Anemia In School-age Children Research Articles

Anemia and Associated Factors among Public Elementary School Children in Asella Town, Southeast Ethiopia: A Facility-Based Cross-Sectional Study.

Anemia has a negative impact on school children, including poor physical growth and reduced mental performance. Children show poor attentiveness, behavior, and memory and reduced school performance. There is limited evidence of the magnitude of anemia and associated factors in school-age children in Ethiopia, including the study area. To assess the magnitude of anemia and associated factors among public elementary school children in Asella Town, Southeast Ethiopia, in 2022. A school-based cross-sectional study was conducted in Asella Town from April 5 to May 5, 2022. A total of 442 school children aged 7-14 years were included in the study using the multistage sampling method. Data were collected using a pretested and semistructured questionnaire through a face-to-face interview technique. The hemoglobin concentration was determined by using the HemoCue 301+ analyzer. Anthropometric data and stool examinations were collected from participants. Data were entered into EpiData version 4.6, transported, and analyzed by Statistical Package for Social Sciences version 26. Bivariable and multivariable logistic regression analyses were carried out. Adjusted odds ratios along with their 95% confidence interval were used, and a p value of ≤0.05 was used for declaring statistical significance. A total of 435 students with a mean age and standard deviation of 10.77 ± 2.21 years participated in the study. The magnitude of anemia was 78 (17.9%), with a 95% CI (14.3, 21.47). Of the participants, 63 (14.5%) were mild anemic and 15 (3.4%) were moderately anemic. Children whose mothers have no formal education (AOR = 3.94, 95% CI: 1.89, 8.21), underweight children (AOR = 3.83, 95% CI: 1.98, 7.40), and parasites in their stool (AOR = 3.72, 95% CI: 1.50, 9.20) were significantly associated with anemia in school-age children. Anemia among school-age children was found to be a mild public health problem. Uneducated mothers, intestinal parasite infections, and underweight children were found to be determinants of anemia among school-age children. Health professionals should provide health education for mothers about child-feeding practices and the consumption of dietary sources of iron.

Integration of Monitoring for Parasitologic Status for Schistosomiasis and Soil-transmitted Helminthiasis Control Programs with Nutritional Status of Pre-school and School Age Children in Selected Municipalities in Northern Leyte, the Philippines

The periodic collection of parasitologic and morbidity indicators is recommended by the World Health Organization (WHO) to monitor schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) control programs. In 2017, the DOH-CHD VIII (Department of Health–Center for Health Development Region 8 Office) – in collaboration with UP-NTDSG (the University of the Philippines Neglected Tropical Diseases Study Group) – conducted a monitoring activity aimed at determining [1] the prevalence and intensity of SCH and STH; [2] seroprevalence of SCH; and [3] prevalence of stunting, underweight, wasting, and anemia in pre-school-age children (PSAC) and school-age children (SAC) in selected municipalities in the province of Northern Leyte, the Philippines as part of monitoring the local implementation of SCH and STH control programs. Stool samples were collected, processed using the Kato-Katz technique, and examined through microscopy. Blood specimens collected from SAC were tested for the presence of Schistosoma japonicum antibody using the IgG ELISA (enzyme-linked immunosorbent assay) kit. Data on anthropometric measurements and hemoglobin levels were collected with adherence to WHO guidelines. Secondary analysis of the gathered data showed that SCH prevalence in SAC was 3.1%, but SCH seroprevalence was 83.1%. Although STH prevalence met the national target of < 50%, heavy-intensity STH prevalence remained higher than the global target of < 2%. The overall prevalence of underweight, stunting, and wasting were 19.2, 38.0, and 10.6%, respectively. STH was significantly associated with stunting in PSAC (p = 0.030) and anemia in SAC (p = 0.033). The monitoring activity demonstrated the utility of an integrated monitoring scheme for SCH and STH control programs and nutrition programs at the local level. This model can be adopted for optimization and utilization by national programs for monitoring and may likewise benefit local government units for purposes of policy and planning.

