HAEMATOLOGICAL PROFILE AND FERRITIN LEVELS IN CHILDREN WITH PROTEIN ENERGY MALNUTRITION IN UNIVERSITY OF ILORIN TEACHING HOSPITAL ILORIN

HAEMATOLOGICAL PROFILE AND FERRITIN LEVELS IN CHILDREN WITH PROTEIN ENERGY MALNUTRITION IN UNIVERSITY OF ILORIN TEACHING HOSPITAL ILORIN

Abstract

This is a case control study carried out at the University of Ilorin Teaching Hospital
to determine the haematologic profile and serum ferritin levels of children with
Protein Energy Malnutrition compared to that of controls. It also determined the
prevalence of anaemia and iron deficiency anaemia in children with Protein Energy
Malnutrition
The socio demographic characteristics, anthropometry, clinical and laboratory
parameters of children with Protein Energy Malnutrition were studied. The
haematologic profile was analyzed by the auto analyzer, serum ferritin was analyzed
by Nova Path TM Ferritin kit. Stool was analyzed for red blood cells. Data entry and
analysis were carried out with a micro-computer using the Epi info version 3.5 (2008)
software packages.
A total of 180 children 90 with Protein Energy Malnutrition and 90 controls were
studied. Fifty Nine(65%) were males and 31 (34.4%) were females with a male to
female ratio of 1.9:1.0. The mean age of the children with Protein Energy
Malnutrition was 22.7 + 14.4 months (Range of 9-59months) compared to 29.3 + 16.9
months (Range 6-59 months) for the controls and the difference was not significant
(p=0.08).
The children with Protein Energy Malnutrition had lower mean values for
haemoglobin, haematocrit and mean corpuscular haemoglobin (p<0.05). The subjects

also had higher mean values of total white cell count, neutrophil and lower
lymphocytes counts (p<0.05). The highest lymphocyte count was seen in children
with Kwashiokor. Platelet counts were comparable in the two groups.
No significant differences were observed in the haematologic profile of the various
types of PEM, except for the mean corpuscular haemoglobin concentration which was
higher in children with Marasmic-Kwashiokor. Children with Kwashiokor had the
highest mean for haemoglobin, (31.6±1.6g/dl) and haematocrit (10.7±0.4%), while
subjects with marasmus had the lowest mean for haematocrit (27.6±5.8%),
haemoglobin (9.1±2.1g/dl) and mean corpuscular haemoglobin (22.9±2.3pg/cell).
The subjects had a lower mean serum ferritin compared to the controls. Serum ferritin
increased with age and females had a higher serum ferritin levels compared to males
(p=0.00001).
The prevalence of anaemia among the children with PEM was 74.4% of which 75%
had microcytic hypochromic anaemia. The prevalence of iron deficiency among
subjects was 24.4%, while 16.6% of these subjects had iron deficiency anaemia.
In conclusion, children with Protein Energy Malnutrition had lower red cell indices
and higher white cell count the controls. Serum ferritin level was lower in the
subjects than in the controls. A high prevalence of anaemia and iron deficiency
anaemia with microcytic hypochromic anaemia was observed in children with PEM.

It is recommended that anaemia and iron deficiency should be sought for in children
with Protein Energy Malnutrition and such should be treated. There is the need to
improve nutrition education among mothers and health workers. Food fortification as
well as supplementation of the important micronutrient especially iron should be
enhanced, as a good nutritional status remains the bedrock for good health and
prevention of diseases.

HAEMATOLOGICAL PROFILE AND FERRITIN LEVELS IN CHILDREN WITH PROTEIN ENERGY MALNUTRITION IN UNIVERSITY OF ILORIN TEACHING HOSPITAL ILORIN

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