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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

1
Department of Nutrition, University of California, Davis, CA 95616, USA
2
KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
3
Helen Keller International, Cameroon, BP 14227 Yaoundé, Cameroon
4
Centre Pasteur du Cameroun, BP 1274 Yaoundé, Cameroon
5
Bill & Melinda Gates Foundation, Seattle, WA 98102, USA
6
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.
Deceased.
Nutrients 2017, 9(7), 693; https://doi.org/10.3390/nu9070693
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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