Association between Knowledge about Anemia, Food Consumption Behaviors, and Hematocrit Level among School-Age Children in Nakhon Si Thammarat Province, Thailand

Anemia is a significant public health problem among children, especially school-age children, because their body quickly produces red blood cells to provide sufficient blood volume with plasma expansion to maintain blood concentration. This research aimed to study the anemia situation, knowledge about anemia, food consumption behaviors, and the association between knowledge, food consumption behaviors, and hematocrit level among school-age children in primary school, in Thasala district, Nakhon Si Thammarat Province. This is a descriptive study among 408 students in grades 4 to 6, aged 9–12 years. Research instruments included the children’s demographic data of the children, their knowledge about anemia, and food consumption behaviors, and hematocrit assessment. Data were analyzed using descriptive, Spearman’s rank correlation coefficient, and logistic regression statistics. The results revealed that 23.2% of the samples had anemia, 0.98% had moderate anemia, and 22.22% had mild anemia. The children knew about anemia, with the mean score at a moderate level (mean = 6.63; SD = 2.51) out of 10. The mean score on food consumption behaviors was at a moderate level (mean = 17.49; SD = 3.68) out of 24. There were significantly positive correlations between the knowledge about anemia and hematocrit level at a moderate level (r = 0.45, p < 0.001). Food consumption behaviors were moderately correlated with hematocrit level (r = 0.40, p < 0.001). Confirmation with logistic regression found that knowledge about anemia (OR = 9.15, 95% CI: 4.57–18.34) and food consumption behaviors (OR = 19.09, 95% CI: 9.71–37.53) were significantly associated with hematocrit level. Conclusions: This study showed that knowledge about anemia and appropriate food consumption behaviors are associated with hematocrit levels. Enhancing knowledge about anemia and food consumption behaviors may reduce the prevalence of anemia in school-age children. Health care providers in primary care should provide health education and encourage children to eat sufficient food.

Impact of a 5-Year Mass Drug Administration Programme for Soil-Transmitted Helminthiases on the Spatial Distribution of Childhood Anaemia in Burundi from 2007 to 2011.

Background: Childhood anaemia affects 1.8 billion people globally. Little is known about the long-term impact of mass drug administration (MDA) for the control of soil-transmitted helminthiases (STH) on the spatiotemporal variation of anaemia prevalence and severity. We describe the long-term spatiotemporal impact of a 5-year STH MDA programme (2007–2011) on the prevalence of anaemia and anaemia severity in school-aged children (SAC) in Burundi. Methodology/Principal Findings: We used annual haemoglobin concentration and STH data collected during 2007–2011 in 31 schools in Burundi. Spatial dependence in prevalence and severity of anaemia was assessed using semivariograms. Bayesian geostatistical models were developed to (a) quantify the role of STH (adjusted for other anaemia determinants) in the spatiotemporal distribution of anaemia prevalence/severity, and (b) predict the geographical variation of both outcomes across Burundi. Adjusted population data were used to estimate the geographical distribution of the number of SAC at risk of anaemia and with low and moderate/severe anaemia. Infections with Ascaris lumbricoides and Trichuris trichiura were positively and significantly associated with childhood anaemia; hookworm infections were not. A significant decrease in anaemia prevalence, from 40–50% (2008) to 10–20% (2011) was predicted in western areas. The predicted prevalence of low-severity anaemia decreased from 40–50% (2008) to <20% (2011) in southern and eastern areas. Moderate/high-severity anaemia was concentrated in western regions of Burundi, with pockets of moderate/high-severity anaemia in central and northern regions in 2008. The overall number of predicted anaemic children decreased from 443,657 (2008) to 232,304 (2011), with a resurgence after MDA disruption in 2010 (to 480,605). Prevalence of low- and moderate-severity anaemia was higher in boys than in girls. Conclusions/Significance: Despite ongoing MDA, the prevalence of anaemia in SAC remained high and increased in certain parts of the country. It is recommended that MDA programmes targeting STH are complemented with specific anaemia interventions.

