Skip to main content

Free Content Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study

Download Article:

You have access to the full text article on a website external to Ingenta Connect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library



In malaria endemic areas anaemia is a usually silent condition that nevertheless places a considerable burden on health services. Cases of severe anaemia often require hospitalization and blood transfusions. The objective of this study was to assess risk factors for admission with anaemia to facilitate the design of anaemia control programmes. We conducted a prospective case–control study of children aged 2–59 months admitted to a district hospital in southern Tanzania. There were 216 cases of severe anaemia [packed cell volume (PCV) < 25%] and 234 age-matched controls (PCV ≥ 25%). Most cases [55.6% (n = 120)] were < 1 year of age. Anaemia was significantly associated with the educational level of parents, type of accommodation, health-seeking behaviour, the child's nutritional status and recent and current medical history. Of these, the single most important factor was Plasmodium falciparum parasitaemia [OR 4.3, 95% confidence interval (CI) 2.9–6.5, P < 0.001]. Multivariate analysis showed that increased recent health expenditure [OR 2.2 (95% CI 1.3–3.9), P = 0.005], malnutrition [OR 2.4 (95%CI 1.3–4.3), P < 0.001], living > 10 km from the hospital [OR 3.0 (95% CI 1.9–4.9), P < 0.001], a history of previous blood transfusion [OR 3.8 (95% CI 1.7–9.1), P < 0.001] and P. falciparum parasitaemia [OR 9.5 (95% CI 4.3–21.3), P < 0.001] were independently related to risk of being admitted with anaemia. These findings are considered in terms of the pathophysiological pathway leading to anaemia. The concentration of anaemia in infants and problems of access to health services and adequate case management underline the need for targeted preventive strategies for anaemia control.

Keywords: Tanzania; anaemia; case–control study; malaria; risk factors

Document Type: Research Article


Affiliations: 1: Unidad de Epidemiologia y Bioestadistica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain 2: Ifakara Health Research and Development Centre, Ifakara, Tanzania.

Publication date: 2002-10-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more