Abstract:

Background and Objectives: Anemia is a major public health problem in developing countries and has been to be a major cause of hospital admission and death among under-fives in Sub Saharan Africa. Parvovirus B19 (B19) has been associated with transient aplastic crisis which has been found to be common among children with severe anemia. Despite its importance, the magnitude of B19 in relation to anemia has never been studied in this setting. This study was designed to investigate the prevalence of B19 among under-fives with anemia attending at the Bugando Medical Centre in Mwanza, Tanzania.

Methodology: A cross sectional hospital based study involved 265 children aged 6 to 59 months attending at the Bugando Medical Centre was conducted between November 2016 and April 2017. Socio-demographic and relevant clinical information were collected using pre-tested structured questionnaires, Anemia in children were categorized in mild, moderate and severe anemia according to WHO guidelines. Detection of B19 IgM and IgG antibodies was done by Enzyme Immunoassay (EIA) as per manufacturer’s instructions (DRG, GmbH, Germany). Data were analyzed using STATA version 11 as per study objectives.

Results: The median age of 265 enrolled children was 28.5 (IQR: 18-39.5) months. The median hemoglobin (g/dl) level of the study participants was 7.9 with 86 (32.5%) of the participants having hemoglobin below 7g/dl (severe anemia). Out of 265 underfives tested, 24(9%; 95CI; 5.5-12.4) and 46 (17.4%; 95%CI; 12.7-21.9) were B19 seropositive for IgM and IgG respectively. The B19 IgM seropositivity rates were 2.6% and 16.3% for under-fives with mild anemia, moderate anemia and severe anemia respectively (p=0.018. No significant differences were observed between level of anemia and B19 IgG seropositivity. Low hemoglobin level, malaria infection and living in rural areas found to predict IgM seropositivity among under-fives with anemia in the city of Mwanza, Tanzania.

Conclusion and Recommendations: A Significant proportion of under-fives with anemia attending Bugando Medical Centre is acutely infected with B19. Acute B19 infections should be considered among under-fives with severe anemia and malaria.