Factors associated with mortality in under-five children with severe anemia in Ebonyi, Nigeria.

OBJECTIVE

To determine the risk factors associated with poor outcome among under-five children with severe anemia in sub Saharan Africa.

DESIGN

Cross-sectional.

SETTING

University Teaching Hospital, Nigeria.

PARTICIPANTS

Under-five children presenting with severe anemia (PCV <15%, Hb <5g/dL).

METHODS

Between January and June 2006, children admitted with severe anemia were recruited. The biodata, socio-economic status, signs and symptoms were documented for each child after the initial stabilization. Laboratory investigations using blood, stool and urine samples were carried out. Data were analyzed using SPSS version 11.0.

RESULTS

140 out of the 1,450 patients admitted during the period of study had severe anemia (prevalence 9.7%). Malaria either alone or in combination was the most common cause of severe anemia [n=90 (64.3%)]. 117 patients (83.6%) recovered, while 4(2.8%) left against medical advice and 19 died (case fatality rate 13.6%). The variables associated with mortality were malnutrition (P=0.02), tachycardia (P= 0.03), coma (P<0.001), and absence of blood transfusion (P=0.001). On logistic regression analysis coma (P=0.002), not receiving blood transfusion (P=0.002) and female gender (P=0.04) predicted poor outcome.

CONCLUSIONS

The study revealed high mortality rates among under-five children with severe anemia. Coma, malnutrition, female gender and absence of blood transfusion were associated with higher mortality in severe anemia.