Iron deficiency anaemia and its association with malaria infection in children in Siaya County in Western Kenya
Adhiambo, Veronicah Knight
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Iron deficiency anaemia contributes to 50% cases of anaemia and it remains a concern in the public health sector in sub-Saharan Africa and children under five years are at risk. It is associated with poor cognitive development and affects growth of preschool children. The interventions in most of sub-Saharan Africa focus on the improvement of hemoglobin (Hb) levels but it is not clear if Hb and iron levels relate in areas where there are multi-factorial causes of anaemia. The prevalence of malaria in the study area is 57% in children under 5 years of age. Research studies have reported the interaction between iron deficiency and malaria to be complicated. Also, studies have shown inconclusive results on whether iron supplement increases risk to malaria infections and this calls for an independent study to resolve the conflicts in malaria endemic areas. This study was both a prevalence and longitudinal study for a period of 12 months targeting 190 preschool children less than 5 years in Western, Kenya, to establish the relationship between the prevalence of iron deficiency and anaemia, association between iron deficiency and malaria infection and also examined the effect of iron status of an individual on the episodes of malaria infection/s. A blood sample obtained from the study participants was used to determine the haemoglobin (Hb), Iron status (Serum ferritin (SF) coupled to C-reactive protein (CRP)) and Plasmodium falciparum (Pf). Haemoglobin was determined by the hemo-cue. The iron level was measured using the serum ferritin coupled to CRP and Plasmodium falciparum infection was detected using malaria microscopy as the gold standard. The prevalence of iron deficiency was 36% and that of anaemia was 48% (P = 0.09). Those with normal Hb level but with iron deficiency were 35%. Children with no iron deficiency had 63% of malaria infection episodes compared to iron deficiency group with 37% (P<0.0001). However, survival analyses was not statistical significant (P = 0.90). Using continuous variables to reduce the bias, the difference in ferritin levels between individuals with one and more than three episodes was statistically significant (P = 0.02). This study reports that there is no difference between the prevalence of iron deficiency and anaemia (Hb level). The result further suggests that iron deficiency reduces risk to malaria. However, further study should be carried out with a larger sample size and more iron biomarkers to confirm the findings of this study.