Persistent and new-onset anaemia in children aged 6 - 8 years from KwaZulu-Natal Province, South Africa

Abstract

Background. Anaemia impairs normal development in children and has wide-ranging social and economic implications. Existing anaemia control strategies primarily target anaemia in infancy. The contribution, however, of anaemia in preschool- and school-aged children as well as its long-term effects has not been extensively evaluated.

Objectives. To determine the prevalence of anaemia in the same children on two occasions at least 18 months apart.

Method. We carried out a longitudinal study in a rural community of KwaZulu-Natal, South Africa. Haemoglobin (Hb) levels were measured using the HaemoCue at baseline when the children were aged 4 - 6 years, and the follow-up assessment was done at age 6 - 8 years. HIV screening and helminth testing was offered to all the children. 

Results. Hb levels at both baseline and follow-up were available for 181 children. The baseline anaemia prevalence was 56.9% (mean Hb 11.2, standard deviation (SD) 1.14) and at follow-up the anaemia prevalence was 41.9% (mean Hb 11.7, SD 1.19). There were 21/180 (11.7%) children with new-onset anaemia at follow-up, while anaemia from baseline persisted in 43/103 (41.8%).

Conclusions. The findings suggest a high burden of anaemia in these school-aged children, which might be reduced with early interventions. Interventions targeting screening and management of anaemia, chronic infections and nutritional deficiencies are recommended.