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Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

A longitudinal study on anaemia in children with Plasmodium falciparuminfection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers

Authors: Irene Ule Ngole Sumbele, Moses Samje, Theresa Nkuo-Akenji

Published in: BMC Infectious Diseases | Issue 1/2013

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Abstract

Background

In heavily endemic malaria areas, it is almost inevitable that malarial infection will be associated with anaemia, although malaria may not be the prime cause of it. Anaemia is a major public health problem in Cameroon. We hypothesized that, factors other than falciparum malaria account for anaemia in the study area.

Methods

A longitudinal study was conducted among 351 Plasmodium falciparum positive children to determine the prevalence, risk factors and the perception of anaemia by the caregivers in a semi-rural community. The investigative methods included the use of a structured questionnaire, clinical evaluation and laboratory investigations.

Results

At enrolment the overall prevalence of anaemia as assessed by Hb concentration (Hb < 11 g/dl) was 80.3% (282). Following treatment the prevalence of persistent anaemia was 6% and 46.2% of the children achieved haematological recovery by day 42. Exploratory multiple linear regression analysis showed the following; parasitaemia density (P < 0.01), enlarged spleen (P < 0.05), duration of fever > 2 days (P < 0.01), high white blood cell count (P < 0.001), sex (P < 0.05), iron status indicators (ferritin and transferrin) (P < 0.001), level of education of the caregiver (P < 0.05), management of onset of malaria by caregiver (P < 0.005) and wasting (P < 0.05) to be risk factors for anaemia in children with falciparum infection. Approximately 75.5% (265) of the caregivers had some knowledge about anaemia.

