ABSTRACT
The most common cause of anemia is a deficiency of iron; but it may also be caused by deficiencies of folates, vitamin B12 and protein. Some anemias are not caused by nutritional factors, but by congenital factors and parasitic diseases such as malaria. This study attempted to estimate the prevalence of anemia among pre-school and school- aged children in Abidagba health clinicof Ijebu Ode, and to determine whether its cause was nutritional or could be attributed to malaria. Methods: A total of 177 children between the ages of 2 and 11 years were included in the study. Children were examined for malaria parasites by microscopy. The World Health Organization (WHO) age-adjusted cut-off for hemoglobin and hematocrit were used to classify anemia. An enzyme linked immunosorbent assay for serum ferritin was compared with standard methods of determining iron deficiency. Under- nutrition (stunting, wasting and underweight) was classified according to the National Centre for Health Statistics standards. Values below – 2SD were defined as mild-moderate under-nutrition.
Most of the children were anemic, 87.1%, having PCV values below the 32% cut-off and 95% with hemoglobin levels lower than the 11g/dl, although parasite prevalence and density were low. Malnutrition was patent; 36% of the children were stunted, 18.3% wasted and 44.2% underweight. Serum ferritin was more sensitive than PCV in detecting anemic children. Although anemia was higher in boys and preschoolers compared to girls and school aged children, the difference was significant only in preschoolers (P = .004). Anaemia was also significantly higher in Irawo village school than in Iloti (P = .0001) The anemia detected in this population may be due more to under-nutrition than to malaria.
CHAPTER ONE
INTRODUCTION
1.1 Background of Study
Iron deficiency anemia is the most prevalent form of malnutrition, affecting around 50% of pregnant women worldwide, and the eighth leading cause of disease in girls and women in developing countries.1 It has been indicated that around 600-700 million of the world’s population have iron deficiency anemia by WHO criteria.2 Nutritional anemias occur frequently in both developing and industrialized countries. In industrialized countries, the prevalence of iron deficiency anemia is much lower and usually varies between 2% and 8%.3 The prevalence of iron deficiency (inclusive of anemic and non-anemic individuals) ranges from 12 to 18% in women in North America, Europe and Asia. The estimated prevalence in South East Asia is 50- 70%.4 In females of childbearing age in poor countries, prevalence rates range from 23% in South America to 64% in South Asia.4 Prevalence rates are usually considerably higher in pregnant women, with an overall mean of 51%.3
In Nigeria, according to the UNICEF 1993 participatory information collection (PlC) studies, the prevalence rate for anemia in mothers is 24%. The highest prevalence of anemia in children was recorded in South Eastern Nigeria (49.6%) and the lowest (11 0.5%) in North Eastern Nigeria.5 The regional variations have been attributed to high rates of worm infestations and infections in the zones with the highest prevalence. Infants, preschool age children and women of childbearing age are the groups most affected by iron deficiency.6,7 Unlike reported figures for protein energy malnutrition and vitamin A deficiency, which are declining, estimates suggest that anemia prevalence rates are increasing.4 Iron supplementation programmes have been carried out in many places throughout the world over the last two decades. Still, the prevalence of iron deficiency anemia does not appear to be declining.4,5
