Hostname: page-component-5d59c44645-l48q4 Total loading time: 0 Render date: 2024-02-23T22:43:07.674Z Has data issue: false hasContentIssue false

Anaemia in schoolchildren in eight countries in Africa and Asia

Published online by Cambridge University Press:  26 March 2009

Andrew Hall*
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Emily Bobrow
Affiliation:
Save the Children Federation, 54 Wilton Road, Westport, CT 06880, USA
Simon Brooker
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Matthew Jukes
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Kate Nokes
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Jane Lambo
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Helen Guyatt
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Don Bundy
Affiliation:
Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK
Sam Adjei
Affiliation:
Ghana Partnership for Child Development, Health Research Unit, Adabraka, P.O. Box 184, Accra, Ghana
Su-Tung Wen
Affiliation:
Ghana Partnership for Child Development, Health Research Unit, Adabraka, P.O. Box 184, Accra, Ghana
Satoto
Affiliation:
Partnership for Child Development (Mitra), Research Institute, University of Diponegoro, Semarang, Central Java, Indonesia
Hertanto Subagio
Affiliation:
Partnership for Child Development (Mitra), Research Institute, University of Diponegoro, Semarang, Central Java, Indonesia
Mohammed Zen Rafiluddin
Affiliation:
Partnership for Child Development (Mitra), Research Institute, University of Diponegoro, Semarang, Central Java, Indonesia
Ted Miguel
Affiliation:
ICS Monitoring & Evaluation, P.O. Box 599, Busia, Kenya
Sylvie Moulin
Affiliation:
ICS Monitoring & Evaluation, P.O. Box 599, Busia, Kenya
Joseph de Graft Johnson
Affiliation:
Save the Children Federation, NGO Onions Village, P.O. Box 30374, Lilongwe, Malawi
Mary Mukaka
Affiliation:
Save the Children Federation, NGO Onions Village, P.O. Box 30374, Lilongwe, Malawi
Nathalie Roschnik
Affiliation:
Save the Children Federation, Bamako, Mali
Moussa Sacko
Affiliation:
Institut National de Recherche en Santé Publique, B.P. 1771, Bamako, Mali
Anna Zacher
Affiliation:
Save the Children Federation, Avenida Tomas Nduda, CP 1854, Maputo, Mozambique
Bonifacio Mahumane
Affiliation:
Save the Children Federation, Avenida Tomas Nduda, CP 1854, Maputo, Mozambique
Charles Kihamia
Affiliation:
Tanzania Partnership for Child Development, Ocean Road Hospital, P.O. Box 9383, Dar es Salaam, Tanzania
Lillian Mwanri
Affiliation:
Tanzania Partnership for Child Development, Ocean Road Hospital, P.O. Box 9383, Dar es Salaam, Tanzania
Simon Tatala
Affiliation:
Tanzania Partnership for Child Development, Ocean Road Hospital, P.O. Box 9383, Dar es Salaam, Tanzania
Nicholas Lwambo
Affiliation:
National Institute of Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania
Julius Siza
Affiliation:
National Institute of Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania
Le Nguyen Bao Khanh
Affiliation:
Viet Nam Partnership for Child Development, National Institute of Nutrition, 48 Tang Bat Ho, Hanoi, Vietnam
Ha Huy Khoi
Affiliation:
Viet Nam Partnership for Child Development, National Institute of Nutrition, 48 Tang Bat Ho, Hanoi, Vietnam
Nguyen Duy Toan
Affiliation:
Viet Nam Partnership for Child Development, National Institute of Nutrition, 48 Tang Bat Ho, Hanoi, Vietnam
*
*Corresponding author: Email ahall@hkidhaka.org
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To report on the haemoglobin concentrations and prevalence of anaemia in schoolchildren in eight countries in Africa and Asia.

Design

Blood samples were collected during surveys of the health of schoolchildren as a part of programmes to develop school-based health services.

Setting

Rural schools in Ghana, Indonesia, Kenya, Malawi, Mali, Mozambique, Tanzania and Vietnam.

Subjects

Nearly 14 000 children enrolled in basic education in three age ranges (7–11 years, 12–14 years and Ä15 years) which reflect the new UNICEF/WHO thresholds to define anaemia.

Results

Anaemia was found to be a severe public health problem (defined as >40% anaemic) in five African countries for children aged 7–11 years and in four of the same countries for children aged 12–14 years. Anaemia was not a public health problem in the children studied in the two Asian countries. More boys than girls were anaemic, and children who enrolled late in school were more likely to be anaemic than children who enrolled closer to the correct age. The implications of the four new thresholds defining anaemia for school-age children are examined.

Conclusions

Anaemia is a significant problem in schoolchildren in sub-Saharan Africa. School-based health services which provide treatments for simple conditions that cause blood loss, such as worms, followed by multiple micronutrient supplements including iron, have the potential to provide relief from a large burden of anaemia.

