title: Anaemia in Ugandan preschool-aged children: the relative contribution of intestinal parasites and malaria.
abstract: Anaemia is a severe public health issue among African preschool-aged children, yet little effective progress has been made towards its amelioration, in part due to difficulties in unravelling its complex, multifactorial aetiology. To determine the current anaemia situation and assess the relative contribution of malaria, intestinal schistosomiasis and infection with soil-transmitted helminths, two separate cross-sectional epidemiological surveys were carried out in Uganda including 573 and 455 preschool-aged children (≤6 years) living along the shores of Lake Albert and on the islands in Lake Victoria, respectively. Anaemia was found to be a severe public health problem in Lake Albert, affecting 68·9% of children (ninety-five percent confidence intervals (95% CI) 64·9-72·7%), a statistically significant higher prevalence relative to the 27·3% detected in Lake Victoria (95% CI: 23·3-31·7%). After multivariate analysis (controlling for sex and age of the child), the only factor found to be significantly associated with increased odds of anaemia in both lake systems was malaria (Lake Albert, odds ratio (OR)=2·1, 95% CI: 1·4-3·2; Lake Victoria, OR=1·9, 95% CI: 1·2-2·9). Thus intervention strategies primarily focusing on very young children and combating malaria appear to represent the most appropriate use of human and financial resources for the prevention of anaemia in this age group and area. Looking to the future, these activities could be further emphasised within the National Child Health Days(PLUS) agenda.
authors.affiliation: Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London (St Mary's Campus), Norfolk Place, London W2 1PG, UK.
authors.forename: Helen K
authors.initials: HK
authors.lastname: Green
authors.forename: Jose C
authors.initials: JC
authors.lastname: Sousa-Figueiredo
authors.forename: Maria-Gloria
authors.initials: MG
authors.lastname: Basáñez
authors.forename: Martha
authors.initials: M
authors.lastname: Betson
authors.forename: Narcis B
authors.initials: NB
authors.lastname: Kabatereine
authors.forename: Alan
authors.initials: A
authors.lastname: Fenwick
authors.forename: J Russell
authors.initials: JR
authors.lastname: Stothard
mesh_terms: D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D000818:Animals; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D060106:Lakes / Q000469:parasitology; D008137:Longitudinal Studies; D008288:Malaria / Q000150:complications* / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000150:complications; D008429:Maternal Welfare; D011247:Pregnancy; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000453:epidemiology; D012987:Soil / Q000469:parasitology; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology
chemical_list: D012987:Soil