Abstract
Introduction Child mortality rate in sub-Saharan Africa is 29 times higher than that in industrialized countries. Anemia is one of the preventable causes of child morbidity. During a humanitarian medical mission in rural South-Eastern Nigeria, the prevalence and risk factors of anemia were determined in the region in order to identify strategies for reduction. Methods A cross-sectional study was done on 96 children aged 1-7 years from 50 randomly selected families. A study questionnaire was used to collect information regarding socioeconomic status, family health practices, and nutrition. Anemia was diagnosed clinically or by point of care testing of hemoglobin (Hb) levels. Results 96 children were selected for the study; 90 completed surveys were analyzed (43% male and 57% females). Anemia was the most prevalent clinical morbidity (69%), followed by intestinal worm infection (53%) and malnutrition (29%). Mean age (months) at which breastfeeding was stopped was 11.8 (±2.2) in children with Hb <11mg/dl (severe anemia), 10.5±2.8 in those with Hb = 11-11.9mg/dl (mild-moderate anemia), and 9.4±3.9 in children with Hb >12mg/dl (no anemia) (P=0.0445). Conclusions The longer the infant was breastfed, the worse the severity of childhood anemia was. Childhood anemia was likely influenced by the low iron content of breast milk in addition to maternal anemia and poor nutrition. A family-centered preventive intervention for both maternal and infant nutrition may be more effective in reducing childhood anemia and child mortality rate in the community.
Highlights
Child mortality rate in sub-Saharan Africa is 29 times higher than that in industrialized countries
This study suggests that anemia related to prolonged breastfeeding persists into childhood, independently of dietary intake, malnutrition status, disease status, or socioeconomic status
Persistent childhood anemia was likely influenced by the low iron content of breast milk, an indication of maternal anemia and poor nutrition
Summary
Child mortality rate in sub-Saharan Africa is 29 times higher than that in industrialized countries. A family-centered preventive intervention for both maternal and infant nutrition may be more effective in reducing childhood anemia and child mortality rate in the community. While there are different etiologies of anemia such as iron deficiency, [4] hereditary hemoglobinopathies like sickle cell disease [6], and acquired hemoglobinopathies like malaria, [7] anemia from chronic iron deficiency is the most prevalent nutrition-related health problem in children in developing countries and is known to correlate with childhood malnutrition [8, 9]. Fifty to sixty percent of Nigerian children are moderately to severely anemic, though the prevalence of anemia in rural Nigeria remains largely unstudied [10, 11]. Both biological and social determinants interact with malnutrition
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