Prevalence and Aetiology of Severe Anaemia in Under-5 Children in Abakaliki South Eastern Nigeria

Background: Severe anaemia is a common childhood problem which is associated with various degrees of morbidity and mortality especially in children under five years of age. It remains a major public health challenge in Nigeria and sub-Saharan Africa. Objectives: To determine the prevalence, aetiology and outcome of severe anaemia in children aged 6 months to 5 years. Methods: This was a prospective study of children less than 5 years that presented with severe anaemia at the Children’s Emergency Unit and the Outpatient Department of Ebonyi State University Teaching Hospital Abakaliki (EBSUTH), Abakaliki. Severe anaemia was defined as PCV ≤ 15%. Biodata of subjects selected included age, sex, and socio-economic status. Laboratory tests carried out included haemoglobin levels, haemoglobin electrophoresis, blood film examination, blood culture, urinalysis, microscopy, and other relevant tests. Results: One hundred and forty subjects out of the 1450 patients admitted during the period of study had severe anaemia giving a prevalence rate of 9.7%. Majority of the patients (63.6%) were less than 2years of age. Malaria was the commonest cause of severe anaemia 64.3% (90). Other common causes included sickle cell anaemia 13 (9.3%), Septicemia 19 (13.6 %), and malnutrition 10 (7.1%). One hundred and seventeen (83.6%) patients recovered and were discharged home while 19 died giving mortality rate was 13.6%. Conclusion: The study revealed high prevalence of severe anaemia while malaria was observed to be the commonest cause among under-5 children seen at EBSUTH Abakaliki. *Corresponding author: Uzoamaka.V. Muoneke, Department of Paediatrics, Ebonyi State University/ Teaching Hospital, Abakaliki, Ebonyi State, Nigeria, Tel: 234-8037432258; E-mail: [email protected] Received November 24, 2011; Accepted December 16, 2011; Published December 18, 2011 Citation: Muoneke VU, ChidiIbekwe R (2011) Prevalence and Aetiology of Severe Anaemia in Under-5 Children in Abakaliki South Eastern Nigeria. Pediatr Therapeut 1:107. doi:10.4172/2161-0665.1000107 Copyright: © 2011 Muoneke VU, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Severe anaemia is a major paediatric problem in Nigeria [1-4]. It is associated with many unwanted effects on the patient, one of which is congestive cardiac failure. Severe anaemia which is a life threatening condition is a common occurrence in children’s emergency units in most hospitals in the developing countries [2-6]. Most anaemia related deaths encountered are usually due to severe anaemia [1-3]. It is a common blood disorder in children and imposes an economic burden on the parents/caregivers and the country as a whole [7,8]. In various African settings, about 12 to 29%of hospitalized children have severe anaemia with thein-hospital case fatality rate ranging between 8 and 17% [1-4]. Reasons like malaria endemicity, poor nutrition including micronutrient deficiency, haemoglobinopathies, frequent bacterial infections and high parasitic infestations have been given for these high prevalence rates [2,8-11]. Late presentation of patients to health facilities, ignorance and poverty on the part of the parents/ caregivers are other factors which compound these high prevalence rates [2,7,8]. In most African studies, including reports from Nigeria, severe anaemia occurs more commonly in children less than 5 years of age and is predominant among the males, occurring most often during the rainy seasons (in the tropics) when the incidence of malaria infection is at its peak [3,4,6,9]. The need to carry out this study was informed by the paucity of literature on the prevalence and aetiological factors of severe anaemia among children in the vulnerable age-group of under-5 years. It is hoped that the information obtained in this study would be helpful to health care practitioners and health policy makers in this area, in curbing this preventable but potentially fatal disorder particularly among children in this vulnerable age group. Methods The study area This study was done at the Children’s Emergency Unit and the Children’s Outpatient Department of Ebonyi State University Teaching Hospital, Abakaliki, Ebonyi State. Abakaliki is the capital of Ebonyi State, located in the South Eastern part of Nigeria and covering an area approximately 51km2, with an average atmospheric temperature of 30°C. Abakaliki, like most part of southern Nigeria is in the holendemic zone for malaria transmission and thus has intense malaria transmission all year round. The study design Between January 2007 and June 2007, a consecutive sample of children(140 patients) who presented at the Outpatient Departmentand the Children’s Emergency Room with a primary diagnosis of severe anaemia(defined as a haemoglobin concentration of ≤5.0g/dl or PCV of ≤15%) were recruited into this prospective, cross sectional and Citation: Muoneke VU, ChidiIbekwe R (2011) Prevalence and Aetiology of Severe Anaemia in Under-5 Children in Abakaliki South Eastern Nigeria. Pediatr Therapeut 1:107. doi:10.4172/2161-0665.1000107