Characteristics of severe anemia and its association with malaria in young children of the Kassena-Nankana District of northern Ghana.

Owusu‐Agyei, Seth; Fryauff, David J.; Chandramohan, Daniel; Koram, Kwadwo A.; Binka, Fred; Nkrumah, Francis; Utz, G; Hoffman, Stephen L.

doi:10.4269/ajtmh.2002.67.371

Cited by 36 publications

(29 citation statements)

References 20 publications

(20 reference statements)

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“…As was reported by others (7,26), some anemia still remained in the intervention groups, even among the NT and NB children, who received a full complement of micronutrients. Although malaria could play a role (27), only 6.8% of the 44 intervention children with anemia at 12 mo were smear-positive for malaria, and we found no significant difference (t test; data not shown) in hemoglobin concentration between children with and without malaria in the 3 intervention groups. Other possible reasons could be infections and/or other factors such as sickle cell disease (28).…”

Section: Discussionmentioning

confidence: 45%

Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Adu‐Afarwuah

Lartey²,

Brown³

et al. 2008

The American Journal of Clinical Nutrition

186

166

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Background: Micronutrient deficiencies are common during infancy, and optimal approaches for their prevention need to be identified. Objective: The objective was to compare the efficacy and acceptability of Sprinkles (SP), crushable Nutritabs (NT), and fat-based Nutributter (NB; 108 kcal/d), which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods. Design: Ghanaian infants were randomly assigned to receive SP (n ҃ 105), NT (n ҃ 105), or NB (n ҃ 103) daily from 6 to 12 mo of age. We assessed dietary intake, morbidity, and compliance weekly. Hemoglobin and plasma ferritin, TfR, C-reactive protein, and zinc were measured at 6 and 12 mo. We used an exit interview to assess acceptability. A randomly selected control group of infants who received no intervention (NI; n ҃ 96) were assessed at 12 mo. Results: All supplements were well accepted, and the mean percentage of days that supplements were consumed (87%) did not differ between groups. At 12 mo, all 3 intervention groups had significantly higher ferritin and lower TfR concentrations than did the NI control group. Mean (Ȁ SD) hemoglobin was significantly higher in NT (112 Ȁ 14 g/L) and NB (114 Ȁ 14 g/L) but not in SP (110 Ȁ 14 g/L) infants than in NI infants (106 Ȁ 14 g/L). The prevalence of iron deficiency anemia was 31% in the NI control group compared with 10% in the intervention groups combined (P 0.0001). Conclusion: All 3 options for home fortification of complementary foods are effective for reducing the prevalence of iron deficiency in such populations.Am J Clin Nutr 2008;87:929 -38.

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Section: Discussionmentioning

confidence: 45%

Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Adu‐Afarwuah

Lartey²,

Brown³

et al. 2008

The American Journal of Clinical Nutrition

186

166

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“…Second, we observed a significant reduction in haemoglobin concentration and proportion of anaemia (Table 2) in P. falciparum infected children compared to those not infected-with severe anaemia only seen in a minority (n = 4/105, 3.8 %) of the children infected with malaria but none in the controls. Because, malaria-induced immune response contributes to accelerated lysis of both parasitized and non-parasitized red cells, which in turn results in increased erythropoiesis under the influence of a combination of haemolytic mechanisms, anaemia is a common complications in P. falciparum infected children (Wickramasinghe and Abdalla, 2000;Owusu-Agyei et al 2002). We noted severe malarial anaemia as the most common form of severe malaria (n = 2/4, 50 %) encountered.…”

Section: Discussionmentioning

confidence: 76%

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

et al. 2014

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Malaria is hyper-endemic in Ghana. Haematological alterations in the disease pathology may offer complimentary criteria to improve clinical and microscopy diagnosis. Our primary outcome was to evaluate haematological parameters in children with Plasmodium falciparum infections and report their predictive risk and diagnostic performance for malaria infections in Ghana. Haematological data, including thin and thick blood films were examined for children less than 12 years of age in a multicenter-based active case finding approach. Haematological changes were common in P. falciparum infected children and more pronounced in severe malaria cases. More so, a unit increase in parasiteamia increased the odds for severe malaria infection by 93 % [OR, 95 % CI: 1.93 (1.28-2.91); P value = 0.02]. In multivariate regression, low haemoglobin was a significant haematological change in predicting P. falciparum infections [OR,); P value = 0.001]. Low haemoglobin levels \11 g/dl was the most reliable indicator for P. falciparum infections [with a sensitivity of (64 %), specificity (71 %), positive predictive value (83 %) and likelihood ratio (2.2)]-even when evaluated in combination with leucocytosis, lymphocytopaenia and high neutrophil counts [7,500 lL. In malaria endemic settings, low haemoglobin concentration (\11 g/dl) in children with febrile illness should prompt a more diligent search for the malarial parasite to limit the misuse and abuse of anti-malarial drugs.

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“…However, the jump in the mortality rate for 2000 compared to 1998 and 1999 may be due to the outbreak of a cerebro-spinal meningitis epidemic in the district, which also occurred in 1997. This overall decline in mortality in the district may be attributable to the many interventions being implemented in the district by the Navrongo Health Research Centre among which were the malaria intervention studies (14–16) and the Community Health and Family Planning Project (CHFP) (17–19). …”

Section: Discussionmentioning

confidence: 99%

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Adjuik

Kanyomse

Kondayire

et al. 2010

Global Health Action

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BackgroundUnder-five mortality is a major public health problem and one of the health indicators of health care in sub-Saharan Africa. In order to address inefficient health systems, there is a need to identify the spatial distribution of under-five mortality, especially areas of high mortality clustering. This study aimed to explore spatial and temporal clustering in under-five mortality in the Kassena-Nankana1 District of the Upper East region.MethodsWe used data from the Navrongo Health and Demographic Surveillance System in the Kassena- Nankana District of northern Ghana, which had an average population of 140,000 of which about 18,400 were under five years of age. We analysed under-five mortality in 49 villages during the period 1997–2006. We calculated total under-five mortality rates and investigated their geographical distributions. A spatial scan statistic was used to test for clustering of the mortality in both space and time.ResultsUnder-five mortality has been declining during the period. However, the data show a persistently higher than average clustering of mortality over the period among villages mainly in the north-eastern parts of the district.ConclusionThere is a higher than average under-five mortality clustering in the villages in the north-east of the district and this may suggest a relatively poor health care system despite the many health interventions that took place over time in the district, including the Community Health and Family Planning Project, whose impact may not have been felt in these parts of the district between 1995 and 2004.

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Characteristics of severe anemia and its association with malaria in young children of the Kassena-Nankana District of northern Ghana.

Cited by 36 publications

References 20 publications

Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

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