Conclusion

The identified risk factors revealed the important contributors to the pathogenesis of anaemia in the Mount Cameroon region. Control efforts should therefore be directed towards proper health education emphasizing on proper health seeking behaviour and attitudes of the population.
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Literature
1.
go back to reference WHO: World Malaria report. Global malaria programme. 2011, Geneva: World Health Organization publication WHO: World Malaria report. Global malaria programme. 2011, Geneva: World Health Organization publication
3.
go back to reference Facer CA: Hematological aspects of malaria. Infection and Hematology. 1994, Oxford: Butterworth Heinmann Ltd, 259-294. Facer CA: Hematological aspects of malaria. Infection and Hematology. 1994, Oxford: Butterworth Heinmann Ltd, 259-294.
4.
go back to reference Murphy GS, Oldfield EC: Falciparum malaria. Infect Dis Clin North Am. 1996, 10: 747-770. 10.1016/S0891-5520(05)70325-1.CrossRefPubMed Murphy GS, Oldfield EC: Falciparum malaria. Infect Dis Clin North Am. 1996, 10: 747-770. 10.1016/S0891-5520(05)70325-1.CrossRefPubMed
5.
go back to reference Nussenblatt V, Semba RD: Micronutrient malnutrition and the pathogenesis of malarial anaemia. Acta Trop. 2002, 82: 321-337. 10.1016/S0001-706X(02)00049-9.CrossRefPubMed Nussenblatt V, Semba RD: Micronutrient malnutrition and the pathogenesis of malarial anaemia. Acta Trop. 2002, 82: 321-337. 10.1016/S0001-706X(02)00049-9.CrossRefPubMed
6.
go back to reference Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Edited by: Benoist B, McLean E, Egli I, Cogswell M. 2008, Geneva: World Health Organization publication Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Edited by: Benoist B, McLean E, Egli I, Cogswell M. 2008, Geneva: World Health Organization publication
7.
go back to reference Le Cornet M, Hesran JUL, Fievet N, Personne P, Gounoue R, Beyeme M, Deloron P: Prevalence of and risk factors for anaemia in young children in southern Cameroon. Am J Trop Med Hyg. 1998, 58: 606-611. Le Cornet M, Hesran JUL, Fievet N, Personne P, Gounoue R, Beyeme M, Deloron P: Prevalence of and risk factors for anaemia in young children in southern Cameroon. Am J Trop Med Hyg. 1998, 58: 606-611.
8.
go back to reference Tolentino K, Friedman FF: An update on anaemia in less developed countries. Am J Trop Med Hyg. 2007, 77: 44-51.PubMed Tolentino K, Friedman FF: An update on anaemia in less developed countries. Am J Trop Med Hyg. 2007, 77: 44-51.PubMed
9.
go back to reference van Eijk AM, Ayisi JG, ter Kuile FO, Misore A, Otieno JA, Kolczak MS, Kager PA, Steketee RW, Nahlen BL: Malaria and human immunodeficiency virus infection as risk factors for anemia in infants in Kisumu, western Kenya. AmJTrop Med Hyg. 2002, 67: 44-53. van Eijk AM, Ayisi JG, ter Kuile FO, Misore A, Otieno JA, Kolczak MS, Kager PA, Steketee RW, Nahlen BL: Malaria and human immunodeficiency virus infection as risk factors for anemia in infants in Kisumu, western Kenya. AmJTrop Med Hyg. 2002, 67: 44-53.
10.
go back to reference Salako LA, Ajayi FO, Sowunmi A, Walker O: Malaria in Nigeria: a revisit. Ann Trop Med Par. 1990, 84: 435-445. Salako LA, Ajayi FO, Sowunmi A, Walker O: Malaria in Nigeria: a revisit. Ann Trop Med Par. 1990, 84: 435-445.
11.
go back to reference Luxemburger C, Thwai KL, White NJ, Webster HK, Kyle DE, Maelankirri L, Chongsuphajaisiddhi T, Nosten F: The epidemiology of malaria in a Karen population on the western border of Thailand. Trans R Soc Trop Med Hyg. 1996, 90: 105-111. 10.1016/S0035-9203(96)90102-9.CrossRefPubMed Luxemburger C, Thwai KL, White NJ, Webster HK, Kyle DE, Maelankirri L, Chongsuphajaisiddhi T, Nosten F: The epidemiology of malaria in a Karen population on the western border of Thailand. Trans R Soc Trop Med Hyg. 1996, 90: 105-111. 10.1016/S0035-9203(96)90102-9.CrossRefPubMed
12.