Type
Research Article
Copyright
Copyright © CABI Publishing 2001

References

1Stoltzfus, RJ, Dreyfuss, ML. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anaemia. INACG/WHO/UNICEF. Washington, DC: ILSI Press, 1998.Google Scholar
2Nokes, C, van den Bosch, C, Bundy, DAP. The Effects of Iron Deficiency and Anemia on Mental and Motor Performance, Educational Achievement, and Behaviour in Children. An Annotated Bibliography. Washington, DC: INACG and ILSI Press, 1998.Google Scholar
3WHO. Iron Deficiency Anaemia: Assessment, Prevention and Control. Geneva: World Health Organization, 2000 [in.press].Google Scholar
4Hudson, TM, Bingham, KC, Simmons, WK. An evaluation of the HemoCue for measuring haemoglobin in field studies in Jamaica. Bull. World Health Org. 1994; 72: 423–6.Google Scholar
5PCD (Partnership for Child Development). Short stature and the age of enrolment in primary school: studies in two African countries. Soc. Sci. Med. 1999; 48: 675–82.Google Scholar
6DeMaeyer, E, Adiels-Tegman, M.The prevalence of anaemia in the world. World Health Stat. Quart. 1985; 38: 302–16.Google Scholar
7Lwambo, NJS, Brooker, S, Siza, JE, Bundy, DAP, Guyatt, H.Age patterns in stunting and anaemia in African school children: a cross-sectional study in Tanzania. Eur. J. Clin Nutr. 2000; 54: 3640.Google Scholar
8Fairweather-Tait, SJ. Iron requirements and prevalence of iron deficiency in adolescents. An overview. In: Hallberg, L, Asp, N-G, eds. Iron requirements and prevalence of iron deficiency in adolescents. An overview Iron Nutrition in Health and Disease. London: John Libbey & Co., 1996; 137–48.Google Scholar
9Fakeye, O, Adegoke, A.The characteristics of the menstrual cycle in Nigerian schoolgirls and the implication for school health. Afr. J. Med. Sci. 1994; 23: 13–7.Google Scholar
10Cameron, N, Grieve, CA, Kruger, A, Leschner, KF. Secondary sexual development in rural and urban South African black children. Ann. Hum. Biol. 1993; 20: 583–93.Google Scholar
11WHO. A Picture of Health? A Review and Annotated Bibliography of the Health of Young People in Developing Countries. Geneva: World Health Organization, 1995.Google Scholar
12Fentiman, A, Hall, A, Bundy, DAP. Health and cultural factors associated with enrolment in basic education: a study in rural Ghana. Soc. Sci. Med. 2001; 52: 429–39.Google Scholar
13Tatala, S, Svanberg, U, Mduma, B.Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania. Am. J. Clin. Nutr. 1998; 68: 171–8.Google Scholar
14Roche, M, Layrisse, M.The nature and causes of hookworm anaemia. Am. J. Trop. Med. Hyg. 1966; 15: 1031–110.Google Scholar
15Stephenson, LS, Latham, MC, Kurz, KM, Kinoti, SN, Oduori, ML, Crompton, DWT. Relationship of Schistosoma haematobium, hookworm and malaria infections and metrifonate treatment to hemoglobin levels in Kenyan school children. Am. J. Trop. Med. Hyg. 1985; 34: 519–28.Google Scholar
16Stoltzfus, RJ, Chwaya, HM, Tielsch, JM, Schulze, KJ, Albonico, M, Savioli, L.Epidemiology of iron deficiency anemia in Zanzibari schoolchildren: the importance of hookworms. Am. J. Clin. Nutr. 1997; 65: 153–9.Google Scholar
17Kurtzhals, JA, Addae, MM, Akanmori, BD, Dunyo, S, Koram, KA, Appawu, MA, Nkrumah, FK, Hviid, L.Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren. Trans. R. Soc. Trop. Med. Hyg. 1999; 93: 623–7.Google Scholar
18WHO. Report of the WHO Informal Consultation on the Use of Chemotherapy for the Control of Morbidity due to Soil-transmitted Nematodes in Humans. WHO/CTD/SIP/96.2. Geneva: World Health Organization, 1996.Google Scholar
19PCD (Partnership for Child Development). The cost of large-scale school health programmes which deliver anthelmintics to children in Ghana and Tanzania. Acta Tropica 1999; 73: 183204.Google Scholar
20Ndossi, G, Taylor, A. Multiple Micronutrient Supplementation in Tanzania. Dar es Salaam, Tanzania: UNICEF, 1999.Google Scholar
21 UNICEF/MoH Brazil. Micronutrient Supplementation through the Life Cycle. Report of a Workshop in Rio de Janeiro, 17–19 11 1999.Google Scholar