Abstract:

Background: Anaemia is a major public health problem in developing countries contributing significantly to morbidity and mortality in children under five years. About 43% of children under five years are anaemic worldwide, and two-third are residing in Sub Saharan Africa. Even where blood transfusions are available there is a significant case fatality rate of 6-18%. This study aimed at determining the prevalence of anaemia, associated factors of severe anaemia as well as morphological types of anaemia among children under five years admitted at Bugando Medical Centre.

Methods: A hospital based cross-sectional study conducted between November 2012 and February 2013. About 448 subjects were eligible. To study morphological types of anaemia and factors associated with severe anaemia information from 309 subjects was obtained as well as performance of selected laboratory investigations. Data were cleaned and analyzed using STATA version 11.

Results: The prevalence of anaemia was 77.2%. Mild, moderate and severe anaemia were 16.5%, 33% and 27.7% respectively. Malaria parasitaemia (p-value < 0.001), presence of haemoglobin S (p-value 0.018) and unemployment among caretakers (p-value 0.007 were strongly associated with severe anaemia. Of 239 children with moderate and severe anaemia 22.6% had iron deficiency. Majority of the anaemic children (37.5%) and microcytic hypochromic anaemia.

Conclusion: Prevalence of anaemia among under-fives admitted at BMC is high. Iron deficiency anaemia is the leading type. Factors strongly associated with severe anaemia were malaria parasitaemia, presence of hemoglobin S and unemployment among caretakers.

Recommendations: Considering a high prevalence of anaemia, the approach to anaemia control should be revised. Preventive strategies such as iron supplementation, antimalarial prophylaxis, follow up clinics, regular screening of haemoglobin level must target all under-fives irrespective of their haemoglobin level or clinical status.