Nakimera Christine, Bwajojo Philip Bright, Kaweesa William, Nampiima Joan, Chebet Faith, Namuwawu Sharifah, Bwemage Martin, Nuwabasa Moses, Ndagire Regina, Lugaajju Allan, Tumwebaze Joel, Lwanira Catherine Nassozi
Institute of Public Health and Management, Clarke International University, Kampala, P.O. Box 7782, Uganda.
Community Integrated Development Initiatives, Kyangwali Refugee settlement, Kampala, P.O. Box 692, Uganda.
BMC Pediatr. 2025 Jan 11;25(1):26. doi: 10.1186/s12887-024-05377-8.
Anaemia is a major cause of morbidity among children under five years in Uganda. However, its magnitude among refugee populations is marginally documented. In this study, the prevalence and contributors to anaemia among children 6 to 59 months in Kyangwali refugee settlement in Western Uganda was determined.
This was a cross-sectional study that was carried out among 415 mother- child dyads at Kwangwali refugee settlement. Anaemia was determined by measuring haemoglobin concentration using the HaemoCue method, while nutritional status was examined using standard World Health Organisation (WHO) nutritional indices. Data abstraction forms, pretested questionnaires and face to face interviews were used to collect patient data. Associations between the independent variables and anaemia were examined using modified Poisson regression with robust standard errors. In all statistical tests, a P- value of < 0.05 was considered as significant.
The proportion of children with anaemia was 49.2% (95% CI: 44.4-53.9). Anaemia was 1.4 times (95% CI = 1.13-1.82; p = 0.003) more prevalent among wasted children than the normal children. The prevalence of anaemia was also higher among underweight children than those with normal weight (aPR = 1.37, 95% CI = 1.11-1.70; p = 0.004). Additionally, the prevalence of anaemia was higher among children of birth order of 6 or above (aPR = 2.00, 95% CI = 1.22-3.29; p = 0.006), while anaemia prevalence was lower among children whose mothers' had attained secondary level of education (aPR = 0.19, CI = 0.04-0.98; p = 0.048) and those who fed on fish (aPR = 0.75, 95% CI = 0.57-0.99; p = 0.039) and meals prepared with oils and fats (aPR = 0.70, 95% CI = 0.51-0.97; p = 0.029). There was no significant relationship between anaemia occurrence and the household dietary diversity score.
About half of the study children were found to be anaemic. The most significant contributors to anaemia in the study population were malnutrition, maternal education, feeding practices and birth order. The study findings suggest need of screening of children for anaemia at all nutritional clinics, promotion of education, addressing barriers to sustainable food supply and accessibility of nutrient-dense foods, treating anaemia in children alongside other micronutrient deficiencies and addressing the nutritional needs of multiparous mothers in refugee communities.
贫血是乌干达5岁以下儿童发病的主要原因。然而，关于难民群体中贫血情况的记录却很少。本研究旨在确定乌干达西部Kyangwali难民安置点6至59个月儿童贫血的患病率及其影响因素。
这是一项横断面研究，在Kwangwali难民安置点的415对母婴中开展。采用血红蛋白比色计法测量血红蛋白浓度来确定贫血情况，同时使用世界卫生组织（WHO）的标准营养指标检查营养状况。通过数据提取表、预测试问卷和面对面访谈收集患者数据。使用稳健标准误的修正泊松回归分析自变量与贫血之间的关联。在所有统计检验中，P值<0.05被视为具有统计学意义。
贫血儿童的比例为49.2%（95%CI：44.4 - 53.9）。消瘦儿童的贫血患病率是正常儿童的1.4倍（95%CI = 1.13 - 1.82；p = 0.003）。体重不足儿童的贫血患病率也高于体重正常的儿童（调整后患病率比[aPR]=1.37，95%CI = 1.11 - 1.70；p = 0.004）。此外，出生顺序为6及以上的儿童贫血患病率更高（aPR = 2.00，95%CI = 1.22 - 3.29；p = 0.006），而母亲受过中等教育的儿童（aPR = 0.19，CI = 0.04 - 0.98；p = 0.048）、食用鱼类的儿童（aPR = 0.75，95%CI = 0.57 - 0.99；p = 0.039）以及食用油脂烹制食物的儿童（aPR = 0.70，95%CI = 0.51 - 0.97；p = 0.029）贫血患病率较低。贫血发生与家庭饮食多样性得分之间无显著关系。
研究发现约一半的儿童患有贫血。该研究人群中贫血的最重要影响因素是营养不良、母亲教育程度、喂养方式和出生顺序。研究结果表明，需要在所有营养诊所对儿童进行贫血筛查，促进教育，消除可持续食物供应和营养丰富食物获取方面的障碍，同时治疗儿童贫血及其他微量营养素缺乏症，并满足难民社区多产次母亲的营养需求。
