Malarial Anaemia and Anaemia Severity in Apparently Healthy Primary School Children in Urban and Rural Settings in the Mount Cameroon Area: Cross Sectional Survey

Abstract

BackgroundThis study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children.MethodsA cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11g/dL); mild MA (Hb of 8–10.9g/dL); moderate MA (Hb of 6.1–7.9g/dL) and severe MA (Hb≤6g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors.ResultsOut of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia.ConclusionsMalarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.

Malaria, Moderate to Severe Anaemia, and Malarial Anaemia in Children at Presentation to Hospital in the Mount Cameroon Area: A Cross-Sectional Study

“…Why females had a higher attributable risk of anaemia and moderate to severe anaemia due to malaria is unclear as no significant gender differences were observed in prevalence and density. Even though studies on the attributable risk of anaemia and moderate to severe anaemia due to falciparum malaria have seldom been carried out in Cameroon, previous studies in the Mount Cameroon area, in apparently healthy children, revealed a moderate (24.5%) contribution of falciparum malaria to anaemia [23]. Inferences from both studies most likely indicate the notion that of greater importance is the contribution of asymptomatic P. falciparum infection to the public health problem of anaemia compared to falciparum infection in febrile children.…”

“…The socioeconomic status was classified as poor, average, and rich as described by Kimbi et al [5] and Sumbele et al [23]. …”

Coinfection with malaria and intestinal parasites, and its association with anaemia in children in Cameroon

“…In the present study, the prevalence of malaria among the study participants was 98.5 %, which is very high compared to the prevalence reported in children in other areas of the Southwest Region of Cameroon. This includes the 50.7 % reported in villages in Mbonge [ 11 ], 33.8 % in Limbe and Buea [ 28 ], and 40.6 % in the Centre Region of Cameroon [ 29 ]. These discrepancies could be explained by the fact that the present study was hospital-based in which febrile children were enrolled, compared to the other studies in which apparently healthy children either from schools or the community were enrolled.…”

Epidemiology of Malaria Using LED Fluorescence Microscopy among Schoolchildren in Douala, Cameroon

“… Fever was considered as armpit temperature ≥ 37.5°C [21].  Asymptomatic malaria was defined as the presence of malaria parasite with an axillary temperature < 37.5°C [22].…”