 43%.

Objective

To determine the magnitude, associated factors and morphological types of anemia among hospitalized 6-59 months age children from June 15 to October 15, 2022 at Jimma Medical Center, southwest Ethiopia.

Methodology

Hospital-based cross- sectional study design was conducted from June 15 to October 15, 2022 at Jimma Medical Center, involving 383 hospitalized children aged 6-59 months by employing convenient sampling technique. Data of sociodemographic characteristics and other associated factors of the study individuals waere collected using a pre-structured questionnaire. Clinical data were collected by physical examination and from history of client by medical interns and nurses. Then 3 mL venous blood was collected and analyzed for complete blood count. Data were coded, cleared and entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Bivariable and multivariable binary logistic regression was used to identify associated factors.

Results

The overall prevalence of anemia among hospitalized 6-59 months age children was 57.2%; out of them 30.82% were moderate. In the present study children with malaria infection, AOR = 1.15 (95% CI: 0.017, 0.781), Cchildren with severe malnutrition, AOR = 2.046 (95% CI: 0.306, 1.366), and children with low family income, AOR = 2.6 (95% CI 0.475, 0.894) were independent variables associated with anemia.

Conclusion and Recommendation

Anemia among study participants is found to be a severe public health problem. Based on this finding, more intervention is needed with health education on nutrition and child feeding.

Burden and Determinants of Anemia among Under-Five Children in Africa: Systematic Review and Meta-Analysis

Introduction

Globally, anemia among under-five children is a serious public health problem. Even if there are pocket studies here and there, there is limited evidence on the pooled prevalence of anemia among under-five children in Africa. Therefore, the aim of this study was to determine the pooled prevalence and determinants of anemia. Methods and Analysis. This systematic review and meta-analysis was done following the PRISMA guidelines. A comprehensive search was made in PubMed/MEDLINE, Cochrane Library, HINARI, and Ethiopian Journal of Health Development for studies published since 2009. It was supplemented with Google Scholar search. Study selection, data extraction, and quality of studies were assessed by eight reviewers. The Cochrane Q test and I 2 test statistic were used to test the heterogeneity of studies. A random-effects model of DerSimonian-Laird method was used.

Result

A total of 37 articles were included in this systematic review and meta-analysis. The pooled prevalence of anemia among under-five children in Africa was 59% (95% CI: 55, 63). Being female (AOR = 0.71; 95% CI: 0.57, 0.87), maternal education (AOR = 1.47; 95% CI: 1.31, 1.66), residence (AOR = 0.80; 95% CI: 0.67, 0.95), and family size (AOR = 0.93; 95% CI: 0.89, 0.98) were the determinants of anemia among African under-five children. Conclusion and Recommendation. This pooled study revealed that anemia was a severe public health problem. Sex, maternal education, residence, and family size were the determinants of anemia. Therefore, anemia prevention strategy should include sex consideration, educating mothers through youth education, area specific intervention, and encouraging birth spacing.

Magnitude of anemia and associated factors among children aged 6-59 months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study

Background

Anemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia.

Methods

A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05.

Results

Of the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians.

In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia.

Conclusion

Overall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.

A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia

Background

Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia.

Method

The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined.

Results

The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children.

Conclusion

In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem.

Prevalence of Anemia and Associated Factors Among Hospitalized Children Attending the University of Gondar Hospital, Northwest Ethiopia

BACKGROUND

Anemia in children continues to be a major public health challenge in most developing countries, particularly in Africa.In the early stages of life, it leads to severe negative consequences on the cognitive functions as well as growth and development of the children, which may persist even after treatment.

OBJECTIVE

The main aim of this study was to assess the prevalence and associated factors of anemia among hospitalized children attending at university of Gondar comprehensive and specialized referral hospital, Northwest Ethiopia.

METHOD

A cross sectional study was conducted on 384 hospitalized children, between February and June, 2018. Data of socio demographic characteristics and clinical conditions of the study individuals were collected using questionnaire after taking appropriate written informed consent and assent. Then 3 mL of blood was collected for complete blood count analysis and also stool examination was done for intestinal parasites. Data were coded, cleared and entered into SPSS version 20 for analysis.Bivariate and multivariate logistic regression models were used to identify associated factors of anemia. P-value ≤ 0.05 was considered as statistically significant.

RESULT

The overall magnitude of anemia among hospitalized children was 58.6%; of them 56.4% were males. Of anemic children, 28% had mild, 51.1% moderate and 20.9% severe anemia. The magnitude of anemia among children aged 6-59 months, 5-11 years and 12-14 years were 54.1%, 58.9% and 67.5%, respectively.In this study, anemia was positively associated with parasitic infection (AOR= 2.541; 95% CI: 1.363, 4.737), not eating meat and animal products (AOR = 1.615; 95% CI: 1.014, 2.574).

CONCLUSION

Anemia among hospitalized children in this study was found to be a severe public health problem. It was strongly associated with intestinal parasitic infection and not eating meat and animal products.Focused polices and strategies should be designed to reduce anemia among hospitalized children in Ethiopia.