Prevalence, morphological characterization, and associated factors of anemia among children below 5 years of age attending St. Mary's Hospital Lacor, Gulu District, Northern Uganda.

Aim/objective: The aim of this study was to determine the prevalence, severity, morphological characterization, and the associated factors of anemia among children under the age of 5 years at St. Mary's Hospital Lacor, Gulu District, Northern Uganda.

Materials and methods: A structured questionnaire was administered to each participant's parent/caregiver to collect data on sociodemographic factors, feeding pattern, and history of chronic illness. Hemoglobin (Hb) estimation was performed using a HemoCue 201+ analyzer. Peripheral thin and thick blood films were made from venous blood and stained with Giemsa to morphologically characterize red blood cells (RBCs) and investigate hemoparasites, respectively. We collected and examined stool specimens from each participant using wet preparations and formol-ether concentration technique for intestinal parasites. Descriptive statistics was used to describe study participants and to determine the prevalence of anemia. Logistic regression analysis was done to determine the factors associated with acquiring anemia at a P -value≤ 0.05.

Results: The study enrolled 343 children below the age of 5 years. Of these, 62.7% (N=215) were females. The IQR, median, and mean Hb levels were 5.1±3.2 g/dL, 8.2 g/dL, and 7.9 g/dL, respectively. Overall, 160 (46.6%, 95% CI: 42.1-51.46) children had anemia. The magnitude of severe, moderate, and mild anemia was 11.9%, 58.8%, and 29.4%, respectively. Morphologic characterization of anemia revealed hypochromic-microcytic (65.4%, N=106), hypochromic-macrocytic (15.4%, N=25), and normochromic-microcytic (19.1%, N=31) anemia. Factors associated with anemia were parasitic infestation, history of chronic disease, lack of complementary foods, complementary feeding for not more than twice a month, and households' with annual income less than 200,000 Ugandan Shillings.

Conclusion: We report the high prevalence of anemia among children below 5 years of age in Gulu District, Northern Uganda. Thus, strategies geared at addressing the etiologic causes (such as, nutrient deficiency and parasitic infections) are key to reduce it in the region.