# Clinical and Epidemiological Profile of Nutritional Anemia and Its Impact on Developmental Outcome Among Children Attending Ruhengeri Referral Hospital

## TL;DR

This study examines the causes and effects of nutritional anemia in young children in Rwanda, finding it is strongly linked to developmental delays.

## Contribution

The study identifies key risk factors for iron deficiency and megaloblastic anemia and their impact on child development in a specific regional hospital setting.

## Key findings

- Iron deficiency anemia was significantly more prevalent (93.4%) than megaloblastic anemia (6.6%).
- Nutritional anemia was strongly associated with developmental delay (p < 0.0001).
- Factors like rural residence, meal frequency, and lack of nutritional knowledge were significantly linked to anemia.

## Abstract

Nutritional anemia is a serious health concern that affects particularly children under 5 years of age and causes problems of physical and mental growth and development. A cross-sectional study determined the rates and risk factors of iron deficiency anemia (IDA) and megaloblastic anemia (MA) and assessed the effect of IDA and MA on developmental outcome at Ruhengeri Referral Hospital from April 2021 to March 2022. The Cochran's formula: n=Z2PQ/d2 was used to calculate the sample size of 318 and children aged between 6 and 59 months were purposively selected and included in the study. Venous blood specimens were collected in EDTA and clot activator tubes for complete blood count (CBC) and ferritin, respectively, used Sysmex 500i and Cobas e411 analyzers, respectively. Demographic and clinical information was collected on participants and the data were analyzed by Statistical Package for Social Science (SPSS) Version 20. A p value of less than 0.05 was considered significant at 95% confidence level. Logistic regression analysis and Chi-square test were used to examine the significance of the associations between explanatory and outcome variables. The ratio of male to female participants was 1.7:1 and the age group 12–23 was the most predominant (35.2%). IDA was more prevalent (93.4%) than MA (6.6%). The factors significantly associated with nutritional anemia at 95% confidence level were residence in rural area (OR = 3.896 and CI = 1.504–10.094), number of meal per day (OR = 23.640 and CI = 3.561–156.949), lacking knowledge of nutritional anemia (OR = 3.242 and CI = 1.205–8.723), parity (OR = 0.197 and CI = 0.108–0.360), history of breastfeeding (OR = 0.38 and CI = 0.004–0.904), source of diet (OR = 0.295 and CI = 0.088–0.988), and lack of food supplements (OR = 3.685 and CI = 1.583–8.580). Nutritional anemia was significantly associated with developmental delay (p < 0.0001). Iron deficiency and megaloblastic anemia present a sizeable challenge in the furtherance of primary healthcare outstandingly in young children and are associated with developmental delay. The mothers' education on nutrition and early diagnosis and management of nutritional anemia would reduce the risk of IDA and MA and related morbidity and mortality in the children at risk.