Introduction

Anaemia is a health condition in which the red blood cells count or haemoglobin concentration within them are lower than normal (World Health Organization, 2021). According to the WHO (2015), an estimated 273 million children under the age of five years old are anaemic with 60.2% residing in sub-Saharan Africa. The normal haemoglobin level range in a child under the age of five is 10.9-15.0g/dL and a child is said to be anaemic if his/her haemoglobin level falls below 11.0g/dL (World Health Organization, 2021). 

Relevant Data on Anaemia

Anaemia is a serious global health challenge affecting about 39.8% of children (equivalent to 269 million) below the age of 5 years old. An estimated 60.2% of children between the ages of 6-59 months in the Africa region were infected with anaemia in 2019 (WHO, 2021). Furthermore, the estimated prevalence of anaemia in children aged 6-59 months is 62.3% in sub-Saharan Africa (approximately 84.5 million). These statistics put sub-Saharan Africa as the region with the highest prevalence of anaemia worldwide (Ogunsakin et al, 2020). In Nigeria, an estimated 68.0% of the children between the ages of 6-59 months were anaemic in 2018; of which about 27.0% had mild anaemia, 38% had moderate anaemia and 3% had severe anaemia (Nigeria Demographic and Health Survey, 2018).

Figure 1; Percentage of children (aged 6-59 months) with anaemia, by state
Source: NDHS, 2018.

The prevalence of anemia is highest in the North West and North East (as shown above) and lowest in the South West.

Economic Implication of Childhood Anaemia

Horton and Ross (2003) estimated the median productivity lost due to anaemia alone to be approximately $2.32 per capita or 4.05% of gross domestic product. It also estimated that an additional $14.46 per capita is lost in cognitive function in children, for a total annual loss (cognitive and productive) of about $50 billion in gross domestic product worldwide from anaemia (Sanou and Ngnie, 2012). 

Implication of Anaemia in children

Anaemia is a major public health issue in underdeveloped nations due to the prevalence of nutritional deficiency illnesses. In Nigeria, anaemia was the leading cause of death among children under the age of five in 2014 (Scott et al, 2014). Nearly half of all instances of anaemia are caused by iron deficiency; however, this percentage varies greatly among various demographic groups and geographical locations (Scott et al, 2014). Reduced levels of circulating red blood cells and a correspondingly reduced ability to carry oxygen are the two main symptoms of anaemia. Anaemia affects a child’s ability to carry oxygen throughout the body. Red blood cells use hemoglobin, a protein type, to transport oxygen to the rest of the body. Loss of red blood cells can induce anaemia, as can a lack of red blood cell production or the death of red blood cells. Infections, certain disorders, certain drugs, and a lack of certain vitamins or minerals in the diet can all cause low amounts of red blood cells or hemoglobin (Semedo et al, 2014).

Anaemia’s most common symptoms are caused by a shortage of oxygen in the body’s cells. Mild anaemia does not cause many of these symptoms. In general, the symptoms are as follows: rapid heartbeat, shortness of breath, fatigue easily, lack of energy and irritability when standing or sitting, dizziness or vertigo when standing or sitting for long periods of time, headaches, swollen tongue, jaundice, or yellowing of the skin, eyes and mouth; an enlarged liver; slow or delayed growth and development; and poor healing of wounds or tissue. Anaemia’s symptoms might be mistaken for those of other medical diseases. Anaemia is frequently a sign of another illness. Any symptoms should be reported to your child’s physician. When in doubt, consult with your child’s physician (Egbi et al., 2014).

Figure 2: Global map showing regions in relation to children anaemia burden (WHO, 2012). 

The above figure shows the prevalence of anaemia in children in relation to various regions in the world, the region with the highest burden of anaemia is the Sub-Saharan Africa region.

Types of Anaemia

It is possible for any child to be diagnosed with one of the following forms of anaemia:

1, Iron deficiency anaemia. An iron deficiency is the most prevalent cause of sickle cell anaemia. Hemoglobin is produced in the bone marrow. The body can’t make enough hemoglobin for red blood cells if it doesn’t have enough iron.

2, Vitamin deficiency anaemia. Red blood cell production requires folate and vitamin B-12 in addition to iron. Reduced red blood cell production can be caused by a diet deficient in these and other critical nutrients. The vitamin B-12 may not be absorbed by certain people even when they get adequate B-12 through their diets. This can progress to pernicious anaemia, which is a kind of vitamin deficient anaemia.

3, Hemolytic anaemia. When red blood cells are depleted quicker than bone marrow can replenish them, anaemia occurs. It’s possible that some blood disorders enhance the death of red blood cells. Hemolytic anaemia might run in an individual’s family or be acquired later in life.

4, Sickle cell anaemia. A hemoglobinopathy is a blood disorder marked by irregularly formed red blood cells that is passed down via families. A hemolytic anaemia is a hereditary, yet potentially dangerous, illness. In accordance with the findings of Gayawan et al (2014) Hemoglobin deficiency is to blame, as sickle-shaped red blood cells are the result of the problem. Premature death of these abnormal red blood cells causes a persistent lack of red blood cells.

