Early Childhood Anemia in a Birth Cohort in Coastal Kenya: Links to Infection and Nutrition
Date
2019Author
Mutuku, Francis
Kao, Julia
Shanique, Martin
Lee, Justin
Mwandi, Jackson
Mukoko, Dunstan
Malhotra, Indu
King, Charles H.
LaBeaud, Angelle Desiree
Metadata
Show full item recordAbstract
Anemia is known to impact a child’s growth and development, but not all anemia are caused by iron
deficiency, and the CDC and WHO have emphasized investigating other contributors to anemia. This cross-sectional sub study of a 2012–2016 maternal-child cohort in coastal Kenya evaluated 244 children and found 185 (76%) to have been
anemic on at least one time point since birth. At the time of assessment in 2016, evaluation included a complete blood
count, nutritional assessment, and testing for parasitic infections, focusing on the primary outcome of anemia, defined as
hemoglobin (Hb) < 11 g/dL. The average age at assessment was 20.5 ± 7 months. Ninety-five percent had a lifetime
average Hb in the anemic range. Adjusting for age and gender, prior or current malaria infection (prior: Hb β = −0.99, 95%
CI: −1.49 to −0.49, P = 0.01), or having any current infection with hookworm, Trichuris, Strongyloides, Ascaris, and/or
malaria (β = −0.84, 95% CI: −1.36 to −0.33, P = 0.01) was associated with decreased current Hb. Nutritional evaluation
revealed that children with a declining Hb ate fewer vitamin-A–rich vegetables per week (P = 0.01) or eggs (P = 0.01), drank
more milk (P = 0.07), and ate more bread (P = 0.01), and were more likely to live in a household that experienced food
shortage (P = 0.05). The high prevalence of anemia, polyparasitism, and dietary insufficiency among children in rural
coastal Kenya suggests that remedial interventions will need to address both diet and parasitic infections to effectively
combat this significant health threat.