Impact of Soil-Transmitted Helminthes (STHs) on nutritional and anemia status in school-aged children in Batagarawa Local Government Area, Katsina State, Nigeria

Malnutrition and anaemia in school-aged children, particularly in developing nations, are serious public health issues linked to Soil-transmitted helminths (STHs). To determine the prevalence and impacts of STHs on children's nutritional and anaemia status, a across-sectional study involving 320 randomly selected school-aged children aged 5 to 10 years in Batagarawa Local Government Area; Katsina State, Nigeria was conducted. Stool samples were collected and examined for the presence of STHs using the Formal-ether concentration technique. Body mass index (BMI) for age and haematocrit packed cell volume (PCV), respectively, were used to assess the nutritional and anaemia condition of the sampled children. A systematic questionnaire was used to obtain socio-demographic information. Three types of STH were identified, with an overall prevalence of 59.1%. Ascaris lumbricoides was more common (44.7%) than hookworm (29.1%) and Trichuris trichiura (2.5%). Location, soil play habits, not washing of hands after defecation, and walking barefoot were significantly associated with STHs (p&lt;0.05). Infected children were more anaemic than the uninfected, but the difference was not statistically significant (p&gt;0.05). Body mass index (BMI) percentile for age showed that 74.6% of the infected children were thin or under grown. Only 22.2% of the children achieve the normal growth and 3.2% were overweight. This study showed that STHs affected the children nutritional and anaemia status. Therefore, public education, deworming, and further research are encouraged to reduce the impact of STHs infection in the study area

Establishing the Nexus Between Iron Status and Markers of Immune Functions Among School Age Children in Ogun State, Nigeria

Iron deficiency as a public health problem is based on the seriousness of its consequences on human health suggesting that certain indices of iron status are associated with anthropometric measures which are used independently as markers of immune functions. This study established the relationship between the iron status, and markers of immune functions among school age children in selected Local Government Areas (LGAs) of Ogun state. A multistage sampling technique was used to select three hundred and twelve school age children from the three senatorial districts of Ogun State, Nigeria. A pre-tested and structured questionnaire was used to obtain information on socio-economic characteristics as well as information on Water, Sanitation and Hygiene (WASH) among the respondents. Blood samples of the children were analyzed for biochemical [serum ferritin (SF), C-reactive protein (CRP), Heamoglobin (Hb), reticulocyte count] parameters. Selected immune function markers [CD4, white blood cell differentials (Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils)] and parasitic infections (stool examination and Malaria screening) were also measured using standard procedures. Data were analyzed using frequency counts, percentages, means, standard deviations, correlation, T-test and Chi-Square. Results showed that 36.5% of the respondent families earned less than two hundred thousand naira annually. Also, 43.0% and 62.0% of the mothers had secondary and tertiary education respectively. WASH practices showed that 61.1% of the respondents did not have a place for handwashing. The study further revealed that the prevalence of iron deficiency was 23.7%, aneamia was 16.3% while 13.1% of the anaemic children were due to iron deficiency aneamia with significant sector (p=0.003) and gender (p=0.032) differences. Malaria (17.6%) and helmintes (18.3%) infection also showed a significant difference in the sector (p=0.020, p=0.042). The range of CD4 counts, Neutrophils, Lymphocytes, Monocytes, Basophils and Eosinophils were 708.85 to 727.11, 3.31 to 3.88, 3.03 to 4.38, 0.53 to 0.59, 0.03 to 0.04, 0.33 to 0.38 respectively. CRP positively correlated with household size (r= 0.155), Heamoglobin(r= 0.238), serum ferittin (r= 0.101), and PCV (r= 0.103). CD4 also positively correlated with mothers age and education (r= 0.252; r= 0.142) but negatively related to PCV(r= -0.102) while malaria and Household size (r=0.109) also shows a positive relationship. This study concluded that a significant relationship exists between socio economic status, makers of iron status and infections in the children. Hence, appropriate investigations for iron status and inflammation/infection screening, need to be integral in the evaluation of anaemia, and Interventions that target the multifactorial nature of anaemia in school-aged children need to be strengthened.&#x0D;

Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania.

In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.

Nutritional Pattern among Primary School Children with Iron Deficiency Anemia

anemia in school-age children is an important public health problem; it reduces physicalwork capacity and cognitive function and adversely affects learning and scholastic performance.

