ABSTRACT

Anemia in children is defined by the World Health Organization as a hemoglobin concentration below 11 g/dl for children (0.5 - 5.0 yrs) and 12 g/dl for teens (12 - 15 yrs). 4 ml of venous blood sample was collected in EDTA container. Of the total of three hundred and thirty four (334) subjects, one hundred and fifty two (152) were Females and one hundred and eighty two (182) were Males. Intestinal parasite assessment was done by Direct Smear technique and Formol-Ether concentration methods. Hemoglobin concentration was analyzed using Cyanmethaemoglobin method. Thirty (30) subjects were infested with Ascaris lumbricoides (single infestation), Ninety Five (95) subjects were infested with Ascaris lumbricoides and Hookworm (Double infestation) and Forty Two (42) subjects were infested with Ascaris lumbricoides, Hookworm, Entamoeba histolytica and Trichuris trichiura (Multiple infestation). The Mean ± Standard Deviation of Hemoglobin concentration of the various infestation types against the control subject shows a statistically significant decrease (P < 0.05). Our data confirm that intestinal parasites are associated with anemia irrespective of gender and age in children.

1. INTRODUCTION

It is estimated globally that about 3.5 billion people are infested with intestinal parasite and that 450 million are ill as a result of these infection, the majority being children [1]. These infestations are regarded as a serious health problem, due to its iron deficiency capability, growth retardation in children and other physical and mental health problems. Parasitosis is a major health problem in Nigeria with 50% prevalence among urban dwellers and 68% prevalence among rural population [2,3].

Anemia in children is defined by the World Health Organization as a hemoglobin concentration below 11 g/dl for children (0.5 - 5.0 yrs) and 12 g/dl for teens (12 - 15 yrs) [4]. It can denote decreased oxygen binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some types of hemoglobin deficiency [5]. Chronic anemia is associated with behavioral disturbance in children as a result of impaired neurological development in infants and reduced scholastic performance in children of school age. Restless legs syndrome is more common in those with iron deficiency anemia, common symptoms include swelling of the legs or arms, chronic heartburn, vague bruises, vomiting, increased sweating, pallor and blood in stool. The most common cause of microcytic anemia is parasitic infestations, while the most common cause of macrocyte anemia is due to deficiency of vitamin B₁₂ or folate either due to inadequate intake or malabsorption from the gastro intestinal tract as a result of intestinal parasitosis [6].

This study is aim at understanding the causes of alterations in Hemoglobin concentration in intestinal parasites infested children.

2. MATERIALS AND METHODS

Study Area: The study was carried out in the College of Health Science, Department of Hematology, Igbinedion University, Okada. Ethical approval was obtained from the IUO ethic committee and informed consent from the parents of the children.

Sample Size: The sample size was obtained using this formula [7]

where:

N = Minimum sample size D = desired level of significance (0.05)

Z = Confidence interval (1.96)

P = Prevalence rate (68%) [3].

Using this formula, the minimum number of sample will be 334 children.

Inclusion Criteria: The inclusion criteria was young children within the age range of 0 - 15 years with no history of any major illness and have not taken a drugs in recent past (2 or 3 weeks before).

Exclusion Criteria: The exclusion criteria were subject above 15 years and a history of an underlying illness.

Duration of Study: This study was carried out between March 2010 to March 2011.

Limitation of the Study: Subject compliance to samples collection was the limitation to this study.

2.1. Sample Collection and Processing

The subjects consist of 334 children which comprises of 152 females and 182 males. The subjects were further divided into two groups. Group one consist of 167 children infested with intestinal parasite confirmed to be positive with Direct smear technique and Formol-Ether concentration method described earlier [8], while Group two consist of 167 children apparently healthy control subjects and faecal samples were confirmed to be negative using the Formol-Ether concentration methods.

2.2. Blood Sample Processing

Sample Preparation and test performance for Hemoglobin concentrations were done using the Cyanmethemoglobin method described by [9]. 20 Microliter of blood was diluted in a 5 ml buffered solution of Potassium Cyanide to yield the stable hemoglobin derivative cyanmethemoglobin. The Potassium Ferricyanide converts the Hemoglobin to Methemoglobin by the action of Potassium Cyanide. This must be allowed to stand for at least three minutes, to allow for complete conversion of Hemoglobin to Cyanmethemoglobin, before the absorbance is measured against a reagents blank at a wavelength of 540 mm using a Spectrophotometer.

2.3. Statistical Analysis

Data were collected using self administered semi-structured questionnaire. All numerical results were collated from the groups. Data were presented as mean ± standard deviation (S.D) and analyzed using one way analysis of variance (ANOVA) Using SPSS version 18.0, P < 0.05 were considered significant.

3. RESULTS

Table 1: shows that of Three Hundred and Thirty (334) subjects, One Hundred and Fifty Two (152) were Females and One Hundred and Eighty Two (182) were Males.

Table 2: shows that Thirty (30) subjects were infested with Ascaris lumbricoides (single infestation),Ninety Five (95) subjects were infested with Ascaris lumbricoides and Hookworm (Double infestation) and Forty Two (42) subjects were infested with Ascaris lumbricoides, Hookworm, Entamoeba histolytica and Trichuris trichiura (Multiple infestation).