title: Malarial anaemia and anaemia severity in apparently healthy primary school children in urban and rural settings in the Mount Cameroon area: cross sectional survey.
abstract: BACKGROUND
  This study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children.
  
  
  METHODS
  A cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11 g/dL); mild MA (Hb of 8-10.9 g/dL); moderate MA (Hb of 6.1-7.9 g/dL) and severe MA (Hb≤6 g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors.
  
  
  RESULTS
  Out of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6 years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia.
  
  
  CONCLUSIONS
  Malarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Irene Ule Ngole
authors.initials: IU
authors.lastname: Sumbele
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Helen Kuokuo
authors.initials: HK
authors.lastname: Kimbi
authors.affiliation: Department of Biological Sciences, Higher Teachers Training College, University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: Judith Lum
authors.initials: JL
authors.lastname: Ndamukong-Nyanga
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Malaika
authors.initials: M
authors.lastname: Nweboh
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Judith Kuoh
authors.initials: JK
authors.lastname: Anchang-Kimbi
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Emmaculate
authors.initials: E
authors.lastname: Lum
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Nana
authors.affiliation: Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
authors.forename: Kenneth K J
authors.initials: KK
authors.lastname: Ndamukong
authors.affiliation: Department of Biological Sciences, Faculty of Science, University of Douala, Douala, Cameroon.
authors.forename: Leopold G
authors.initials: LG
authors.lastname: Lehman
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D000818:Animals; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006262:Health; D006801:Humans; D008288:Malaria / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D010271:Parasites / Q000502:physiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012574:Schools / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*