Effects of Soil-Transmitted Helminths and Intestinal Protozoan Infections on Haemoglobin Levels among School-Aged Children in Belo and Bui, North West Cameroon: A Cross-Sectional Study

Introduction. Soil-transmitted helminths (STH) remain a public health problem worldwide especially in low-income countries. Soil-transmitted helminths are known to affect both growth and haemoglobin levels. In this study, we determine the prevalence of intestinal parasites and explored its association with anaemia in school-aged children (SAC). Methodology. A cross-sectional study was carried out amongst pupils selected from 18 primary schools in four communities of the North West Region. Stool samples were examined using direct wet mount and formol-ether concentration techniques, while finger prick was performed for the measurement of haemoglobin with a haemoglobinometer. Results. The results showed significant variation of STHs, intestinal protozoan prevalence, and anaemia between age, sex, and communities. The prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworms was 15.1%, 0.8%, and 2%, respectively, with an overall STH prevalence of 18.3% across the four communities. Soil-transmitted helminths were more prevalent in Mbessa (30.2%) in comparison to Nkor (26.7%), Djottin (17.5%), and Kumbo (9.6%) communities. The prevalence of Entamoeba histolytica/dispar was 25.4% and Giardia duodenalis (6.9%), with an overall intestinal protozoa prevalence of 31% across the four communities. The prevalence of anaemia in the study population was 23.1%. Conclusion. Soil-transmitted helminths, intestinal protozoan infections, and anaemia are prevalent in the study area. Anaemia was observed to be associated with STH, intestinal protozoa, and the communities under study. This study recommends continuous deworming and health education on personal sanitation and environmental sanitation.

Prevalence of Helicobacter pylori Infection among Anemic School-Age Children in Egypt: A Cross-Sectional Population-Based Study

AbstractAnemia and Helicobacter pylori infection in school-age children are important public health problems. The association between H. pylori infection and the development of anemia, especially iron deficiency anemia, has been previously studied and until now it is still a matter of argument. This study aimed to determine the prevalence of anemia and H. pylori infection among school-age children and to find the association between H. pylori infection and anemia in school-age children. We conducted this population-based cross-sectional study in six Egyptian primary schools over a 12-month-period, including 1,200 students from all grades who fulfilled the inclusion criteria. The study participants were subjected to the following: medical history, clinical examination, and laboratory investigations included complete blood count and H. pylori antigen in stool, and according to the level of hemoglobin (Hb), we divided the students into two groups; the anemic group with Hb level &lt;11.5 g/dL and nonanemic group with Hb level ≥11.5 g/dL, and the serum ferritin levels were measured only for the anemic group as the best indicator for iron status. The overall prevalence of H. pylori infection was 25%. The overall prevalence of anemia was 13.25%, of which hypochromic microcytic anemia represented 87.4% of the anemic group, and the mean ferritin level in the anemic group was 18.56 ± 9.96 ng/mL. The prevalence of anemia among H. pylori-infected patients (62.3%) was significantly (p &lt; 0.001) higher than in noninfected children (37.7%). In the anemic group, the mean ferritin level in H. pylori-infected children was significantly lower than the mean level in the noninfected children (p &lt;0.001). Furthermore, the anemic group had a significantly higher incidence of H. pylori infection and a lower age (p &lt;0.001) in comparison with the nonanemic group. The dominant type of anemia in H. pylori-infected children was the microcytic hypochromic anemia, with a significantly higher incidence in comparison to other types of anemia (p &lt;0.001). The findings of this study demonstrate a significant association between H. pylori infection and anemia in school-aged children, especially iron deficiency anemia, as the incidence of H. pylori infection was greater in anemic children than in non-anemic children.

Prevalence and Factors Associated with Iron Deficiency Anemia among School-Age Children in Primary Schools in Burao City, Somaliland, 2020

