Risk Factors and Socioeconomic Indicators of Iron Deficiency Anemia in Children Under 5 Years of Age in Rural Imo State, Nigeria

Accepted for presentation at the Consortium of Universities for Global Health Annual Conference 2017

Jennie G. Godwin
Jennie G. Godwin

Jennie G. Godwin; A. Nwaba; A. A. Nwaba; V. P. Rajamanickam; K. Mezu-Nnabue; E. Esenwah; N. Ikoro; O. J. Mezu-Ndubuisi

Background: Iron deficiency is the most common nutritional deficiency and hematologic disease of children worldwide. A humanitarian medical outreach conducted by Mezu International Foundation (MIF) in rural South-Eastern Nigeria noted a high prevalence of childhood anemia associated with severe malnutrition and chronic illness. This study seeks to determine the prevalence of anemia in children less than five years of age and identify modifiable socioeconomic and health risk factors associated with anemia.

Methods: A cross-sectional study was done on 35 randomly selected children under 5 years old, at the MIF medical outreach following Institutional Review Board approval from a collaborating local institution, Federal University of Technology, Owerri, Imo State, Nigeria. A questionnaire was administered to caregivers addressing socio-economic status (SES), dietary iron intake, and knowledge of anemia. Participants received detailed medical exams by licensed physicians. Hemoglobin (Hgb) was measured with a hemoglobinometer. Anemia was defined as a hemoglobin less than 11.0 g/dl, with severity of anemia stratified as mild (10.0-10.9 g/dl), moderate (7.0-9.9 g/dl), and severe (<7.0 g/dl) per WHO standards.

Findings: Out of 35 subjects, 12 male (34%) and 23 female (65%), fifty-four percent were anemic (17% mild, n=6, 29% moderate, n=10, and 8.5% severe, n=3). Hgb (mean±SD) was 8.1±2.1 g/dl in children < 1 year old, (n=7), and 10.6±1.8 g/dl in those 1-4 years old (n=28). There was a significant association between age and diagnosis of anemia (P=0.02). All patients (100%) had a middle SES score. Eighty-two percent of caregivers did not know the meaning of anemia, and 94% did not know causes of anemia. There was a positive correlation between hemoglobin levels and amount of dietary iron intake (r=0.36, P=0.03). Thirty-four percent were currently breastfeeding (71% < 1 year old); and there was a significant association between age and breastfeeding (P=0.03).

Interpretation: Despite middle-income status, families surveyed had poor knowledge of anemia. Children with lower dietary iron intake and breastfed infants less than 1 year old were more anemic than older children. An educational program incorporating recommendations for sustainable local iron-rich dietary options for both children and breastfeeding mothers would aid in alleviating the burden of iron deficiency anemia in this community.