Prevalence of Iron Defficiency Anemia in Children with malaria
Date
2012-06-26
Authors
Mulendele, Evans
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Abstract
Both iron deficiency and malaria on one hand are common in sub-Saharan Africa and the interaction between the two is complex. On the other hand both cause anemia which is one of the most prevalent diseases suffered by individuals in developing world. The etiology of anemia is frequently multi-factorial, with iron deficiency, malaria, hemoglobinopathies and other nutritional deficiencies contributing to its cause. This study assessed the prevalence of iron deficiency during the acute episode of malaria illness and during convalescence.
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This was a prospective case study and a clinical assessment was used to collect information at the time of enrollment (day 0) and convalescence (day 35). In addition laboratory assessment was conducted on all the recruited children on day O and day 35 which included full blood count and sickling test. Hematological indices of interest in this study were hemoglobin (Hb), mean Corpuscular Volume (MCV), mean cell hemoglobin (MCH) and red cell distribution width (RDW). The Hb, MCV, MCH and RDW were used to determine iron deficiency. The children who had MCV less than 70 fl, MCH less 27 (pg) and RDW percentage more than 16 % were said to have iron deficiency and those who in addition had HB < 12g/dl were defined as iron deficiency anemia. The children with positive malaria parasite slide (ring forms of plasmodium falciparum) were defined as having malaria.Prevalence of iron deficiency was thirty-nine percent (39%) and those with anemia were thirty five percent (35%) at presentation (day 0). The number of children who were iron deficient on day 35 increased to fourty nine percent (49%). Fifty percent (50%) of children with severe anemia (Hb < 6g/dl) had iron deficiency at day 0. Children who had anemia with no iron deficiency at day 0 were 34%, however on day 35 the 18% of the children with anemia and no iron deficiency developed iron deficiency. The changes in iron status between days 0 and day 35 were statistically not significant in all the parameters used to determine iron deficiency. But individually there were some children whose anemia status worsened on day 35.
This study has shown that iron deficiency (shown by the hematological indices of MCV less than 70 fl, MCH less 27 (pg) and RDW percentage more than 16 %) is prevalent among children with malaria and in some cases iron deficiency worsens during convalescence. How much iron deficiency impacts on malaria anemia cannot be concluded from this study. More studies need to be done especially to asses the benefits of supplementation with iron in a child after an episode of malaria. Such studies should involve both rural and urban populations.
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Pediatrics-Zambia , Medicine-Zambia