Background: Anemia is a global public health problem affecting the majority of the population of the world in both developed and developing countries with major consequences on human health as well as social and economic development. It is the world’s second leading cause of disability of the whole global disease burden. It affects 1.62 billion (24.8%) of the population, among them, it is affecting 305 million (25.4%) school-age children (SAC). Objectives: The main objective of this study was to assess the prevalence and factors associated with anemia among school-age children in primary schools in Burao city, Somaliland, 2020. Materials & Methods: A school-based cross-sectional study design was done in four primary schools in Burao, Somaliland. About 285 school-age children in the age group between 6 - 14 years were selected with a respondent rate of 93.4%. Random sampling was used to select schools and systemic random sampling was used to identify children from the selected schools. Socio-demographic data was collected by using a questionnaire & interviews of respondents in addition to anthropometric measurements, hemoglobin measurement, and stool examination. Complete Blood Counting (CBC) was used to determine the mean corpuscular (kor-PUS-kyu-lar) volume (MCV) and hematocrit (HMC) levels to detect hemoglobin status of the children. Data was entered and analyzed using SPSS statistical software for Windows version 21. Anthropometric data was analyzed using ANTHRO Plus. Bivariate logistic regression and multivariable logistic regression were used to identify independent predictors of anemia in school adolescent girls. Statistical significance was set at p Results: A total of 285 school-age children were included in this study. The overall prevalence of anemia was (23.1%) (CI: 18.1%, 28.1%) with the mean and standard deviation of (12.7 ± 1.59). Out of the anemic children, 20.4% were mild and 2.3% and 0.4% of them were moderate and severe, respectively. Children’s from illiterate mothers (AOR = 2.37; 95% CI: 1.14, 4.94. P-value = 0.020), consuming organ meat less than once a week (AOR = 2.19; 95% CI: 1.05, 4.43. P-value = 0.036) and having parasites in stool (AOR = 5.21; 95% CI: 1.10, 24.6. P-value = 0.037) were identified as statistically independent associated factors with prevalence of anemia in school-age children’s from Burao, Somaliland. Conclusion: Prevalence of anemia in Burao city, Somaliland primary schools was a moderate public health problem in the current study area. Nutrition education, iron folic acid supplementation program, deworming, good hygiene, and sanitation are playing an important role in the prevalence of anemia and we recommend to give them more attention from ministry of education and ministry of health in Somaliland.

The Prevalence of Iron Deficiency Anemia and its Associated Risk Factors among a Samples of Primary Schools Students in Burao City,Somaliland

Background: Anemia is a global public health problem affecting the majority of the population of the world in both developed and developing countries with major consequences on human health as well as social and economic development. It is the world's second leading cause of disability of the whole global disease burden. It affects 1.62 billion (24.8%) of the population among them it is affecting 305 million (25.4%) school age children (SAC). Objectives: The main objective of this study was assess prevalence and factors associated with anemia among schoolage children in primary schools in Burao city, Somaliland, 2020. Materials & Methods: A school based cross sectional study design was done in four primary schools in Burao, Somaliland. About 285 school age children with in the age group between 6-14 years were selected with respondent rate of 93.4%. Random sampling was used to select schools and systemic random sampling used to identify children from the selected schools. Sociaodemographic data was collected by using questionnaire & interview of respondents in addition to anthropometric measurement, hemoglobin measurement and stool examination. Complete Blood Counting (CBC) was used to determine the mean corpuscular (kor-PUS-kyu-lar) volume (MCV) and hematocrit (HMC) levels to detect of hemoglobin status of the children. Data was entered and analyzed using SPSS statistical software for Windows version 21. Anthropometric data was analyzed using WHO Anthro Plus. Bivariate logistic regression and multivariable logistic regression were used to identify independent predictors of anemia in-school adolescent girls. Statistical significance was set at p<0.05. Results: A total of 285 school age children were included in this study. The overall prevalence of anemia was ( 23.1%) (CI: 18.1%, 28.1%) with the mean and standard deviation of (12.7±1.59). Out of the anemic children, 20.4% were mild and 2.3% and 0.4% of them were moderate and severe respectively. Children's from illiterate mothers was (AOR = 2.37; 95%CI: 1.14, 4.94), consuming organ meat less than once a week (AOR = 2.19; 95%CI: 1.05, 4.43) and having parasites on stool were identified as statistically independent associated factors of anemia in school age children's from Burao, Somaliland. Conclusion: Prevalence of anemia in Burao city, Somaliland primary schools was moderate public health problem in the current study area. Nutrition education, iron folic acid supplementation program, deworming, good hygiene and sanitation are play important role in the prevalence of anemia and we recommend to give them more attention from ministry education and ministry of health in Somaliland.

Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses

SummaryBackgroundThe burden of malaria infection in sub-Saharan Africa among school-aged children aged 5–15 years is underappreciated and represents an important source of human-to-mosquito transmission of Plasmodium falciparum. Additional interventions are needed to control and eliminate malaria. We aimed to assess whether preventive treatment of malaria might be an effective means of reducing P falciparum infection and anaemia in school-aged children and lowering parasite transmission.MethodsIn this systematic review and two meta-analyses, we searched the online databases PubMed, Embase, Cochrane CENTRAL, and Clinicaltrials.gov for intervention studies published between Jan 1, 1990, and Dec 14, 2018. We included randomised studies that assessed the effect of antimalarial treatment among asymptomatic school-aged children aged 5–15 years in sub-Saharan Africa on prevalence of P falciparum infection and anaemia, clinical malaria, and cognitive function. We first extracted data for a study-level meta-analysis, then contacted research groups to request data for an individual participant data meta-analysis. Outcomes of interest included prevalence of P falciparum infection detected by microscopy, anaemia (study defined values or haemoglobin less than age-adjusted and sex-adjusted values), clinical malaria (infection and symptoms on the basis of study-specific definitions) during follow-up, and code transmission test scores. We assessed effects by treatment type and duration of time protected, and explored effect modification by transmission setting. For study-level meta-analysis, we calculated risk ratios for binary outcomes and standardised mean differences for continuous outcomes and pooled outcomes using fixed-effect and random-effects models. We used a hierarchical generalised linear model for meta-analysis of individual participant data. This study is registered with PROSPERO, CRD42016030197.FindingsOf 628 studies identified, 13 were eligible for the study-level meta-analysis (n=16 309). Researchers from 11 studies contributed data on at least one outcome (n=15 658) for an individual participant data meta-analysis. Interventions and study designs were highly heterogeneous; overall risk of bias was low. In the study-level meta-analysis, treatment was associated with reductions in P falciparum prevalence (risk ratio [RR] 0·27, 95% CI 0·17–0·44), anaemia (0·77, 0·65–0·91), and clinical malaria (0·40, 0·28–0·56); results for cognitive outcomes are not presented because data were only available for three trials. In our individual participant data meta-analysis, we found treatment significantly decreased P falciparum prevalence (adjusted RR [ARR] 0·46, 95% CI 0·40–0·53; p<0·0001; 15 648 individuals; 11 studies), anaemia (ARR 0·85, 0·77–0·92; p<0·0001; 15 026 individuals; 11 studies), and subsequent clinical malaria (ARR 0·50, 0·39–0·60; p<0·0001; 1815 individuals; four studies) across transmission settings. We detected a marginal effect on cognitive function in children older than 10 years (adjusted mean difference in standardised test scores 0·36, 0·01–0·71; p=0·044; 3962 individuals; five studies) although we found no significant effect when combined across all ages.InterpretationPreventive treatment of malaria among school-aged children significantly decreases P falciparum prevalence, anaemia, and risk of subsequent clinical malaria across transmission settings. Policy makers and programme managers should consider preventive treatment of malaria to protect this age group and advance the goal of malaria elimination, while weighing these benefits against potential risks of chemoprevention.

Correlation Between Helicobacter Pylori Infection and Iron Deficiency Anemia in School-Aged Children

Background: Iron deficiency anemia (IDA) is recognized as a common nutritional problem in infants and young children in developing countries mainly due to poor nutrition in most cases. Objective: To evaluate the association between H. pylori infection and iron deficiency anemia in school-aged children. Patients and Methods: This study was conducted on 60 participants divided into two groups. Group I: formed of 30 patients suffering from iron deficiency anemia with hemoglobin (Hb) less than l1g/dL. Group II: formed of 30 healthy children (control Group) Results: In the current study we found that there was a significant decrease in weight and BMI among cases group p-value <0.001. In the current study, we found that there was a significant decrease in all CBC parameters among cases versus control. In the current study we found that there were significant differences between the two groups regarding nutritional status as in cases there was a higher percentage of low iron sources in the diet, there was a significant decrease in serum iron, ferritin, and TIBC in cases versus control. In the current study, we found that there was a significant increase in the number of positive samples for H pylori antigen in stool among cases versus control 63.3% versus 23.3% p-value 0.002. Conclusion: The results of this study demonstrate a significant association between children with iron deficiency anemia and positive H. pylori infection in school-age children. Moreover, H. pylori infection may be one of the significant causes of iron deficiency anemia.

