The contribution of malaria and sickle cell disease to anaemia among children aged 6 to 59 months in Nigeria: A secondary analysis using data from the 2018 Demographic and Health Survey

Abstract

Introduction: Anaemia is a major cause of morbidity and mortality among children in sub-Saharan Africa. Anaemia has many aetiologies best addressed by different treatments, so regional studies of the aetiology of anaemia may be required. Methods: We analysed data from Nigeria's 2018 Demographic and Health Survey (DHS) to study predictors of anaemia among children ages 6-59m. We computed the fraction of anaemia at different degrees of severity attributable to malaria and sickle cell disease (SCD) using a regression model adjusting for demographic and socioeconomic risk factors. We also estimated the contribution of the risk factors to haemoglobin concentration. Results: We found that 63.7% (95% CI: 58.3-69.4) of semi-severe anaemia (<80 g/L) was attributable to malaria compared to 12.4% (95% CI: 11.1-13.7) of mild-to-severe (adjusted haemoglobin concentration <110 g/L) and 29.6% (95% CI: 29.6-31.8) of moderate-to-severe (<100 g/L) anaemia and that SCD contributed 0.6% (95%CI: 0.4-0.9), 1.3% (95% CI: 1.0-1.7), and 7.3% (95%CI: 5.3-9.4) mild-to-severe, moderate-to-severe, and semi-severe anaemia, respectively. Sickle trait was protective against anaemia and was associated with higher haemoglobin concentration compared to children with normal haemoglobin (HbAA) among malaria-positive but not malaria-negative children. Conclusion: This approach used offers a new tool to estimate the contribution of malaria to anaemia in many settings using widely available DHS data. The fraction of anaemia among young children in Nigeria attributable to malaria and SCD is higher at more severe levels of anaemia. Prevention of malaria and SCD and timely treatment of affected individuals would reduce cases of severe anaemia.

Bayesian spatio-temporal and joint modelling of malaria and anaemia among Nigerian children aged under five years, including estimation of the effects of risk factors.

“…Nutritional deficiencies such as iron deficiency, folate deficiency, insufficient Vitamin B12 and communicable diseases such as hookworm infection, HIV, malaria, and other parasitic infections are major causes of anaemia (Cappellini et al, 2020;Roche and Layrisse, 1966;Malizia et al, 2022;Gupta et al, 2022;Cao et al, 2022;Chao et al, 2022;Karagöl and Yiğit, 2022;Mrimi et al, 2022;Powers, 2022). Nevertheless, in the areas where malaria infection is most endemic, the major cause of anaemia is malaria (Agagliati et al, 2022;Keating et al, 2021;WHO, 2021b;Ibeji et al, 2022).…”