Prevalence, morphological characterization, and associated factors of anemia among children below 5 years of age attending St. Mary’s Hospital Lacor, Gulu District, Northern Uganda

Abstract

Aim/objective

The aim of this study was to determine the prevalence, severity, morphological characterization, and the associated factors of anemia among children under the age of 5 years at St. Mary’s Hospital Lacor, Gulu District, Northern Uganda.

Materials and methods

A structured questionnaire was administered to each participant’s parent/caregiver to collect data on sociodemographic factors, feeding pattern, and history of chronic illness. Hemoglobin (Hb) estimation was performed using a HemoCue 201⁺ analyzer. Peripheral thin and thick blood films were made from venous blood and stained with Giemsa to morphologically characterize red blood cells (RBCs) and investigate hemoparasites, respectively. We collected and examined stool specimens from each participant using wet preparations and formol–ether concentration technique for intestinal parasites. Descriptive statistics was used to describe study participants and to determine the prevalence of anemia. Logistic regression analysis was done to determine the factors associated with acquiring anemia at a P-value≤ 0.05.

Results

The study enrolled 343 children below the age of 5 years. Of these, 62.7% (N=215) were females. The IQR, median, and mean Hb levels were 5.1±3.2 g/dL, 8.2 g/dL, and 7.9 g/dL, respectively. Overall, 160 (46.6%, 95% CI: 42.1–51.46) children had anemia. The magnitude of severe, moderate, and mild anemia was 11.9%, 58.8%, and 29.4%, respectively. Morphologic characterization of anemia revealed hypochromic-microcytic (65.4%, N=106), hypochromic-macrocytic (15.4%, N=25), and normochromic-microcytic (19.1%, N=31) anemia. Factors associated with anemia were parasitic infestation, history of chronic disease, lack of complementary foods, complementary feeding for not more than twice a month, and households’ with annual income less than 200,000 Ugandan Shillings.

Conclusion

We report the high prevalence of anemia among children below 5 years of age in Gulu District, Northern Uganda. Thus, strategies geared at addressing the etiologic causes (such as, nutrient deficiency and parasitic infections) are key to reduce it in the region.

Keywords:

• anemia
• associated factors
• children below 5 years
• Uganda

Acknowledgments

Our deep gratitude goes to our study subjects who were volunteers and took their time to give us all the relevant laboratory samples and questionnaire responses to the study. We are grateful to laboratory staff of St. Mary’s Hospital, Lacor for the assistance accorded during the time of data collection. We wholeheartedly thank the Emmaus Foundation and Benedict Medical Centre, Luzira for the logistical support toward this study. We did not receive funding for this study; however, we obtained laboratory consumables (vacutainers, HemoCue 201⁺ analyzer and cuvettes, gloves, syringes, and cotton) as a generous donation from Emmaus Foundation and Benedict Medical Centre, Luzira. This did not in any way interfere with our study design, results obtained, and interpretation as well as the decision to publish.

Author contributions

AO, CO, FW, BM, and IMT conceived the study idea, participated in study design, data acquisition, analysis, and interpretation. AO, CO, FW, and BM participated in drafting data collection tools and manuscript drafting. IMT oversaw the entire research process, scheduling for internal responsibilities and critically reviewed the manuscript. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.