Correlation Between Helicobacter Pylori Infection and Iron Deficiency Anemia in School-Aged Children

Background: Iron deficiency anemia (IDA) is recognized as a common nutritional problem in infants and young children in developing countries mainly due to poor nutrition in most cases. Objective: To evaluate the association between H. pylori infection and iron deficiency anemia in school-aged children. Patients and Methods: This study was conducted on 60 participants divided into two groups. Group I: formed of 30 patients suffering from iron deficiency anemia with hemoglobin (Hb) less than l1g/dL. Group II: formed of 30 healthy children (control Group) Results: In the current study we found that there was a significant decrease in weight and BMI among cases group p-value <0.001. In the current study, we found that there was a significant decrease in all CBC parameters among cases versus control. In the current study we found that there were significant differences between the two groups regarding nutritional status as in cases there was a higher percentage of low iron sources in the diet, there was a significant decrease in serum iron, ferritin, and TIBC in cases versus control. In the current study, we found that there was a significant increase in the number of positive samples for H pylori antigen in stool among cases versus control 63.3% versus 23.3% p-value 0.002. Conclusion: The results of this study demonstrate a significant association between children with iron deficiency anemia and positive H. pylori infection in school-age children. Moreover, H. pylori infection may be one of the significant causes of iron deficiency anemia.

Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013.

BackgroundThis study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012–2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country.MethodologyNational Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces.Principal findingsStool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%).SignificanceColombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels.

Prevalence of anemia and iron profile among children and adolescent with low socio-economic status.

BackgroundA national health survey in Indonesia conducted in 2013 showed that the prevalence of anemia in school-aged children and adolescents tripled from a survey conducted in 2007. Children and adolescents are particularly susceptible to iron deficiency anemia (IDA) and iron deficiency (ID) because of their rapid growth and puberty. Teenage girls are at risk because of their menstrual bleeding. Low socioeconomic status in children and adolescents is also a strong risk factor for experiencing iron deficiency. Studies regarding the prevalence of ID and IDA in Indonesia still vary and are lacking. This study aims to describe the prevalence of anemia in children and adolescents with low socioeconomic conditions.MethodsThis is a cross-sectional study conducted at two schools in the suburbs of Jakarta on children and adolescents aged 6–18 years old. Personal data and laboratory identities (complete peripheral blood count, reticulocyte hemoglobin content, ferritin, transferrin saturation, and C-reactive protein) were collected to determine iron status. Analysis was performed using SPSS program version 22.0.ResultsThe overall prevalence of anemia was 14.0%. The prevalence of IDA, ID without anemia, and iron depletion was 5.8%, 18.4%, and 4.3%, respectively. The prevalence of IDA, ID, and iron depletion was higher in females than in males.ConclusionThe overall prevalence of anemia in children and adolescents is lower than the national data. Special consideration needs to be taken for the female population, who are more at risk of developing ID and IDA.

Association between Helicobacter pylori Infection and Iron Deficiency Anemia in School-aged Iranian Children

To find the relationship between Helicobacter pylori infection and iron deficiency anemia in school-aged children. 71 children with dyspepsia, epigastric and vague abdominal pain attending a tertiary medical center in Iran underwent upper gastrointestinal endoscopy and were investigated for H. Pylori infection. Hemoglobin, mean corpuscular volume (MCV), serum ferritin, total iron binding capacity (TIBC) and serum iron levels were compared between children with or without H. pylori infection. H. pylori infection was detected in 42 (59.1%) patients. Proportion of children with iron deficiency anemia was not statistically different between two groups (26.2% vs. 14.3%; P=0.48). While hemoglobin was significantly lower in children with H. pylori infection (P=0.01), there were no significant differences in serum level of ferritin, iron, mean corpuscular volume and total iron binding capacity. Presence of H. pylori does not seem to play an important role in the pathophysiology and development of iron deficiency anemia in school-aged Iranian population.

