title: Impact of Plasmodium falciparum infection on the frequency of moderate to severe anaemia in children below 10 years of age in Gabon.
abstract: BACKGROUND
  Improving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies.
  
  
  METHODS
  A prospective observational study over a two-year period to assess the burden of anaemia and its relationship to Plasmodium falciparum infection and age was conducted in 8,195 febrile Gabonese children.
  
  
  RESULTS
  The proportion of children with anaemia was 83.6% (n = 6830), higher in children between the ages of six and 23 months. Those under three years old were more likely to develop moderate to severe anaemia (68%). The prevalence of malaria was 42.7% and P. falciparum infection was more frequent in children aged 36-47 months (54.5%). The proportion of anaemic children increased with parasite density (p < 0.01). Most of infected children were moderately to severely anaemic (69.5%, p < 0.01). Infants aged from one to 11 months had a higher risk of developing severe malarial anaemia. In children over six years of age, anaemia occurrence was high (>60%), but was unrelated to P. falciparum parasitaemia.
  
  
  CONCLUSIONS
  Malaria is one of the main risk factors for childhood anaemia which represents a public health problem in Gabon. The risk of severe malarial anaemia increases up the age of three years. Efforts to improve strategies for controlling anaemia and malaria are needed.
authors.affiliation: Department of Parasitology, Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé (USS), Libreville-Gabon, Malaria Clinical Research Unit, Centre Hospitalier de Libreville, Gabon. mariellebouyou@gmail.com
authors.forename: Marielle K
authors.initials: MK
authors.lastname: Bouyou-Akotet
authors.forename: Arnaud
authors.initials: A
authors.lastname: Dzeing-Ella
authors.forename: Eric
authors.initials: E
authors.lastname: Kendjo
authors.forename: Diane
authors.initials: D
authors.lastname: Etoughe
authors.forename: Edgard B
authors.initials: EB
authors.lastname: Ngoungou
authors.forename: Timothy
authors.initials: T
authors.lastname: Planche
authors.forename: Jean
authors.initials: J
authors.lastname: Koko
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Kombila
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000453:epidemiology*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D015995:Prevalence; D011446:Prospective Studies