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