Association of anaemia with micronutrient (iron, folate and Vitamin B12) deficiencies among children admitted at Muhimbili National hospital in Dar Es salaam, Tanzania

Abstract

Objective: Anaemia is the major cause of morbidity and mortality in paediatric age with much aetiology. The aetiology of childhood anaemia has been inadequately studied at Muhimbili National Hospital (MNH). The study was aimed at determining the frequency of anaemia and the association of anaemia with micronutrient deficiencies in patients admitted in general paediatric wards at MNH in Dar es Salaam.
Methods: We conducted a descriptive cross-sectional study at MNH in general paediatric wards from 20th August, 2009 to 15th December, 2009. Patients, aged 1- 84 months, consecutively admitted were recruited in the study. After informed verbal consent from the guardian or parent was obtained, information on demographic and clinical characteristics was collected from the parent or guardian. The following laboratory tests on blood were done on all subjects: full blood count; serum iron; serum transferrin; serum folate; and active serum vitamin B12. The frequency of anaemia and the association (if any) of anaemia with micronutrient deficiencies were determined as percentages of all paediatric patients recruited. Analysis was done using SPSS version 13.0. A P value of < 0.05 was considered statistically significant.
Results: A total of 315 children were assessed. The frequency of anaemia was 79.4%. This is much higher than the WHO prevalence of 67.6% in Africa for anaemia to be taken as a disease of public health importance. The proportion of iron deficiency was 41.0%, folate deficiency was 8.6% and vitamin B12 deficiency was 3.4% of 290 recruited patients. Around 16%, 20% and 10% of non anaemic patients had iron, folate and vitamin B12 deficiencies, respectively. When patients with and without micronutrient deficiency were compared to those with and without anaemia, no statistically significance difference was found (p > 0.05).
Conclusion: The frequency of anaemia in paediatric patients admitted at MNH was high and might as well carry a high burden in the rest of the country. Iron deficiency was the most common micronutrient deficiency and folate and vitamin B12 deficiencies were rare. It was interesting to note that these micronutrient deficiencies had no statistically significant association with anaemia. If the current situation of micronutrient deficiency found at MNH is indeed the same in other parts of the country, then other risk factors of anaemia should be investigated with a goal of reducing the burden of anaemia.

Key words: Anaemia, frequency, association, iron, folate, vitamin B12, under-five children