Parasitology

Research Article

Anaemia in Ugandan preschool-aged children: the relative contribution of intestinal parasites and malaria

HELEN K. GREENa1, JOSE C. SOUSA-FIGUEIREDOa2a3, MARIA-GLORIA BASÁÑEZa1, MARTHA BETSONa4, NARCIS B. KABATEREINEa5, ALAN FENWICKa6 and J. RUSSELL STOTHARDa4 c1

a1 Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London (St Mary's Campus), Norfolk Place, London W2 1PG, UK

a2 WHO Collaborating Centre for Schistosomiasis, Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, London SW7 5BD, UK

a3 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

a4 Centre for Tropical and Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK

a5 Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda

a6 Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Norfolk Place, London W2 1PG, UK

SUMMARY

Anaemia is a severe public health issue among African preschool-aged children, yet little effective progress has been made towards its amelioration, in part due to difficulties in unravelling its complex, multifactorial aetiology. To determine the current anaemia situation and assess the relative contribution of malaria, intestinal schistosomiasis and infection with soil-transmitted helminths, two separate cross-sectional epidemiological surveys were carried out in Uganda including 573 and 455 preschool-aged children (≤6 years) living along the shores of Lake Albert and on the islands in Lake Victoria, respectively. Anaemia was found to be a severe public health problem in Lake Albert, affecting 68·9% of children (ninety-five percent confidence intervals (95% CI) 64·9–72·7%), a statistically significant higher prevalence relative to the 27·3% detected in Lake Victoria (95% CI: 23·3–31·7%). After multivariate analysis (controlling for sex and age of the child), the only factor found to be significantly associated with increased odds of anaemia in both lake systems was malaria (Lake Albert, odds ratio (OR)=2·1, 95% CI: 1·4–3·2; Lake Victoria, OR=1·9, 95% CI: 1·2–2·9). Thus intervention strategies primarily focusing on very young children and combating malaria appear to represent the most appropriate use of human and financial resources for the prevention of anaemia in this age group and area. Looking to the future, these activities could be further emphasised within the National Child Health DaysPLUS agenda.

(Received January 07 2011)

(Revised March 17 2011)

(Revised May 25 2011)

(Accepted May 25 2011)

(Online publication August 08 2011)

Correspondence:

c1 Corresponding author: E-mail: jrstoth@liverpool.ac.uk

Metrics