背景:贫血,异细胞增多症,营养不良(特别是发育迟缓)是发展中国家常见的健康问题,儿童是最脆弱的。这些条件对人类的表现有负面影响,成长和发展,如果在喀麦隆山地区等具有强和多年性疟疾寄生虫传播的全流行地层中存在合并症,则可能会进一步复杂化。该研究旨在确定营养不良的患病率和严重程度,≤5岁儿童的贫血和红细胞增多症,生活在冲突中的喀麦隆山地区的疟疾常年传播区。
方法:进行了一项基于社区的横断面调查,涉及628名≤5岁儿童。通过Giemsa染色的显微镜检查确认了疟疾寄生虫血症,并对密度进行了对数转换。血红蛋白(Hb),使用自动血液学分析仪估算平均细胞体积和红细胞分布宽度,并根据WHO标准进行定义.使用WHOAnthro软件对人体测量指数进行了分析,并与WHO生长参考标准进行了比较。
结果:疟原虫感染,贫血,小细胞性贫血,在36.0,72.8,30.1,54.1和29.0%的儿童中,分别。≤24个月的儿童发育迟缓程度更高(14.7%),与年龄较大的儿童相比,小红细胞性贫血(38.8%)和红细胞增多症(68.8%)的患病率更高(分别为P<0.002和P<0.001)。研究人群的平均Hb水平为10.04g/dL,与年龄较大的儿童相比,≤24个月的儿童的平均血红蛋白水平最低(9.69g/dL),P<0.001。营养不良的儿童中出现红细胞增多症的几率最高(OR=4.66,P=0.005),感染疟疾寄生虫的人(OR=1.85,P=0.007),父母的受教育程度分别为小学(OR=3.51,P=0.002)和中学(OR=2.69,P=0.017)。
结论:疟疾,贫血,在喀麦隆山地区,≤60个月的儿童中,缺氧和营养不良仍然是严重的公共卫生问题.因此,这强调必须执行一致的政策,避免疟疾的方案和活动,贫血,小儿年龄组的红细胞增多和发育迟缓。
BACKGROUND: Anaemia,
anisocytosis, malnutrition (especially stunting) are common health problems in developing countries with children being the most vulnerable. These conditions have negative impacts on human performance, growth and development, and can further be complicated if comorbidity exists within a holoendemic stratum with strong and perennial malaria parasite transmission such as the Mount Cameroon area. The study aimed at determining the prevalence and severity malnutrition, anaemia and
anisocytosis in children ≤ 5 years, living in the conflict hit malaria perennial transmission zone of the Mount Cameroon area.
METHODS: A cross-sectional community-based survey involving 628 children ≤ 5 years was conducted. Malaria parasitaemia was confirmed by Giemsa-stained microscopy and the density was log transformed. Haemoglobin (Hb), mean cell volume and red blood cell distribution width were estimated using an auto-haematology analyser and defined according to WHO standards. Anthropometric indices were analysed and compared with WHO growth reference standards using WHO Anthro software.
RESULTS: Plasmodium infection, anaemia, microcytic anaemia,
anisocytosis and stunting were prevalent in 36.0, 72.8, 30.1, 54.1 and 29.0% of the children, respectively. The ≤ 24 months children were more moderately stunted (14.7%), with higher prevalence of microcytic anaemia (38.8%) and anisocytosis (68.8%) (P < 0.002 and P < 0.001, respectively) when compared with the older children. The mean Hb level in the study population was 10.04 g/dL with children ≤ 24 months having the least mean haemoglobin level (9.69 g/dL) when compared with their older counterparts at P < 0.001. The odds of having
anisocytosis were highest among children who were malnourished (OR = 4.66, P = 0.005), those infected with malaria parasites (OR = 1.85, P = 0.007), and whose parents had a primary (OR = 3.51, P = 0.002) and secondary levels of education (OR = 2.69, P = 0.017).
CONCLUSIONS: Malaria, anaemia,
anisocytosis and undernutrition still remain severe public health concerns among children ≤ 60 months in the Mount Cameroon area. This therefore emphasizes the need for the implementation of consistent policies, programmes and activities to avoid malaria, anaemia, anisocytosis and stunting in the paediatric age group.