go back to reference Price RN, Simpson JA, Nosten F, Luxemburger C, Hkirjaroen L, ter Kuile F, Chongsuphalaisiddh T, White NJ: Factors contributing to anaemia after uncomplicated falciparum malaria. Am J Trop Med Hyg. 2001, 65: 614-622.PubMedPubMedCentral Price RN, Simpson JA, Nosten F, Luxemburger C, Hkirjaroen L, ter Kuile F, Chongsuphalaisiddh T, White NJ: Factors contributing to anaemia after uncomplicated falciparum malaria. Am J Trop Med Hyg. 2001, 65: 614-622.PubMedPubMedCentral
13.
go back to reference Desai MR, Terlouw DJ, Kwena AM, Phillips-Howard PA, Kariuki SK, Wannemuehler KA, Odhacha A, Hawley WA, Shi YP, Nahlen BL, Ter Kuile FO: Factors associated with hemoglobin concentrations in pre-school children in Western Kenya: cross-sectional studies. Am J Trop Med Hyg. 2005, 72: 47-59.PubMed Desai MR, Terlouw DJ, Kwena AM, Phillips-Howard PA, Kariuki SK, Wannemuehler KA, Odhacha A, Hawley WA, Shi YP, Nahlen BL, Ter Kuile FO: Factors associated with hemoglobin concentrations in pre-school children in Western Kenya: cross-sectional studies. Am J Trop Med Hyg. 2005, 72: 47-59.PubMed
14.
go back to reference Ronald LA, Kenny SL, Klinkenberg E, Akoto AO, Boakye I, Barnish G, Donnelly MJ: Malaria and anaemia among children in two communities of Kumasi, Ghana: a cross-sectional survey. Mal J. 2006, 5: 105-10.1186/1475-2875-5-105.CrossRef Ronald LA, Kenny SL, Klinkenberg E, Akoto AO, Boakye I, Barnish G, Donnelly MJ: Malaria and anaemia among children in two communities of Kumasi, Ghana: a cross-sectional survey. Mal J. 2006, 5: 105-10.1186/1475-2875-5-105.CrossRef
15.
go back to reference Zhao A, Zhang Y, Peng Y, Li J, Yang T, Liu Z, Yanli L, Wang P: Prevalence of anemia and its risk factors among children 6–36 months old in Burma. Am J Trop Med Hyg. 2012, 87: 306-311. 10.4269/ajtmh.2012.11-0660.CrossRefPubMedPubMedCentral Zhao A, Zhang Y, Peng Y, Li J, Yang T, Liu Z, Yanli L, Wang P: Prevalence of anemia and its risk factors among children 6–36 months old in Burma. Am J Trop Med Hyg. 2012, 87: 306-311. 10.4269/ajtmh.2012.11-0660.CrossRefPubMedPubMedCentral
16.
go back to reference Sumbele IUN, Nkuo-Akenji T, Samje M, Ndzeidze T, Ngwa EM, Titanji VPK: Haematological changes and recovery associated with treated and untreated Plasmodium falciparum infection in children in the Mount Cameroon Region. J Clin Med Res. 2010, 2: 143-151. Sumbele IUN, Nkuo-Akenji T, Samje M, Ndzeidze T, Ngwa EM, Titanji VPK: Haematological changes and recovery associated with treated and untreated Plasmodium falciparum infection in children in the Mount Cameroon Region. J Clin Med Res. 2010, 2: 143-151.
17.
go back to reference Nkuo-Akenji T, Ntonifor NN, Ching JK, Kimbi HK, Ndamukong KN, Anong DA, Boyo MG, Titanji VPK: Evaluating a malaria intervention strategy using knowledge, practices and coverage surveys in rural Bolifamba, South West Cameroon. Trans R Soc Trop Med Hyg. 2005, 99: 325-332. 10.1016/j.trstmh.2003.12.016.CrossRefPubMed Nkuo-Akenji T, Ntonifor NN, Ching JK, Kimbi HK, Ndamukong KN, Anong DA, Boyo MG, Titanji VPK: Evaluating a malaria intervention strategy using knowledge, practices and coverage surveys in rural Bolifamba, South West Cameroon. Trans R Soc Trop Med Hyg. 2005, 99: 325-332. 10.1016/j.trstmh.2003.12.016.CrossRefPubMed
18.
go back to reference Obonyo CO, Taylor W, Ekvall H, Kaneko A, Ter Kuile F, Olliaro P, Bjorkman A, Oloo AJ: Effect of artesunate plus sulfadoxine-pyrimethamine on haematological recovery and anaemia, in Kenyan children with uncomplicated, Plasmodium falciparum malaria. Ann Trop Med Parasitol. 2007, 101: 281-295. 10.1179/136485907X176337.CrossRefPubMed Obonyo CO, Taylor W, Ekvall H, Kaneko A, Ter Kuile F, Olliaro P, Bjorkman A, Oloo AJ: Effect of artesunate plus sulfadoxine-pyrimethamine on haematological recovery and anaemia, in Kenyan children with uncomplicated, Plasmodium falciparum malaria. Ann Trop Med Parasitol. 2007, 101: 281-295. 10.1179/136485907X176337.CrossRefPubMed
19.
go back to reference Gilles HM: Pathology of malaria: Handbook of malaria infection in the tropics. 1997, Italy: Italian Association Amicidi Raoul Follerau (AIFO) Gilles HM: Pathology of malaria: Handbook of malaria infection in the tropics. 1997, Italy: Italian Association Amicidi Raoul Follerau (AIFO)
20.
