Correlates of Anemia among Infants Aged 6-10 Months Attending Msambweni County Referral Hospital, Kwale County Kenya

Abstract

Globally, anemia is one of the most prevalent nutritional deficiencies with the children under five being the most affected. African region has highest prevalence of 62.3%. Locally, previous studies have shown Kwale county to experience a higher burden 70.5% as compared to national prevalence of 41.1%. Anemia greatly affects and influences growth and development of children not withstanding their mental and social development and weakening of the immune system. The objective of this study was to determine the correlates of anemia among infants 6-10 months attending the Msambweni County Referral Hospital in Kwale County. This was determined by looking at the correlates of a child’s anemia: socio-demographic factors, maternal factors, anthropometric measures dietary practices. The study involved infants recruited from surrounding villages and from the Msambweni maternal child health clinic. This study adopted a descriptive cross-sectional study design, where 134 infants were selected through simple random sampling from 195 infants involved in a randomized control trial that this study was nested. The infant’s characteristics, infants diet, nutritional status and maternal characteristics was determined using a structured questionnaire. A hemocue Hb 301+ device was used to measure hemoglobin (Hb) concentration of the infants. An infant with a Hb concentration <11g/dl was considered anemic. The mean Hb concentration of the infants in the study was 10.61 g/dl (95% C.I: 10.404, 10.789g/ dl). The proportion of infants with anemia was 0.69 (92/134). Among the anemic infants, those with mild and moderate anemia accounted for 70% and 30%, respectively. The mean age of the participating infants was 7.96±1.337 months. In the study,74 of them were females while 60 were male. A proportion of 0.48 male infants was anemic and 0.52 female infants. The mothers had a mean age of 28±7.11 years. Majority of the mothers (65.6%) had attained primary educational level. The mean maternal hemoglobin during pregnancy was 10.34±1.54 g|dl and the prevalence was 60.2% (Hb<11g/dl). Infants delivered through caesarian section were more likely to be anemic (p=0.001), (OR=1.23,95% C.I: 1.11, 1.35). The prevalence of underweight, wasting and stunting was 7.5%, 7.5% and 8.2% respectively. There was an association between the infant diet and anemia status, with meat, poultry, fish and vitamin A and C rich vegetables having a positive association with infants anemic status while tea and leafy vegetables were shown to negatively affect the infants anemic status. A logistic regression revealed an increase in intake of meat/poultry/fish in an infants’ diet contributed to a 2.2times more likely chance of an infant to be non-anemic as compared to being moderately anemic(AOR=2.22, 95%CI=1.15-4.33, p=0.018). An infant was 3.8 times more likely to be non-anemic than moderately anemic, with an increase in intake of vegetables in diet (OR=3.8, 95% CI=1.68-8.7, p=0.001).An infant was 2.2x more likely to be moderately anemic than non-anemic with an increase intake of tea in diet (OR=2.22, 95% CI=1.33-3.85, p=0.003). An infant was 4x more likely to be moderately anemic than non-anemic with an increase in intake of leafy vegetables in diet (OR=4.0, 95% CI=1.7-9.1, p=0.001).Reduce the burden of anemia by setting measures to address the high proportion as the disease jeopardizes the quality of an infants health. Kwale County government should update the county burden of disease report and embrace feasible programs and activities to reduce the anemia burden in the population as it is an underlying condition in most of the county’s common illnesses. Special attention to be given to cesarean section delivered infants to monitor and prevent anemia development. Regular outreach services should be done by the nutrition department on importance of mixed feeding practices and diet variability. Further intervention studies are recommended, especially in areas with high anemia burden, to improve infants’ anemia status given it’s a preventable disorder.