Prevalence of inherited hemoglobin disorders and relationships with anemia and micronutrient status among children in Yaoundé and Douala, Cameroon

Reina Engle-Stone, Thomas N. Williams, Martin Nankap, Alex Ndjebayi, Marie Madeleine Gimou, Yannick Oyono, Ann Tarini, Kenneth H. Brown, Ralph Green

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Article number693
JournalNutrients
Volume9
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Cameroon
Micronutrients
anemia
Anemia
hemoglobin
Hemoglobins
malaria
Malaria
inflammation
thalassemia
Inflammation
Reticulocyte Count
Sickle Hemoglobin
reticulocytes
Thalassemia
etiology
Genotype
High Pressure Liquid Chromatography
Polymerase Chain Reaction
genotype

Keywords

  • Anemia
  • Children
  • Hemoglobinopathy
  • Iron
  • Sickle cell
  • Thalassemia

ASJC Scopus subject areas

  • Food Science

Cite this

Prevalence of inherited hemoglobin disorders and relationships with anemia and micronutrient status among children in Yaoundé and Douala, Cameroon. / Engle-Stone, Reina; Williams, Thomas N.; Nankap, Martin; Ndjebayi, Alex; Gimou, Marie Madeleine; Oyono, Yannick; Tarini, Ann; Brown, Kenneth H.; Green, Ralph.

In: Nutrients, Vol. 9, No. 7, 693, 01.07.2017.

Research output: Contribution to journalArticle

Engle-Stone, Reina ; Williams, Thomas N. ; Nankap, Martin ; Ndjebayi, Alex ; Gimou, Marie Madeleine ; Oyono, Yannick ; Tarini, Ann ; Brown, Kenneth H. ; Green, Ralph. / Prevalence of inherited hemoglobin disorders and relationships with anemia and micronutrient status among children in Yaoundé and Douala, Cameroon. In: Nutrients. 2017 ; Vol. 9, No. 7.
@article{960418577d634108900829b60fd42e27,
title = "Prevalence of inherited hemoglobin disorders and relationships with anemia and micronutrient status among children in Yaound{\'e} and Douala, Cameroon",
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 Yaound{\'e} 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",
author = "Reina Engle-Stone and Williams, {Thomas N.} and Martin Nankap and Alex Ndjebayi and Gimou, {Marie Madeleine} and Yannick Oyono and Ann Tarini and Brown, {Kenneth H.} and Ralph Green",
year = "2017",
month = "7",
day = "1",
doi = "10.3390/nu9070693",
language = "English (US)",
volume = "9",
journal = "Nutrients",
issn = "2072-6643",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "7",

}

TY - JOUR

T1 - Prevalence of inherited hemoglobin disorders and relationships with anemia and micronutrient status among children in Yaoundé and Douala, Cameroon

AU - Engle-Stone, Reina

AU - Williams, Thomas N.

AU - Nankap, Martin

AU - Ndjebayi, Alex

AU - Gimou, Marie Madeleine

AU - Oyono, Yannick

AU - Tarini, Ann

AU - Brown, Kenneth H.

AU - Green, Ralph

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

AB - 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.

KW - Anemia

KW - Children

KW - Hemoglobinopathy

KW - Iron

KW - Sickle cell

KW - Thalassemia

UR - http://www.scopus.com/inward/record.url?scp=85021921238&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021921238&partnerID=8YFLogxK

U2 - 10.3390/nu9070693

DO - 10.3390/nu9070693

M3 - Article

C2 - 28671630

AN - SCOPUS:85021921238

VL - 9

JO - Nutrients

JF - Nutrients

SN - 2072-6643

IS - 7

M1 - 693

ER -