Public Health Nutrition

Research Article

Anaemia in schoolchildren in eight countries in Africa and Asia

Partnership for Child Development. Principal investigators:, Andrew Halla1 c1 p1, Emily Bobrowa2, Simon Brookera1, Matthew Jukesa1, Kate Nokesa1, Jane Lamboa1, Helen Guyatta1, Don Bundya1, Sam Adjeia3, Su-Tung Wena3, Satotoa4, Hertanto Subagioa4, Mohammed Zen Rafiluddina4, Ted Miguela5, Sylvie Moulina5, Joseph de Graft Johnsona6, Mary Mukakaa6, Nathalie Roschnika7, Moussa Sackoa8, Anna Zachera9, Bonifacio Mahumanea9, Charles Kihamiaa10, Lillian Mwanria10, Simon Tatalaa10, Nicholas Lwamboa11, Julius Sizaa11, Le Nguyen Bao Khanha12, Ha Huy Khoia12 and Nguyen Duy Toana12

a1 Scientific Coordinating Centre, Partnership for Child Development, Wellcome Trust Centre for the Epidemiology of Infectious Disease, Oxford University, South Parks Road, Oxford OX1 3FY, UK

a2 Save the Children Federation, 54 Wilton Road, Westport, CT 06880, USA

a3 Ghana Partnership for Child Development, Health Research Unit, Adabraka, P.O. Box 184, Accra, Ghana

a4 Partnership for Child Development (Mitra), Research Institute, University of Diponegoro, Semarang, Central Java, Indonesia

a5 ICS Monitoring & Evaluation, P.O. Box 599, Busia, Kenya

a6 Save the Children Federation, NGO Onions Village, P.O. Box 30374, Lilongwe, Malawi

a7 Save the Children Federation, Bamako, Mali

a8 Institut National de Recherche en Santé Publique, B.P. 1771, Bamako, Mali

a9 Save the Children Federation, Avenida Tomas Nduda, CP 1854, Maputo, Mozambique

a10 Tanzania Partnership for Child Development, Ocean Road Hospital, P.O. Box 9383, Dar es Salaam, Tanzania

a11 National Institute of Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania

a12 Viet Nam Partnership for Child Development, National Institute of Nutrition, 48 Tang Bat Ho, Hanoi, Vietnam


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 Ä15 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.

(Received April 10 2000)

(Accepted October 16 2000)


c1 Corresponding author: Email

p1 Helen Keller International, P.O. Box 6066, Gulshan, Dhaka 1212, Bangladesh