SEVERE ANAEMIA IN CHILDREN AGED 6 MONTHS TO 5 YEARS SEEN AT EBONYI STATE UNIVERSITY TEACHING HOSPITAL (EBSUTH) ABAKALIKI, EBONYI STATE, NIGERIA

Abstract

Background
Anaemia is a very common childhood problem which is associated with various
degrees of morbidity especially in children under five years of age (a vulnerable age
group). It imposes an economic burden on the parents/caregivers and the country as a
whole. The mortality rates from severe anaemia are high especially in poor
developing countries like ours with high levels of poverty, infections and malnutrition
in addition to the problems of inaccessible and poorly funded health facilities.
Objectives: To determine the prevalence, aetiological factors/ social determinants and
outcome of severe anaemia among children aged 6 months to 5years admitted at
Ebonyi State University Teaching Hospital Abakaliki.
Methods:
This was a 6-month prospective observational study of children with severe
anaemia (PCV ≤ 15%, Hb ≤ 5g/dl) admitted to the Paediatric Services of the hospital
(Study subjects were children presenting with severe anaemia PCV ≤ 15%, Hb ≤
5g/dl). The biodata, socio-economic status, signs and symptoms were documented for
every patient after the initial stabilization, especially of the very acute cases.
Haematocrit levels, haemoglobin levels, haemoglobin electrophoresis, blood film
examination, stool microscopy and urinalysis / microscopy were carried out for every
patient while tests like retroviral screening/ CD4 count, G-6-PD assay, blood, urine
and stool cultures were done for some subjects based on their specific history,
presenting clinical conditions and outcome of their initial tests. (Presence of iron
deficiency anaemia was inferred from the MCHC value).
Results:
One hundred and forty subjects out of the 1450 patients admitted during the period of
study had severe anaemia giving a prevalence rate of 9.7% and a male: female ratio of
1.2:1.0. The mean age was 25.1  16.7 months. Majority of the patients (63.6%) were
less than 2years of age. The main symptoms at presentation were fast
breathing/breathlessness (88.6%) and fever (71.4%). Pallor was seen in all the patients
while 90.0% had tachycardia. Fifty-three percent (74) of the patients were admitted in
cardiac failure. The PCV levels ranged from 5 to 15 % with a mean level of 11.8 
3.0%; 38.6% of the subjects had PCV levels of 5 –10%.
Malaria was the disease most commonly associated with severe anaemia (64.3%).
One hundred and twenty-six (90%) of the patients received blood transfusion, 117
patients recovered giving a survival rate of 83.6%. The overall case fatality rate was
13.6% which included 20.3% (15/74) of the study subjects who had presented in
cardiac failure while 2.8% of the study subjects took their discharge against medical
advice. Malaria was presumed to be associated with the highest number of deaths
(57.8%) among the study population.
Conclusion: The study revealed high prevalence and mortality rates of severe
anaemia among children aged 6months to 5 years. Malaria was the commonest cause
of severe anaemia as well as deaths while congestive cardiac failure was a common
complication among the study subjects. Almost all the study subjects received blood
transfusion.