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High Prevalence of Anemia but Low Level of Iron Deficiency in Preschool Children during a Low Transmission Period of Malaria in Rural Kivu, Democratic Republic of the Congo.

Abstract Anemia is a worldwide public health concern especially in preschool children in developing countries and iron deficiency (ID) is generally assumed to cause at least 50% of the cases. However, data on this contribution are scarce. To close this gap, we determined in 2013 the contribution of ID in the etiology of anemia and measured others factors associated to noniron deficiency anemia (NIDA) in 900 preschool children randomly selected during a two-stage cluster nutritional survey in the Miti-Murhesa health zone, in eastern Democratic Republic of the Congo. In these children, we collected sociodemographic, clinical, and biological parameters and determined the nutritional status according to the World Health Organization 2006 standards. Anemia was defined as altitude-adjusted hemoglobin < 110 g/L and ID was defined as serum ferritin < 12 μg/L or < 30 μg/L in the absence or presence of inflammation, respectively. Median (interquartile range) age was 29.4 (12-45) months. The prevalence of anemia was 46.6% (391/838) among whom only 16.5% (62/377) had ID. Among children without signs of inflammation, only 4.4% (11/251) met the ferritin-based (unadjusted) definition of ID. Logistic regression analysis identified ID, history of fever during the last 2 weeks and mid-upper arm circumference < 125 mm as the only independent factors associated to anemia. In conclusion, anemia is a severe public health problem in the Miti-Murhesa health zone, but NIDA is mostly predominant and needs to be further studied. Control of infections and prevention of acute undernutrition (wasting) are some of appropriate interventions to reduce the burden anemia in this region.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american journal of tropical medicine and hygiene
Publication Year Start




PMID- 28829731
OWN - NLM
STAT- In-Process
DA  - 20170822
LR  - 20170822
IS  - 1476-1645 (Electronic)
IS  - 0002-9637 (Linking)
VI  - 97
IP  - 2
DP  - 2017 Aug
TI  - High Prevalence of Anemia but Low Level of Iron Deficiency in Preschool Children 
      during a Low Transmission Period of Malaria in Rural Kivu, Democratic Republic of
      the Congo.
PG  - 489-496
LID - 10.4269/ajtmh.17-0030 [doi]
AB  - Anemia is a worldwide public health concern especially in preschool children in
      developing countries and iron deficiency (ID) is generally assumed to cause at
      least 50% of the cases. However, data on this contribution are scarce. To close
      this gap, we determined in 2013 the contribution of ID in the etiology of anemia 
      and measured others factors associated to noniron deficiency anemia (NIDA) in 900
      preschool children randomly selected during a two-stage cluster nutritional
      survey in the Miti-Murhesa health zone, in eastern Democratic Republic of the
      Congo. In these children, we collected sociodemographic, clinical, and biological
      parameters and determined the nutritional status according to the World Health
      Organization 2006 standards. Anemia was defined as altitude-adjusted hemoglobin &lt;
      110 g/L and ID was defined as serum ferritin &lt; 12 mug/L or &lt; 30 mug/L in the
      absence or presence of inflammation, respectively. Median (interquartile range)
      age was 29.4 (12-45) months. The prevalence of anemia was 46.6% (391/838) among
      whom only 16.5% (62/377) had ID. Among children without signs of inflammation,
      only 4.4% (11/251) met the ferritin-based (unadjusted) definition of ID. Logistic
      regression analysis identified ID, history of fever during the last 2 weeks and
      mid-upper arm circumference &lt; 125 mm as the only independent factors associated
      to anemia. In conclusion, anemia is a severe public health problem in the
      Miti-Murhesa health zone, but NIDA is mostly predominant and needs to be further 
      studied. Control of infections and prevention of acute undernutrition (wasting)
      are some of appropriate interventions to reduce the burden anemia in this region.
FAU - Bahizire, Esto
AU  - Bahizire E
AD  - Center of Research in Epidemiology, Biostatistics and Clinical Research,
      Universite Libre de Bruxelles, Brussels, Belgium.
AD  - Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, Democratic Republic 
      of the Congo.
FAU - Bahwere, Paluku
AU  - Bahwere P
AD  - Valid International, Oxford, United Kingdom.
AD  - Center of Research in Epidemiology, Biostatistics and Clinical Research,
      Universite Libre de Bruxelles, Brussels, Belgium.
FAU - Donnen, Philippe
AU  - Donnen P
AD  - Center of Research in Epidemiology, Biostatistics and Clinical Research,
      Universite Libre de Bruxelles, Brussels, Belgium.
FAU - Tugirimana, P Lundimu
AU  - Tugirimana PL
AD  - Faculty of Medicine, Universite de Goma, Goma, Democratic Republic of the Congo.
AD  - Department of Clinical Biology, National University of Rwanda, Kigali, Rwanda.
FAU - Balol'ebwami, Serge
AU  - Balol'ebwami S
AD  - Department of Pediatrics, Universite Catholique de Bukavu, Bukavu, Democratic
      Republic of the Congo.
FAU - Dramaix, Michele
AU  - Dramaix M
AD  - Center of Research in Epidemiology, Biostatistics and Clinical Research,
      Universite Libre de Bruxelles, Brussels, Belgium.
FAU - Nfundiko, Chouchou
AU  - Nfundiko C
AD  - National Program of Nutrition, Division Provinciale de la Sante du Sud-Kivu,
      Bukavu, Democratic Republic of the Congo.
FAU - Chirimwami, Raphael
AU  - Chirimwami R
AD  - Department of Pathology, Universite Catholique de Bukavu, Bukavu, Democratic
      Republic of the Congo.
FAU - Mubagwa, Kanigula
AU  - Mubagwa K
AD  - Department of Cardiovascular Diseases, Katholieke Universiteit Leuven, Leuven,
      Belgium.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Trop Med Hyg
JT  - The American journal of tropical medicine and hygiene
JID - 0370507
EDAT- 2017/08/23 06:00
MHDA- 2017/08/23 06:00
CRDT- 2017/08/23 06:00
AID - 10.4269/ajtmh.17-0030 [doi]
PST - ppublish
SO  - Am J Trop Med Hyg. 2017 Aug;97(2):489-496. doi: 10.4269/ajtmh.17-0030.