Malaria, anaemia and under-nutrition: three frequently co-existing conditions among preschool children in rural Rwanda

Fredrick Kateera,Martin P Grobusch,Petra F Mens,Parfait Kalinda,Chantal M Ingabire,Leon Mutesa,Emmanuel Hakizimana,Michèle Van Vugt

doi:10.1186/s12936-015-0973-z

Fredrick Kateera, Martin P Grobusch + Show 6 more

Open Access

https://doi.org/10.1186/s12936-015-0973-z

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Abstract

BackgroundMalaria, anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality particularly among children aged less than 5 years. Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions.MethodsA cross-sectional household (HH) survey involving children aged 6–59 months was conducted. Data on malaria parasitaemia, haemoglobin densities, anthropometry, demographics, socioeconomic status (SES) and malaria prevention knowledge and practices were collected.ResultsThe prevalences of malaria parasitaemia and anaemia were 5.9 and 7.0 %, respectively, whilst the prevalence of stunting was 41.3 %. Malaria parasitaemia risk differed by age groups with odds ratio (OR) = 2.53; P = 0.04 for age group 24–35 months, OR = 3.5; P = 0.037 for age group 36–47 months, and OR = 3.03; P = 0.014 for age group 48–60 months, whilst a reduced risk was found among children living in high SES HHs (OR = 0.37; P = 0.029). Risk of anaemia was high among children aged ≥12 months, those with malaria parasitaemia (OR = 3.86; P ≤ 0.0001) and children living in HHs of lower SES. Overall, under-nutrition was not associated with malaria parasitaemia. Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004).ConclusionsIn this study group, four in 10 and one in 10 children were found stunted and underweight, respectively, in an area of low malaria transmission. Under-nutrition was not associated with malaria risk. While the high prevalence of stunting requires urgent response, reductions in malaria parasitaemia and anaemia rates may require, in addition to scaled-up use of insecticide-treated bed nets and indoor residual insecticide spraying, improvements in HH SES and better housing to reduce risk of malaria.

Highlights

Malaria, anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality among children aged less than 5 years
Malaria, anaemia and under-nutrition are each associated with significant morbidity and mortality, among children in sub-Saharan Africa [1,2,3]
Study population As reported in the earlier publication for the larger survey, a total of 4705 HHs were surveyed and of these, data from 12,965 individuals from 3968 (84.3 %) HHs that had complete laboratory and questionnaire data was aggregated in the primary database [26]

Summary

Introduction

Anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality among children aged less than 5 years. Anaemia and under-nutrition are each associated with significant morbidity and mortality, among children in sub-Saharan Africa [1,2,3]. Malaria is responsible for over 450,000 deaths among children under 5 years [1]; anaemia is prevalent in 273 million (43 %) of children aged 6–59 months [2]; and severe under-nutrition affects about 20 million preschool-aged children living mostly in African and SouthEast Asia Regions [4]. The main causes of anaemia include acute or chronic blood loss, nutritional deficiencies (including vitamins A, B12, C and folic acid and iron) [9], infectious diseases [10,11,12] and genetic disorders [13, 14]

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