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Indicators of anaemia in under-fives with malaria at a hospital in northern Cameroon.

BACKGROUND
Severe malarial anaemia accounts for nearly one million deaths annually in under-fives in Africa.


OBJECTIVE
To describe the clinical and social indicators of anaemia in under-fives with malaria seeking healthcare at a hospital in northern Cameroon.


METHODS
This cross-sectional study included 91 consecutive patients below the age of 60 months in whom malaria was diagnosed by symptomatic fever and microscopic examination. Patients were clinically investigated and mothers questioned on related clinical and social aspects.


RESULTS
Anaemia (haemoglobin less than 110 g/L) was detected in 69 (82%), and a high parasite load (more than 100 Plasmodia per 100 high-power fields) in 24 (26%) of the patients. Clinical findings were associated with the levels of haemoglobin, rather than the parasite load in a single blood slide. Anaemia was found significantly more often in children between the ages of 12 and 23 months and in patients born at home (p = 0.035 and p = 0.048 respectively). Severe anaemia (haemoglobin less than 50 g/L) was found significantly more often in patients who had not been vaccinated (p = 0.008).


CONCLUSION
Anaemia is an important health issue in this population. Clinical signs appear to be associated with the haemoglobin status of the patient rather than the parasite load determined in a single blood slide. Recently weaned children and children of mothers with low socio-economic status and who do not usually use the hospital services, may need particular attention in prevention of anaemia. Further studies are required in order to establish cost-effective interventions against anaemia in under-fives in northern Cameroon.