go back to reference Cheesbrough M: District Laboratory Practice in Tropical Countries. Part1& 2. 1998, Edinburg Building UK: Cambridge University Press Cheesbrough M: District Laboratory Practice in Tropical Countries. Part1& 2. 1998, Edinburg Building UK: Cambridge University Press
21.
go back to reference Trape JF: Rapid evaluation of malaria parasite density and standardization of thick smear examination for epidemiological investigations. Trans R Soc Trop Med Hyg. 1985, 79: 181-184. 10.1016/0035-9203(85)90329-3.CrossRefPubMed Trape JF: Rapid evaluation of malaria parasite density and standardization of thick smear examination for epidemiological investigations. Trans R Soc Trop Med Hyg. 1985, 79: 181-184. 10.1016/0035-9203(85)90329-3.CrossRefPubMed
22.
go back to reference Mogensen CB, Sørensen JE, Bjorkman A: Pallor as a sign of anaemia in small Tanzanian children at different health care levels. Acta Trop. 2006, 99: 113-118. 10.1016/j.actatropica.2005.12.010.CrossRefPubMed Mogensen CB, Sørensen JE, Bjorkman A: Pallor as a sign of anaemia in small Tanzanian children at different health care levels. Acta Trop. 2006, 99: 113-118. 10.1016/j.actatropica.2005.12.010.CrossRefPubMed
23.
go back to reference Dacie JV, Lewis SM: Red Cell Count in Practical Haematology. 1995, Michigan: Churchill Livingstone Dacie JV, Lewis SM: Red Cell Count in Practical Haematology. 1995, Michigan: Churchill Livingstone
24.
go back to reference Jourdan PM, Laoussou P, Lybie A, Kjetland EF: Indicators of anaemia in under-fives with malaria at a hospital in Northern Cameroon. W Afri J Med. 2008, 27: 7-12. Jourdan PM, Laoussou P, Lybie A, Kjetland EF: Indicators of anaemia in under-fives with malaria at a hospital in Northern Cameroon. W Afri J Med. 2008, 27: 7-12.
25.
go back to reference Premji Z, Hamisi Y, Shiff C, Minjas J, Lubega P, Makwaya C: Anemia and Plasmodium falciparum infections among young children in an holoendemic area, Bagamoyo, Tanzania. Acta Trop. 1995, 59: 55-64. 10.1016/0001-706X(94)00079-G.CrossRefPubMed Premji Z, Hamisi Y, Shiff C, Minjas J, Lubega P, Makwaya C: Anemia and Plasmodium falciparum infections among young children in an holoendemic area, Bagamoyo, Tanzania. Acta Trop. 1995, 59: 55-64. 10.1016/0001-706X(94)00079-G.CrossRefPubMed
26.
go back to reference Kahigwa E, Schellenberg D, Sanz S, Aponte JJ, Wigayi J, Mshinda H, Alonso P, Menendez C: Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study. Trop Med Int Hlth. 2002, 7: 823-830. 10.1046/j.1365-3156.2002.00938.x.CrossRef Kahigwa E, Schellenberg D, Sanz S, Aponte JJ, Wigayi J, Mshinda H, Alonso P, Menendez C: Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study. Trop Med Int Hlth. 2002, 7: 823-830. 10.1046/j.1365-3156.2002.00938.x.CrossRef
27.
go back to reference Warrell DA, Molyneux ME, Beales PF: Severe and complicated malaria. Trans R Soc Trop Med Hyg. 1990, 84: 1-65. Warrell DA, Molyneux ME, Beales PF: Severe and complicated malaria. Trans R Soc Trop Med Hyg. 1990, 84: 1-65.
28.
go back to reference Menendez C, Fleming AF, Alonso PL: Malaria - related anaemia. Parasitol Today. 2000, 16: 469-476. 10.1016/S0169-4758(00)01774-9.CrossRefPubMed Menendez C, Fleming AF, Alonso PL: Malaria - related anaemia. Parasitol Today. 2000, 16: 469-476. 10.1016/S0169-4758(00)01774-9.CrossRefPubMed
29.
go back to reference Engwerda CR, Beattie L, Amante FH: The importance of the spleen in malaria. Trends Parasitol. 2005, 21: 75-80. 10.1016/j.pt.2004.11.008.CrossRefPubMed Engwerda CR, Beattie L, Amante FH: The importance of the spleen in malaria. Trends Parasitol. 2005, 21: 75-80. 10.1016/j.pt.2004.11.008.CrossRefPubMed
30.
go back to reference Ong’echa JM, Keller CC, Were T, Ouma C, Otieno RO, Landis-Lewis Z, Ochiel D, Slingluff JL, Mogere S, Ogonji GA, Orago AS, Vulule JM, Kaplan SS, Day RD, Perkins DJ: Parasitemia, anemia, and malarial anemia in infants and young children in a rural holoendemic Plasmodium falciparum transmission area. Am J Trop Med Hyg. 2006, 74: 376-385.PubMed Ong’echa JM, Keller CC, Were T, Ouma C, Otieno RO, Landis-Lewis Z, Ochiel D, Slingluff JL, Mogere S, Ogonji GA, Orago AS, Vulule JM, Kaplan SS, Day RD, Perkins DJ: Parasitemia, anemia, and malarial anemia in infants and young children in a rural holoendemic Plasmodium falciparum transmission area. Am J Trop Med Hyg. 2006, 74: 376-385.PubMed
