Abstract
BackgroundAnaemia is one of the world’s most prevalent child health problems. Its control in Africa and other developing nations has been hindered by uncertainty regarding its cause. Anaemia control has been particularly problematic in regions where the non-iron deficiency causes of anaemia, are projected to be substantial. The implementation of effective interventions to reduce the anaemia prevalence, requires improved documentation on iron status and other causes of anaemia for target populations.MethodsThis cross-sectional study enrolled n = 184 children, aged 6–8 years from Kwazulu-Natal, South Africa. Tests of haemoglobin, serum ferritin, soluble transferrin receptor and C-reactive protein were performed. These conventional measures of iron status were used to calculate body iron and to categorize the children into different groups of anaemia profiles.ResultsAnaemia prevalence was high, 43/184 (23.4%). Iron deficiency anaemia contributed 7/43 (16.3%) to the anaemia prevalence compared to non-iron deficiency anaemia 34/43 (79.1%) and mixed anaemia 2/43 (4.7%). In total 47/184 (25.5%) of the sampled children had either iron deficiency or anaemia. Information about the presence of inflammation was used to adjust serum ferritin concentrations, resulting in improved diagnosis of iron deficiency.ConclusionAppropriate investigations for iron status and inflammation/infection screening, need to be integral in the evaluation of anaemia and its causes before anaemia control interventions are implemented. Interventions that target the multifactorial nature of anaemia in school-aged children need to be strengthened. Additionally, regular screening of anaemia in school-aged children from disadvantaged communities is recommended.
Highlights
Anaemia is one of the world’s most prevalent child health problems
This study revealed a high anaemia prevalence of 43/184 (22.3%) and highlighted the importance of inflammation (79.1%) and iron deficiency (16.3%) in the aetiology of anaemia among children in this low-resource setting
The findings of this study emphasize the need for population-based screening, and for epidemiologic findings to be incorporated into basic treatment algorithms for use during individual level care and for population based interventions
Summary
Anaemia is one of the world’s most prevalent child health problems. Its control in Africa and other developing nations has been hindered by uncertainty regarding its cause. The sTfR level which is an early marker of functional iron deficiency, is generally believed to be unaffected by inflammation some researchers have reported that its levels may be increased in the presence of infections [12]. To increase reliability in the estimation of body iron stores, the use of a ratio of the transferrin receptor and ferritin has been recommended [7]. Both SF and sTfR go through characteristic sequential changes, as body iron stores decrease from normal iron-replete levels to IDA [7]. The calculation technique or the most suitable equation, for these ratios is not yet settled and continues to be a subject of debate [7, 8, 11, 12]
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