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©
2005
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Updated
20 Nov 2005
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ANEMIA
Schellenberg D, Schellenberg JR, Mushi A, Savigny D, Mgalula L, Mbuya C, Victora
CG. The silent burden of anaemia in Tanzanian children: a community-based study.
Bull World Health Organ 81(8), 581-90, 2003.
OBJECTIVE: To document the prevalence, age-distribution,
and risk factors for anaemia in Tanzanian children less than 5 years old,
thereby assisting in the development of effective strategies for controlling
anaemia. METHODS: Cluster sampling was used to identify 2417 households at
random from four contiguous districts in south-eastern United Republic of
Tanzania in mid-1999. Data on various social and medical parameters were
collected and analysed. FINDINGS: Blood haemoglobin concentrations (Hb) were
available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to
18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an
Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of
all three levels was in children aged 6-11 months, of whom 10% (22/226) had an
Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged
1-5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5
g/dl). Anaemia was usually asymptomatic and when symptoms arose they were
nonspecific and rarely identified as a serious illness by the care provider. A
recent history of treatment with antimalarials and iron was rare. Compliance
with vaccinations delivered through the Expanded Programme of Immunization (EPI)
was 82% and was not associated with risk of anaemia. CONCLUSION: Anaemia is
extremely common in south-eastern United Republic of Tanzania, even in very
young infants. Further implementation of the Integrated Management of Childhood
Illness algorithm should improve the case management of anaemia. However, the
asymptomatic nature of most episodes of anaemia highlights the need for
preventive strategies. The EPI has good coverage of the target population and it
may be an appropriate channel for delivering tools for controlling anaemia and
malaria.
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