31.
go back to reference Grenfell P, Fanello CI, Magris M, Goncalves J, Metzger WG, Vivas-Martınez S, Curtis C, Vivas L: Anaemia and malaria in Yanomami communities with differing access to healthcare. Trans R Soc Trop Med Hyg. 2008, 102: 645-652. 10.1016/j.trstmh.2008.02.021.CrossRefPubMed Grenfell P, Fanello CI, Magris M, Goncalves J, Metzger WG, Vivas-Martınez S, Curtis C, Vivas L: Anaemia and malaria in Yanomami communities with differing access to healthcare. Trans R Soc Trop Med Hyg. 2008, 102: 645-652. 10.1016/j.trstmh.2008.02.021.CrossRefPubMed
32.
go back to reference Tchinda VHM, Tadem AD, Tako EA, Tene G, Fogako J, Nyonglema P, Sama G, Zhoue A, Leke RGF: Severe malaria in Cameroonian children: correlation between plasma levels of three soluble inducible adhesion molecules and TNF-α. Acta Trop. 2007, 102: 20-28. 10.1016/j.actatropica.2007.02.011.CrossRefPubMed Tchinda VHM, Tadem AD, Tako EA, Tene G, Fogako J, Nyonglema P, Sama G, Zhoue A, Leke RGF: Severe malaria in Cameroonian children: correlation between plasma levels of three soluble inducible adhesion molecules and TNF-α. Acta Trop. 2007, 102: 20-28. 10.1016/j.actatropica.2007.02.011.CrossRefPubMed
33.
go back to reference Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CRJC: Changes in white blood cells and platelets in children with falciparum malaria: relationship to disease outcome. Br J Haematol. 2002, 119: 839-847. 10.1046/j.1365-2141.2002.03904.x.CrossRefPubMed Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CRJC: Changes in white blood cells and platelets in children with falciparum malaria: relationship to disease outcome. Br J Haematol. 2002, 119: 839-847. 10.1046/j.1365-2141.2002.03904.x.CrossRefPubMed
34.
go back to reference Bashawri LAM, Mandil AA, Bahnassy AA, Ahmed MA: Malaria: hematological aspects. Ann S Med. 2002, 22: 372-377. Bashawri LAM, Mandil AA, Bahnassy AA, Ahmed MA: Malaria: hematological aspects. Ann S Med. 2002, 22: 372-377.
35.
go back to reference Graham SM, Walsh AL, Molyneux EM, Phiri AJ, Molyneux ME: Clinical presentation of non-typhoidal Salmonella bacteraemia in Malawian children. Trans R Soc Trop Med Hyg. 2000, 94: 310-314. 10.1016/S0035-9203(00)90337-7.CrossRefPubMed Graham SM, Walsh AL, Molyneux EM, Phiri AJ, Molyneux ME: Clinical presentation of non-typhoidal Salmonella bacteraemia in Malawian children. Trans R Soc Trop Med Hyg. 2000, 94: 310-314. 10.1016/S0035-9203(00)90337-7.CrossRefPubMed
36.
go back to reference Bronzan RN, Taylor TE, Mwenechanya J, Tembo M, Kayira K, Bwanaisa L, Njobvu A, Kondowe W, Chalira C, Walsh AL, Phiri A, Wilson LK, Molyneux ME, Stephen M, Graham SM: Bacteremia in Malawian children with severe malaria: prevalence, etiology, HIV coinfection, and outcome. J Infect Dis. 2007, 195: 895-904. 10.1086/511437.CrossRefPubMed Bronzan RN, Taylor TE, Mwenechanya J, Tembo M, Kayira K, Bwanaisa L, Njobvu A, Kondowe W, Chalira C, Walsh AL, Phiri A, Wilson LK, Molyneux ME, Stephen M, Graham SM: Bacteremia in Malawian children with severe malaria: prevalence, etiology, HIV coinfection, and outcome. J Infect Dis. 2007, 195: 895-904. 10.1086/511437.CrossRefPubMed
37.
go back to reference Brooker S, Peshu N, Warn PA, Masobo M, Guyatt H, Marsh K, Snow RW: The epidemiology of hookworm infection and its contribution to anaemia among pre-school children on the Kenyan coast. Trans R Soc Trop Med Hyg. 1999, 93: 240-246. 10.1016/S0035-9203(99)90007-X.CrossRefPubMed Brooker S, Peshu N, Warn PA, Masobo M, Guyatt H, Marsh K, Snow RW: The epidemiology of hookworm infection and its contribution to anaemia among pre-school children on the Kenyan coast. Trans R Soc Trop Med Hyg. 1999, 93: 240-246. 10.1016/S0035-9203(99)90007-X.CrossRefPubMed
38.
