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A Profile of Acquired Causes of Childhood Anaemia in General Paediatric Wards at Muhimbili National Hospital Dar es Salaam, Tanzania

Magesa, S. A. (2010) A Profile of Acquired Causes of Childhood Anaemia in General Paediatric Wards at Muhimbili National Hospital Dar es Salaam, Tanzania. Masters thesis, Muhimbili University of Health and Allied Science.

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Abstract

Anaemia is a growing public health and greatly determines the prognosis of children in the paediatric wards. There is paucity of data describing its magnitude, haematological values and acquired causes among patients admitted in paediatric wards. Anaemia is the major cause of morbidity and mortality in paediatric age yet the magnitude of acquired causes of anaemia have been inadequately studies in Tanzania. The study was aimed at determining the profile of acquired cause of childhood anaemia in general paediatric wards at Mihimbili National Hospital (MNH) in Dar es Salaam. This was a descriptive cross-sectional study. This was conducted at MNH in general paediatric wards from 20th August, 2009 to 15th December, 2009; and A total of 315 patients, aged 1-84 months, consecutively admitted were recruited in the study. After informed verbal content consent from the guardian or parent was obtained, information on demographic and clinical characteristics was collected from the parent or guardian. Physical examination and laboratory tests on blood; stool samples for hookworm screening; blood slides for malaria parasites; Human Immunodeficiency Virus (HIV); blood peripheral smears; active serum vitamin B12;serum folate; serum transferrrin; and serum iron were done on all subjects Additional information was taken from medical files. The prevalence of anemia was determined as a percentage of all paediatric patients recruited during the time of data collection. All information was recorded using questionnaires and analysis was done using SPSS version 13.0. A p value of <0.05 was considered statistically significant. Fatigue, headache, pallor, jaundice, hepatomegaly and splenomegaly were shown to be the most common presenting clinical feature in patients with anaemia (p<0.05). The status of anaemia (Hb<11g/dl) was 80.3%. The proportion of malaria was 7.9%, HIV seropositive was 10.2% and hookworm was 1.0% of all admissions. There was an increased risk of anaemia in patients with HIV seropositive and or malaria although this was not statistically significant (OR>1.0,p>0.05). Iron deficiency was the most common micronutrient deficiency occurring in 42% of all admission and 41-46% among the anaemic children; around one third of non anaemic patients had iron deficiency (p=0.05). The proportion of folate deficiency was 8.6% and vitamin B12 deficiency 3.4% of all recruited patients (p>0.05). Stutus of anaemia was 80.3%. Iron deficiency was common but HIV seropositive, malaria, hookworm, folate and vitamin B12 deficiencies were not prominent. It was noted that one third of the non anaemic paediatric patients have iron deficiency as stages of developing anaemia. Iron studies should be performed in microcytic anaemia and causes of iron deficiency investigated. Iron food fortification programs should be developed and implemented. Further studies should be done to determine serum B12 and serum and red cell folate levels in children on a large scale in order to resolve the controversy of these micronutrient deficiencies in children. Since this was a cross sectional hospital based study, bias could not be avoided in determining the profile of acquired causes of childhood anaemia.

Item Type: Thesis (Masters)
Keywords: Anaemia, Paediatric Wards, Malaria, HIV, Muhimbili Nationa Hospital
Subjects: Health Systems > Surveillance, monitoring & evaluation
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 18 Sep 2013 13:32
Last Modified: 18 Sep 2013 13:32
URI: http://ihi.eprints.org/id/eprint/2120

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