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Malaria, anaemia and under-nutrition: three frequently co-existing conditions among preschool children in rural Rwanda.

Kateera F, Ingabire CM, Hakizimana E, Kalinda P, Mens PF, Grobusch MP, Mutesa L, van Vugt M - Malar. J. (2015)

Bottom Line: Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions.A cross-sectional household (HH) survey involving children aged 6-59 months was conducted.Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004).

View Article: PubMed Central - PubMed

Affiliation: Division of Internal Medicine, Department of Infectious Diseases, Centre of Tropical Medicine and Travel Medicine, Academic Medical Centre, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands. fkkateera@yahoo.com.

ABSTRACT

Background: Malaria, anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality particularly among children aged less than 5 years. Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions.

Methods: A cross-sectional household (HH) survey involving children aged 6-59 months was conducted. Data on malaria parasitaemia, haemoglobin densities, anthropometry, demographics, socioeconomic status (SES) and malaria prevention knowledge and practices were collected.

Results: The prevalences of malaria parasitaemia and anaemia were 5.9 and 7.0 %, respectively, whilst the prevalence of stunting was 41.3 %. Malaria parasitaemia risk differed by age groups with odds ratio (OR) = 2.53; P = 0.04 for age group 24-35 months, OR = 3.5; P = 0.037 for age group 36-47 months, and OR = 3.03; P = 0.014 for age group 48-60 months, whilst a reduced risk was found among children living in high SES HHs (OR = 0.37; P = 0.029). Risk of anaemia was high among children aged ≥12 months, those with malaria parasitaemia (OR = 3.86; P ≤ 0.0001) and children living in HHs of lower SES. Overall, under-nutrition was not associated with malaria parasitaemia. Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004).

Conclusions: In this study group, four in 10 and one in 10 children were found stunted and underweight, respectively, in an area of low malaria transmission. Under-nutrition was not associated with malaria risk. While the high prevalence of stunting requires urgent response, reductions in malaria parasitaemia and anaemia rates may require, in addition to scaled-up use of insecticide-treated bed nets and indoor residual insecticide spraying, improvements in HH SES and better housing to reduce risk of malaria.

No MeSH data available.


Related in: MedlinePlus

Map of Ruhuha sector, Bugesera district showing lay out of the 5 cells and associated key geographical features of elevation, wetlands, road net and a lake
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Fig1: Map of Ruhuha sector, Bugesera district showing lay out of the 5 cells and associated key geographical features of elevation, wetlands, road net and a lake

Mentions: Regarding administration, Rwanda has 30 districts: Each divided into sectors, cells, and villages locally term “umudugudus” (of about 50–100 households). This survey was conducted in 35 villages that are aggregated into five cells that constitute Ruhuha sector, Bugesera District in Eastern Rwanda (Fig. 1). Ruhuha sector is located 42 kms from Kigali city, has an area of 54 square meters and is separated from Burundi in the south by Lake Cyohoha. The sector has a population of ~23,900 individuals living in 5098 households (HHs): By sector, Gatanga has 1048 HHs, Ruhuha 696 HHs, Gikundamvura 869 HHs, Bihari 957 HHs and Kindama 1528 HHs. Ruhuha is a rural agricultural traditionally high malaria transmission setting with prior reported health facility slide positivity rates among sick individuals and community-based asymptomatic malaria positivity rates of 22 % and 5 %, respectively [25, 26].Fig. 1


Malaria, anaemia and under-nutrition: three frequently co-existing conditions among preschool children in rural Rwanda.

Kateera F, Ingabire CM, Hakizimana E, Kalinda P, Mens PF, Grobusch MP, Mutesa L, van Vugt M - Malar. J. (2015)

Map of Ruhuha sector, Bugesera district showing lay out of the 5 cells and associated key geographical features of elevation, wetlands, road net and a lake
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4635556&req=5

Fig1: Map of Ruhuha sector, Bugesera district showing lay out of the 5 cells and associated key geographical features of elevation, wetlands, road net and a lake
Mentions: Regarding administration, Rwanda has 30 districts: Each divided into sectors, cells, and villages locally term “umudugudus” (of about 50–100 households). This survey was conducted in 35 villages that are aggregated into five cells that constitute Ruhuha sector, Bugesera District in Eastern Rwanda (Fig. 1). Ruhuha sector is located 42 kms from Kigali city, has an area of 54 square meters and is separated from Burundi in the south by Lake Cyohoha. The sector has a population of ~23,900 individuals living in 5098 households (HHs): By sector, Gatanga has 1048 HHs, Ruhuha 696 HHs, Gikundamvura 869 HHs, Bihari 957 HHs and Kindama 1528 HHs. Ruhuha is a rural agricultural traditionally high malaria transmission setting with prior reported health facility slide positivity rates among sick individuals and community-based asymptomatic malaria positivity rates of 22 % and 5 %, respectively [25, 26].Fig. 1

Bottom Line: Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions.A cross-sectional household (HH) survey involving children aged 6-59 months was conducted.Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004).

View Article: PubMed Central - PubMed

Affiliation: Division of Internal Medicine, Department of Infectious Diseases, Centre of Tropical Medicine and Travel Medicine, Academic Medical Centre, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands. fkkateera@yahoo.com.

ABSTRACT

Background: Malaria, anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality particularly among children aged less than 5 years. Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions.

Methods: A cross-sectional household (HH) survey involving children aged 6-59 months was conducted. Data on malaria parasitaemia, haemoglobin densities, anthropometry, demographics, socioeconomic status (SES) and malaria prevention knowledge and practices were collected.

Results: The prevalences of malaria parasitaemia and anaemia were 5.9 and 7.0 %, respectively, whilst the prevalence of stunting was 41.3 %. Malaria parasitaemia risk differed by age groups with odds ratio (OR) = 2.53; P = 0.04 for age group 24-35 months, OR = 3.5; P = 0.037 for age group 36-47 months, and OR = 3.03; P = 0.014 for age group 48-60 months, whilst a reduced risk was found among children living in high SES HHs (OR = 0.37; P = 0.029). Risk of anaemia was high among children aged ≥12 months, those with malaria parasitaemia (OR = 3.86; P ≤ 0.0001) and children living in HHs of lower SES. Overall, under-nutrition was not associated with malaria parasitaemia. Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004).

Conclusions: In this study group, four in 10 and one in 10 children were found stunted and underweight, respectively, in an area of low malaria transmission. Under-nutrition was not associated with malaria risk. While the high prevalence of stunting requires urgent response, reductions in malaria parasitaemia and anaemia rates may require, in addition to scaled-up use of insecticide-treated bed nets and indoor residual insecticide spraying, improvements in HH SES and better housing to reduce risk of malaria.

No MeSH data available.


Related in: MedlinePlus