Malarial anaemia and anaemia severity in apparently healthy primary school children in urban and rural settings in the Mount Cameroon area: cross sectional survey.

Irene Ule Ngole Sumbele,Yannick Nana,Helen Kuokuo Kimbi,Leopold G Lehman,Kenneth K J Ndamukong,Judith Kuoh Anchang-Kimbi,Emmaculate Lum,Malaika Nweboh,Judith Lum Ndamukong-Nyanga,Richard Paul

doi:10.1371/journal.pone.0123549

Irene Ule Ngole Sumbele, Yannick Nana + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0123549

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Journal: PloS one	Publication Date: Apr 20, 2015
Citations: 59	License type: CC BY 4.0

Affiliation: University of Buea, Université de Yaoundé I

Abstract

BackgroundThis study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children.MethodsA cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11g/dL); mild MA (Hb of 8–10.9g/dL); moderate MA (Hb of 6.1–7.9g/dL) and severe MA (Hb≤6g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors.ResultsOut of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia.ConclusionsMalarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.

Highlights

This study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children
Low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia
Malarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement

Summary

Methods

A cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. The study was carried out in primary school children of both sexes aged 4–15 years in Limbe and rural areas in Buea situated along the slope of the Mount Cameroon area. Limbe is an urban area with high and fairly constant temperatures ranging between 25°C and 30°C on the average [18]. It has abundant rainfall ranging from 5,500mm to 6,500mm per annum [18]. P. falciparum is the main species and Anopheles gambiae is the main vector species [19]

Results

Discussion

Conclusion