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Open AccessArticle

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

Department of Nutrition, University of California, Davis, CA 95616, USA
KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
Helen Keller International, Cameroon, BP 14227 Yaoundé, Cameroon
Centre Pasteur du Cameroun, BP 1274 Yaoundé, Cameroon
Bill & Melinda Gates Foundation, Seattle, WA 98102, USA
Department of Medical Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA 95817, USA
Author to whom correspondence should be addressed.
Affiliation at the time the research was conducted.
Nutrients 2017, 9(7), 693;
Received: 30 April 2017 / Revised: 19 June 2017 / Accepted: 26 June 2017 / Published: 3 July 2017
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. View Full-Text
Keywords: anemia; hemoglobinopathy; iron; children; thalassemia; sickle cell anemia; hemoglobinopathy; iron; children; thalassemia; sickle cell
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Engle-Stone, R.; Williams, T.N.; Nankap, M.; Ndjebayi, A.; Gimou, M.-M.; Oyono, Y.; Tarini, A.; Brown, K.H.; Green, R. Prevalence of Inherited Hemoglobin Disorders and Relationships with Anemia and Micronutrient Status among Children in Yaoundé and Douala, Cameroon. Nutrients 2017, 9, 693.

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