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Nutrients. 2017 Jul 3;9(7). pii: E693. doi: 10.3390/nu9070693.

Prevalence of Inherited Hemoglobin Disorders and Relationships with Anemia and Micronutrient Status among Children in Yaoundé and Douala, Cameroon.

Author information

1
Department of Nutrition, University of California, Davis, CA 95616, USA. renglestone@ucdavis.edu.
2
KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya. tom.williams@imperial.ac.uk.
3
Helen Keller International, Cameroon, BP 14227 Yaoundé, Cameroon. nankapm@gmail.com.
4
Helen Keller International, Cameroon, BP 14227 Yaoundé, Cameroon. andjebayi@hki.org.
5
Centre Pasteur du Cameroun, BP 1274 Yaoundé, Cameroon. oyonoyannick@gmail.com.
6
Centre Pasteur du Cameroun, BP 1274 Yaoundé, Cameroon.
7
Helen Keller International, Cameroon, BP 14227 Yaoundé, Cameroon. khbrown@ucdavis.edu.
8
Department of Nutrition, University of California, Davis, CA 95616, USA. khbrown@ucdavis.edu.
9
Bill & Melinda Gates Foundation, Seattle, WA 98102, USA. khbrown@ucdavis.edu.
10
Department of Medical Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA 95817, USA. ralph.green@ucdmc.ucdavis.edu.

Abstract

Information on the etiology of anemia is necessary to design effective anemia control programs. Our objective was to measure the prevalence of inherited hemoglobin disorders (IHD) in a representative sample of children in urban Cameroon, and examine the relationships between IHD and anemia. In a cluster survey of children 12-59 months of age (n = 291) in Yaoundé and Douala, we assessed hemoglobin (Hb), malaria infection, and plasma indicators of inflammation and micronutrient status. Hb S was detected by HPLC, and α⁺thalassemia (3.7 kb deletions) by PCR. Anemia (Hb < 110 g/L), inflammation, and malaria were present in 45%, 46%, and 8% of children. A total of 13.7% of children had HbAS, 1.6% had HbSS, and 30.6% and 3.1% had heterozygous and homozygous α⁺thalassemia. The prevalence of anemia was greater among HbAS compared to HbAA children (60.3 vs. 42.0%, p = 0.038), although mean Hb concentrations did not differ, p = 0.38). Hb and anemia prevalence did not differ among children with or without single gene deletion α⁺thalassemia. In multi-variable models, anemia was independently predicted by HbAS, HbSS, malaria, iron deficiency (ID; inflammation-adjusted ferritin <12 µg/L), higher C-reactive protein, lower plasma folate, and younger age. Elevated soluble transferrin receptor concentration (>8.3 mg/L) was associated with younger age, malaria, greater mean reticulocyte counts, inflammation, HbSS genotype, and ID. IHD are prevalent but contribute modestly to anemia among children in urban Cameroon.

KEYWORDS:

anemia; children; hemoglobinopathy; iron; sickle cell; thalassemia

PMID:
28671630
PMCID:
PMC5537808
DOI:
10.3390/nu9070693
[Indexed for MEDLINE]
Free PMC Article

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