Prevalence of Inherited Hemoglobin Disorders and Relationships With Anemia and Micronutrient Status Among Children in Yaoundé and Douala, Cameroon

Nutrients. 2017 Jul 3;9(7):693. doi: 10.3390/nu9070693.

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.

MeSH terms

  • Adolescent
  • Adult
  • Anemia / epidemiology*
  • Anemia / etiology*
  • Anemia / genetics
  • Cameroon / epidemiology
  • Child, Preschool
  • Female
  • Genetic Predisposition to Disease
  • Hemoglobins / genetics
  • Humans
  • Infant
  • Male
  • Micronutrients*
  • Middle Aged
  • Nutritional Status*
  • Prevalence
  • Young Adult
  • alpha-Thalassemia / complications
  • alpha-Thalassemia / genetics*

Substances

  • Hemoglobins
  • Micronutrients