Abstract:

Introduction: Iron deficiency (ID) is a public health concern worldwide with children being the most vulnerable. In children with Congenital Heart Defect (CHD), iron deficiency carries a poor prognosis due to exacerbation of left ventricular dysfunction and subsequent heart failure. This study determined iron status and factors associated with iron deficiency among children with congenital heart defects in Mwanza Tanzania.

Methodology: We conducted a hospital-based cross-section study involving 333 children aged 6 months to 12 years. The study was conducted from February 2024 to May 2024 at the Department of Pediatrics and Child Health at the cardiac clinic. Data collection tools were used to obtain social demographics and a detailed physical examination was done on every enrolled patient. After obtaining a consent/assent. A blood sample was taken for a full blood picture, C-reactive protein, and iron status assessment. A stool sample was taken from every enrolled child. Data were analyzed by using STATA version 15.

Objectives To determine iron status and factors associated with iron deficiency.

Results: The median age of the enrolled children was 22 (IQR 11-48) months. Among the 333 studied population, 246 (73.9%) had normal iron status, and 87 (26.1%) participants had iron deficiency which make prevalence of iron deficiency to be 26.1% at 95% Cl (21.4-30.8). The prevalence of anemia was found to be 46.2% at 95% (40.8-51.6) and the prevalence of iron deficiency anemia was 12.9% at 95% (9.2-16.5). By multivariate logistic regression, residing in rural areas, consumption of cow’s milk, and abnormal stool findings such as participants with both worms and red blood cells (RBC), and those with only red blood cells in stool (only RBC) had (AOR=2.4[1.2-4.8] P-0.013), (AOR=6.3[2.0-19.6] P-0.001), (11.3[2.2-59.4] P-0.004) and (9.3[4.4-19.5] P-0.001) respectively were found to predict iron deficiency among children with congenital heart defects.

Conclusion: The prevalence of iron deficiency and iron deficiency anemia among children with congenital heart defects is high in Mwanza. Living in a rural area, consumption of cows' milk and abnormal stool findings (worms and red blood cells) were independent predictors of iron deficiency. Therefore, clinicians should have a high index of suspicion of iron deficiency in children with CHD who consume cows' milk, reside in rural areas and with worm infestation for timely and appropriate management.