Prevalence and determinants of iron-deficiency anaemia among children 6-23 months attending Thika level-5 hospital, Kiambu County, Kenya
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Date
2016-10
Authors
Wangusi, Neddy Lwile
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
It is evident that iron in childhood is key for proper health and cognitive development as it
is required for academic and work productivity in adulthood. Intake of iron rich foods,
sanitation, health, economic and socio-demographic factors are principal determinants of
Iron- deficiency anaemia (IDA) in children. There is paucity of data concerning the
prevalence of IDA in children aged 6-23 months since most studies focus mainly on the
selection of iron rich foods as criteria for determining those at risk of IDA. The age limit
in most of these studies is 5 years and above. There is limited scientific data on the
prevalence and determinants of IDA in children aged 6-23 months old in Thika Level 5
Hospital attending well baby clinic (WBC). A cross-sectional analytical study design was
adopted for the study in the month of May 2013. The study targeted a sample size of 241
children selected by systematic random sampling method. Data were collected by
researcher administered interview schedule given to mothers or caregivers of the children
attending the WBC at Thika Level 5 Hospital. This was followed by a collection of venous
blood samples from children for hemoglobin, red cell width and mean cell volume
determination conducted by a trained laboratory technician. The study participants were
also followed up to their homes at a later date to quantify the utensils used to measure food.
The data were cleaned coded and analyzed using SPPS Version 20. Data on dietary intake
was analyzed using Nutri-survey statistical package (2008) and ENA for smart (2008) was
used to analyze anthropometry. Descriptive statistics were used to describe the daily intake
of nutrients, sanitation, economic and socio-demographic factors. IDA status was based on
hemoglobin levels while predictors of complementary feeding practice were considered an
indicator of proper food intake. Chi-square test was used to determine the relationship
between IDA with dietary intake of iron-rich foods and complementary feeding practices.
Binary logistic regression was used to test the significance between IDA with malaria,
helminthic infestation and immunization status. The level of significance of accepting the
null hypotheses was <0.05. The minimum dietary diversity was (34%), minimum meal
frequency (58%) and minimum acceptable diet was (58%). Binary logistic regression
analysis revealed significant relationships between malaria with IDA (ODDS Ratio [OR]
=2.95, CI=0.72-3.22, p=0.013), helminthic infestation with IDA (ODDS Ratio [OR] = 3.87,
CI=0.84-4.12, p=0.001) and immunization status with IDA (ODDS Ratio [OR] = 2.98, CI
= 0.63-3.16, p=0.032). Mean hemoglobin values from the present study were found to be
(8.3 2.3g/dl) whereas the overall IDA prevalence was (73.2%) indicating severe IDA
among children attending a WBC at Thika Level 5 Hospital. Determinants of IDA
included; the age of the child, education of the caregiver, the occupation of the caregiver,
complementary feeding practices, dietary intake of iron-rich foods, rubbish waste disposal,
human waste disposal, the presence of stagnant water, malaria infection, deworming
practices, helminthic infection and immunization. Aggressive awareness campaigns
targeting proper complementary feeding and proper iron–rich diet for mothers with under
five-year children in hospitals, markets and chief’s barazas should be launched by all
stakeholders in (IYCF) Infant and young child feeding. A follow up study to assess the
relationship between nutritional status and IDA along with associated factors in children
from birth up to 10 years should be done to establish any link between nutritional status
and IDA and the possible effect on their development milestones.
Description
A research thesis submitted in partial fulfillment of the requirements for the award of the degree of Master of Science (foods, nutrition and dietetics) in the school of applied human
Sciences of Kenyatta University October, 2016