ABSTRACT
Nutritional anaemia is a decrease in the amount of red blood
cell volume below 11.0g/dl in children under the age of five years due to a
poor diet which is deficient in iron, folic acid and vitamin B12. A
descriptive cross-sectional study design was used to assess the prevalence and
determinants of nutritional anaemia among under five years children in
SabonGari local government area of Kaduna state. Stratified random sampling
technique was used for the selection of respondents. 311 structured
questionnaires were distributed to caregivers of children under the age of five
yearshowever 284 questionnaires were retrieved which were used for the study.
Socioeconomic and demographic characteristics ofthe respondents (caregivers of
childrenunder five years) were studied and also biochemical analysis was done
among the under five children to determine their serum iron concentration
level, serum folic acid levels and serum vitamin B12 levels. The
data obtained from the study were analyzed using SPSS version 20 and revealed
that of the 284 respondents, 154(54.2%) falls under low socioeconomic
background which lead to poverty and food insecurity in most of their
households. The study demonstrated that poor feeding practices do adversely
affected the health and nutritional anaemic status of the children. Exclusive
breastfeeding was not practiced by majority of the mothers (67%).A total of
191(67.3%) practiced the combination of both breastfeeding and bottlefeeding.
81.4% of the household consume carbohydrate food like rice, maize, yam and
noodles. The socioeconomic status of the care givers is significantly correlated
at p-value < 0.05 with nutritional anaemia. The prevalence of serum iron
deficiency in the study was 53.9% and that of folic acid was 36.3% while that
of vitamin B12 was 49.6%. In conclusion this study revealed high rate of
nutritional anaemia among under five children in Sabongari local government
area of Kaduna State Nigeria. There is need for iron supplementation and
nutritional education inSabonGari LGA.
CHAPTER
ONE
1.0
INTRODUCTION
1.1 Background of
Study
Anaemia is defined as a
decrease in the amount of red blood cell (RBC) volume or haemoglobin
concentration below the range of values occurring in healthy persons. In
children under five anaemia is present when haemoglobin is below 11.0g/dl
(Nelson, 2000).
The most common types of
anaemia are: iron deficiency anaemia, thalassaemia, aplastic anaemia,
haemolytic anaemia, sickle cell anaemia, pernicious anaemia, fanconi anaemia,
megaloblastic anaemia, and hypochromic anaemia (Stoltzfus and Dryfuss, 2011).
Nutritional anaemia refers to a reduced red blood cell count
due to a poor diet which is deficient in iron, folic acid, and /or vitamin B12
(WHO, 2005). Nutritional anaemia is common among infants and children, from
0-59 months of age. Effects of anaemia in many field of studies done in many
countries like Indian, Somalia and Ethiopia has been associated with delayed
psychomotor development and impaired cognitive performance in school children
which leads to poor performance in language skills, motor skills, and
coordination corresponding with a low intelligent Quotient (IQ) score in this
group of children (WHO, 2014).
The presence of nutritional anaemia in children is a serious
health problem because it negatively impacts mental development and future
social performance in children. Children suffering from iron deficiency anaemia
during their first 2 years of life have slow cognitive development and poor
school performance in later years (WHO, 2008).Iron deficiency anaemia has also
been associated with a diminished ability to fight infections by impairing
cell-mediated immunity resulting in greater rates of morbidity due to acute
infections and linear growth (UNICEF, 2004).
The causes of nutritional
anaemia are multi-factorial and are interrelated in a complex way the relative
importance of each factor for example, folic acid deficiency or vitamin B12
deficiency varies in different communities it is higher in rural communities
than urban communities (Stoltzfus, 2001).Anaemia may be chronic example
secondary to iron deficiency, or it may be acute, owing to a sickle cell crisis
or infection. The situation is complicated further because anaemia in childhood
can result not only from events in childhood but also from maternal iron
deficiency and anaemia, which are associated with impaired foetal development,
iron deficient and anaemic babies (Stoltzfus, 2001). Socioeconomic status may
also affect the risk of anaemia by affecting nutritional status, family size,
and interval as well as intensifying problems of affordability and accessibility
of preventive and curative measures (Park, 2005).
1.2 Statement of
the Problem
Anaemia remains a major public
health problem in the world especially in developing countries (WHO, 2014).
Societies are often ignorant of anaemia's capacity to cause permanent cognitive
defects, denying children their right to full mental and emotional development,
before they ever reach a classroom (WHO, 2014).Studies in Nigeria showed the
prevalence of nutritional anaemia among children to be 10% - 60% depending on
geopolitical zones (UNICEF, 2004). Studies in northern Nigeria revealed the
prevalence to be higher than those in the southern region, but the prevalence
was higher in rural areas than urban areas in both geopolitical zones (UNICEF,
2004). Studies done in some communities by UNICEF in Kaduna revealed that the
Prevalence of nutritional anaemia among Under Five Children in the Communities
(ZangonAya, KwananFarakwai, Yalwa, BirninYaro and Jaji) to be 16%-67.6%
(UNICEF, 2004).
1.3 Justification
for the Study
To the best
of our knowledge no such study on nutritional anaemia was ever done in the
proposed study community. It is very relevant to the health and development of
the area, the state, and the nation in general.
A study of this kind in the
study area would be useful in showing the relevant authorities with certainty
of the nutritional needs of these children and so aid in reducing morbidity and
mortality rate by delivering of necessary nutritional interventions.
1.4 Null Hypothesis
There are no nutritional
anaemia in Sabongari local government area and hence no determinants of
nutritional anaemia in Sabongari local government area of Kaduna State Nigeria.
1.5 Aim and
Objectives
1.5.1 Aim
The aim of this study was to
determine the prevalence of nutritional anaemia and its determinants among
under five children inSabongari local government area Kaduna State.
1.5.2 Specific
Objectives
I.
To determine the socio-demographic
characteristics of the care givers of the children under five years of age in
Sabongari local Government area of Kaduna State.
II.
To determine the prevalence of
nutritional anaemia among under five children in the
study
area using haemoglobin estimation, serum iron concentration, folic acid and vitamin
B12 levels in blood.
III.
To assess the predisposing factors
of the determinants of nutritional anaemia (iron, folic acid, and vitamin B12)
in the study area.
IV. To assess the food
consumption pattern of the children and their care givers using food frequency
questionnaire.
V. To determine any relationship between the annual
income of caregivers and their children nutritional anaemia.
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