5, Cooley’s anaemia (thalassemia). This kind of anaemia also has defective red blood cells since it is passed down through families.

6, Aplastic anaemia. This uncommon, life-threatening anaemia is caused by a lack of red blood cells in your system. Toxic chemical exposure and certain infections are among the risk factors for developing aplastic anaemia.

Risk factors predisposing a child to Anaemia

1, A diet lacking in certain vitamins and minerals: anaemia is more likely if one’s diet is deficient in iron, vitamin B-12, folate, and copper.

2, Intestinal disorders: Being anaemic increases the likelihood of having a digestive illness such as Crohn’s or celiac that prevents nutrients from being absorbed into the small intestine.

3, Chronic conditions: anaemia of chronic disease can strike someone with cancer, renal failure, or another long-term illness. These circumstances can result in a deficiency in red blood cells. Blood loss from an ulcer or elsewhere in the body that is slow and continuous can deplete the body’s iron reserves, leading to anaemia from iron deficiency.

4, Family history: anaemia of chronic disease can strike someone with cancer, renal failure, or another long-term illness. These circumstances can result in a deficiency in red blood cells. Blood loss from an ulcer or elsewhere in the body that is slow and continuous can deplete the body’s iron reserves, leading to anaemia from iron deficiency.

If this illness is left unattended to then it can end up in severe cases such as:

1, Extreme fatigue. One may be unable to carry out daily duties if they suffer from severe anaemia.

2, Heart problems. Rapid or irregular heartbeat might be caused by anaemia (arrhythmia). Blood oxygen levels drop when you’re anaemic because your heart has to work harder to compensate for the deficiency. An enlarged heart or heart failure might result as a result of this condition.

3, Death. Sickle cell anaemia, for example, can have life-threatening implications if it is passed down through the family. Acute, severe anaemia can be dangerous if you lose a lot of blood rapidly. Anaemia raises the risk of mortality in the elderly population.

Conclusion and recommendation

Anaemia affects 53.8% of Nigerian children between the ages of 6 and 59 months. Using this statistic we may deduce that 5 out of every 10 kids are anaemic. There are several risk factors at biologic and health systemic levels. However, anaemia intervention programs for children under five years should target younger, jobless moms and intensify maternal education on adequate dietary diversity in order to protect children from anaemia given that iron supplementation during pregnancy alone would not be adequate.

References

Egbi, G., Steiner-Asiedu, F. M., & Kwesi S. (2014). “Anaemia among school children older than five years in the Volta Region of Ghana,” Pan African Medical Journal, vol. 17, no. 1, article 10.

Gayawan, E., Arogundade, D. and Adebayo, S. B. (2014). “Possible determinants and spatial patterns of anaemia among young children in Nigeria: A bayesian semi-parametric modelling,” International Health, vol. 6, no. 1, pp. 35–45.

Legason, I. D., Atiku, A.,  Ssenyonga, R., Olupot-Olupot, P. & Barugahare, J. B. (2017). “Prevalence of anaemia and associated risk factors among children in north-western Uganda: a cross sectional study,” BMC Hematology, vol. 17, no. 10.

Scott, S., Chen-Edinboro, L., Caulfield, L., & Murray-Kolb, L. E. (2014). “The impact of anaemia on child mortality: An updated review,” Nutrients, vol. 6, no. 12, pp. 5915–5932.

Semedo, R., Santos, A., Baião, R., Luiz, R. & Da Veiga, G. (2014). “Prevalence of anaemia and associated factors among children below five years of age in cape verde, West Africa,” Journal of Health, Population and Nutrition, vol. 32, no. 4, pp. 646–657.

USAID, (2013). United States Agency International Development: Health Report, USAID, Geneva, Switzerland.

WHO. (2015). The Global Prevalence of Anaemia 2011, World Health Organization, Geneva, Switzerland. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/177094/9789241564960_eng.pdf?sequence=1.

Who.int. 2021. Anaemia in women and children. [online] Available at: <https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children> [Accessed 4 November 2021].

Ogunsakin, R., Babalola, B. and Akinyemi, O., (2020). Statistical Modeling of Determinants of anaemia Prevalence among Children Aged 6–59 Months in Nigeria: A Cross-Sectional Study. anaemia, 2020, pp.1-9.

​​World Health Organization (2021). Anaemia. [online] Available at: <https://www.who.int/health-topics/anaemia#tab=tab_1>

​​ National Population Commission (NPC) (Nigeria) and ICF. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA

Sanou D., & Ngnie l.,. (2012). Risk Factors for anaemia in Preschool Children in Sub-Saharan Africa. 10.5772/31289.

Horton S, Ross J, (2003). The economics of iron deficiency, Food Policy 28:51-75