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Abstract
Iron deficiency (ID), the leading cause of anemia and the most common nutritional deficiency globally, is not well reported among children in malaria-endemic settings, and little is known about its contribution to anemia in these settings. We aimed to assess the prevalence of anemia, the role of ID using multiple parameters, and the factors associated with anemia in a malaria-endemic rural area. We conducted a community-based cross-sectional study of 432 children aged 1–5 years from the Popokabaka Health Zone, Democratic Republic of Congo. Sociodemographic characteristics, medical history, anthropometric parameters, and biochemical parameters were considered. Hemoglobin and malaria prevalence were assessed using rapid finger-prick capillary blood testing in the field. Venous blood samples were analyzed for serum ferritin, serum iron, total iron-binding capacity, and C-reactive protein (CRP) in a laboratory. Anemia was found in 294 out of 432 (68%) patients. Malaria was found in 375 out of 432 (87%), and ID in 1.8% according to diagnosis by adjusted ferritin only and in 12.9% according to transferrin saturation. ID indicators were not significantly correlated with low hemoglobin levels. Malaria, fever, and CRP > 5 mg/L were major factors associated with anemia in Popokabaka. Anemia control should focus on treating inflammatory conditions and infectious diseases among children in such settings.
Highlights
Anemia, which is characterized by a hemoglobin level below 11.0 g/dL, continues to be a serious global public health problem that affects young children and pregnant women [1]
Fever onset during the 2 weeks preceding the study visits was common among the children in Popokabaka and more so among anemic children (63.3%) than those without anemia (45.7%) (Table A2)
Our study found that anemia was highly prevalent (68.1%) among children aged < 5 years, while iron deficiency (ID) was remarkably low (12.9% according to TSAT, 7.9% according to TIBC, and 1.8% according to regression-adjusted ferritin biomarkers)
Summary
Anemia, which is characterized by a hemoglobin level below 11.0 g/dL, continues to be a serious global public health problem that affects young children and pregnant women [1]. The Multiple Indicators Cluster Survey (MICS), the prevalence of anemia among children aged < 5 years in the Democratic Republic of Congo (DRC) is around 63% [3,4]. One might have expected a decrease in the incidence of anemia, but its prevalence remains high. This is evident in malaria-endemic areas [10]
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