go back to reference Stoltzfus RJ, Chwaya HM, Montresor A, Albonico M, Savioli L, Tielsch JM: Malaria, hookworms and recent fever are related to anaemia and iron status indicators in 0-5-y old Zanzibari children and these relationships change with age. J Nutri. 2000, 130: 1724-1733. Stoltzfus RJ, Chwaya HM, Montresor A, Albonico M, Savioli L, Tielsch JM: Malaria, hookworms and recent fever are related to anaemia and iron status indicators in 0-5-y old Zanzibari children and these relationships change with age. J Nutri. 2000, 130: 1724-1733.
39.
go back to reference Owusu-Agyei S, Fryauff DJ, Chandramohan D, Koram KA, Binka FN, Nkrumah FK, Utz GC, Hoffman SL: Characteristics of severe anemia and its association with malaria in young children of the Kassena-Nankana District of Northern Ghana. Am J Trop Med Hyg. 2002, 67: 371-377.PubMed Owusu-Agyei S, Fryauff DJ, Chandramohan D, Koram KA, Binka FN, Nkrumah FK, Utz GC, Hoffman SL: Characteristics of severe anemia and its association with malaria in young children of the Kassena-Nankana District of Northern Ghana. Am J Trop Med Hyg. 2002, 67: 371-377.PubMed
40.
go back to reference Al-Mekhlafia MH, Surina J, Atiyab AS, Ariffinc WA, Mahdya AKM, Abdullah HC: Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural peninsular Malaysia: an update on a continuing problem. Trans R Soc Trop Med Hyg. 2008, 102: 1046-1052. 10.1016/j.trstmh.2008.05.012.CrossRef Al-Mekhlafia MH, Surina J, Atiyab AS, Ariffinc WA, Mahdya AKM, Abdullah HC: Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural peninsular Malaysia: an update on a continuing problem. Trans R Soc Trop Med Hyg. 2008, 102: 1046-1052. 10.1016/j.trstmh.2008.05.012.CrossRef
41.
go back to reference Caulfield LE, Richard SA, Black RE: Under nutrition as an underlying cause of malaria morbidity and mortality in children less than five years old. Am J Trop Med Hyg. 2004, 71 (Suppl 2): 55-63.PubMed Caulfield LE, Richard SA, Black RE: Under nutrition as an underlying cause of malaria morbidity and mortality in children less than five years old. Am J Trop Med Hyg. 2004, 71 (Suppl 2): 55-63.PubMed
42.
go back to reference Nabakwe EC, Ngare DK: Health and nutritional status of children in Western Kenya in relation to vitamin a deficiency. E Afri J Pub Hlth. 2004, 1: 1-5. Nabakwe EC, Ngare DK: Health and nutritional status of children in Western Kenya in relation to vitamin a deficiency. E Afri J Pub Hlth. 2004, 1: 1-5.
43.
go back to reference Ehrhardt S, Burchard GD, Mantel C, Cramer JP, Kaiser S, Kubo M, Otchwemah RN, Bienzle U, Mockenhaupt FP: Malaria, anemia, and malnutrition in african children—defining intervention priorities. J Infect Dis. 2006, 194: 108-114. 10.1086/504688.CrossRefPubMed Ehrhardt S, Burchard GD, Mantel C, Cramer JP, Kaiser S, Kubo M, Otchwemah RN, Bienzle U, Mockenhaupt FP: Malaria, anemia, and malnutrition in african children—defining intervention priorities. J Infect Dis. 2006, 194: 108-114. 10.1086/504688.CrossRefPubMed
44.
go back to reference Verhoef H, West CE, Veenemans J, Beguin Y, Kok FJ: Stunting may determine the severity of malaria-associated anaemia in African children. Pediatrics. 2002, 110: 1-5. 10.1542/peds.110.1.1.CrossRef Verhoef H, West CE, Veenemans J, Beguin Y, Kok FJ: Stunting may determine the severity of malaria-associated anaemia in African children. Pediatrics. 2002, 110: 1-5. 10.1542/peds.110.1.1.CrossRef
45.
go back to reference Luby SP, Kazembe PN, Redd SC, Ziba C, Nwanyanwu OC, Hightower AW, Franco C, Chitsulo L, Wirima JJ, Olivar MA: Using clinical signs to diagnose anaemia in African children. Bull World Hlth Organ. 1995, 73: 477-482. Luby SP, Kazembe PN, Redd SC, Ziba C, Nwanyanwu OC, Hightower AW, Franco C, Chitsulo L, Wirima JJ, Olivar MA: Using clinical signs to diagnose anaemia in African children. Bull World Hlth Organ. 1995, 73: 477-482.
Metadata
Title
A longitudinal study on anaemia in children with Plasmodium falciparuminfection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers
Authors
Irene Ule Ngole Sumbele
Moses Samje
Theresa Nkuo-Akenji
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-123

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