Prevalence of Anemia and Associated Socio-Economic Determinants amongst Malnourished Children Aged 6-59 Months, Centre Hospitalier Universitaire de Kigali (CHUK) – A Retrospective Observational Study

Abstract

Introduction: In Rwanda, malnutrition among children under five years is a major public health problem. Anemia is one of the comorbidities of malnutrition. This study aimed to investigate the prevalence of anemia in a hospitalized malnourished pediatric population aged under 5 years and associated socio-economic factors.

Methods: This was a retrospective cross-sectional study of malnourished children aged 6-59 months consulted and admitted in CHUK during the time of review, January-December 2017. Data were collected from patients’ files and OpenClinic (an electronic medical record system). The collected data were recorded and calculated means and frequencies using SPSS version 16.0. The cutoff points for anemia in children were based on hemoglobin (Hb) concentration whereby less than 7g/dL, 7-9.9g/dL, and 10-11.5 g/dL were considered severe, moderate and mild anemia, respectively while hemoglobin concentration above 11.5 g/dL was considered normal based on WHO (2001) recommendations.

Results: A total of 113 patients were enrolled. Of those, 66% (n=74) were male and 34% (n=39) were female. The mean age was 27 months. We have found that 15% were stunted and 18.6% were wasted, while 24.8% were underweight. Accordingly, 69% (n=78) of study population were found to be anemic with whom 8.8% were severely anemic (Hb <7g/dL), 30.1% were moderately anemic (Hb 7-9.9g/dL), 30.1% were mildly anemic (Hb 10-11.5 g/dL) and 31% (n=35) were not anemic (Hb >11.5 g/dL). Low education status of parents, poverty, consuming cow’s milk before one year of age, and a high number of siblings (greater than 3) in the household were descriptively found to be predictors of socio-economic determinants of malnutrition associated with anemia.

Conclusion: The significant relationship between increased prevalence of nutritional anemia among children with malnutrition and socio-economic factors, like illiteracy, nutrition and poverty, were identified. Enhancement of social protection services and basic education for all could curb the problem.