Anaemia in schoolchildren in eight countries in Africa and Asia

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 >/= 15 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

Anaemia and organomegaly associated with parasitic infections among schoolchildren in Sengerema District, north-western Tanzania

Anaemia and organomegaly are among the health problems affecting schoolchildren in Tanzania and their causes are multifactorial. The objective of this study was to determine the prevalence of anaemia and organomegaly and their relationship with single and multiple parasitic infections among schoolchildren in Sengerema District in north-west Tanzania. This cross sectional study involved 400 schoolchildren. Anaemia and organomegaly were determined using HemoCue photometer and clinical palpation, respectively. A Kato-Katz technique was employed to screen faecal samples for Schistosoma mansoni and other intestinal helminths. Giemsa stained thick and thin blood smears were examined for malaria parasites. The prevalence of anaemia was 19.5% (<11g/dl) and majority of the children had mild (22.8%) to moderate (36.6%) anaemia. Organomegaly (palpable spleen and liver) was detected in 41% of the children and hepatomegaly was the most common (53.7%). The prevalence of S. mansoni, hookworm and P. falciparum were 64.3%, 38% and 13.5% respectively. No significant relationship was observed between single and multiple parasitic infections with anaemia and organomegaly. Logistic regression analysis revealed that increased infections intensity of S. mansoni was significantly associated with an increased likelihood of hookworm concomitant infections (P<0.002). In conclusion, the data confirm that malaria, intestinal schistosomiasis and hookworm are common among school children but are not associated with anaemia and organomegaly. Further longitudinal studies are recommended to establish any such association. The prevalence of parasitic co-infections among schoolchildren calls for an integrated control approach to reduce the burden of these infections