PREVALENCE OF ANEMIA AND ASSOCIATED FACTORS AMONG SCHOOL-AGE CHILDREN IN AL-HARAM ZONE, GIZA GOVERNORATE, EGYPT

Background: Anemia in school-age children is an important public health problem, and available data of its prevalence and existing risk factors are essential for planning preventive strategies. Anemia is more prevalent among females as compared with males. It reduces physical work capacity and cognitive function and adversely affects learning and scholastic performance. Objectives: To determine the prevalence of anemia among male and female school-age children (6-18 years) in Al-Haram, Giza governorate, Egypt, and to identify factors associated with childhood anemia among the participants. Subjects and methods: A cross-sectional study was conducted on 235 school-age children 6-18 years old (116 males and 119 females) in Al-Haram district, Giza governorate, Egypt. An oral consent was obtained from participants and their relatives. A blood sample was taken from each participant with the aim of providing the prevalence of anemia and associated factors among the study population. Results: The study revealed that the overall prevalence of anemia was 38.7%. Among males were 23.3%, while 53.8% among females with a statistically significant difference. Regarding family size prevalence of anemia among families (less than five) were 27.1%, while 74.1% in families more than five persons with a statistically significant difference. The current study revealed that anemia was 64%, 54.5% and 10.1% among children born to illiterate, moderate and high educated fathers respectively. Anemia was 56.4% and 17.4% among children borne to illiterate and moderate educated mothers with a statistically significant difference. Results of the study revealed that anemia was 61.8%, 48.5%, 5.6% and 26.7% among children who born to farmers, merchant, governmental employee and private employee respectively. Regarding mothers job, 41.4%, 33.3% and 20% of children were anemic who born to house wife, merchant and private employee mothers respectively with statistically significant differences. The study revealed that anemia was 66.2% among children who ate meat once weekly, while 38.7% among children who ate meat twice weekly, with statistically significant differences. Anemia was 55% among children who ate vegetables once weekly, 28.8% among who ate vegetables twice, and 15.9% among who ate vegetables three times and more weekly. The current study revealed that anemia was 44.1% among who ate fruits once weekly, 13% among who ate twice weekly, and 11.8% among who ate three times and more weekly. Recommendations: - School teachers should give advice to both children and their parents regarding advantages of balanced diet. - Improvement of dietary habits regarding consumption of animal proteins, fruits and green leafy vegetables should be included in diet plan. - Health education seminars should be conducted at regular intervals. - Addition of a health education courses to student's curricula. Conclusion: The results suggested that there was a need for proper planning and implementation of preventive measures to combat childhood anemia.

Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa.

The aim of this study was to assess nutrient patterns and their relation to anemia and iron status of school children using pooled data from three study populations in South Africa. Data from 5- to 12-y-old children (N = 578) from three independent studies conducted in two provinces in South Africa were pooled. Data used in the analysis were dietary intake, hemoglobin, and plasma ferritin concentrations. Nutrient patterns were determined using factor analysis. Logistic regression analysis was performed to determine relationships of nutrient patterns with anemia and iron deficiency. In the pooled group, 13.8% of the children were anemic and 27.7% were iron deficient (ID). More than half of children did not meet the Estimated Average Requirement for various nutrients, including vitamins A, C, B12, folate, and zinc, although only 17.7% of children had an iron intake below the requirements. Median intakes for vitamins A and C were lower for anemic than non-anemic children (P = 0.03 and 0.02, respectively) and for ID versus non-ID children (P = 0.03 and 0.046, respectively). Four nutrient patterns were identified: plant protein, carbohydrate, iron, and B vitamins; animal protein and saturated fat; vitamins A and B12; and calcium and fiber. The vitamin A and B12 nutrient pattern was associated with lower odds of being anemic (odds ratio, 0.63; 95% confidence interval, 0.49-0.91; P = 0.035). The present results highlighted the potential role of the combination of dietary vitamin A and B12 in the etiology of nutritional anemia in school-age children in South Africa. Nutrient pattern analysis may improve the understanding of the synergistic role of nutrients related to anemia and may assist in planning intervention strategies.