- INTRODUCTION
- MATERIALS AND METHODS
- Study area and population.
- Bed net study design.
- Participant recruitment and study design.
- Household characteristics.
- Clinical data.
- Laboratory methods.
- Data analyses.
- Anemia.
- Microcytic anemia.
- Malaria.
- Nutritional parameters.
- Upper gastrointestinal problem.
- Hookworm infection.
- Vaccination.
- Ethical clearance and informed consent.
- RESULTS
- DISCUSSION
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1
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Lengeler C, 2000. Insecticide-treated bednets and curtains for preventing malaria. Cochrane Database Syst Rev: CD000363.
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ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):68–77.
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ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kolczak MS, Kariuki SK, Shi YP, Kwena AM, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria and all cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: cross-sectional survey. Am J Trop Med Hyg 68 (Suppl 4):100–107.
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Phillips-Howard PA, ter Kuile FO, Nahlen BL, Alaii JA, Gimnig JE, Kolczak MS, Terlouw DJ, Kariuki SK, Shi YP, Kachur SP, Hightower AW, Vulule JM, Hawley WA, 2003. The efficacy of permethrin-treated bed nets on child mortality and morbidity in western Kenya II. Study design and methods. Am J Trop Med Hyg 68 (Suppl 4):10–15.
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FACTORS ASSOCIATED WITH HEMOGLOBIN CONCENTRATIONS IN PRE-SCHOOL CHILDREN IN WESTERN KENYA: CROSS-SECTIONAL STUDIES
MEGHNA R. DESAI
MEGHNA R. DESAI
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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DIANNE J. TERLOUW
DIANNE J. TERLOUW
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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ARTHUR M. KWENA
ARTHUR M. KWENA
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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PENELOPE A. PHILLIPS-HOWARD
PENELOPE A. PHILLIPS-HOWARD
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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SIMON K. KARIUKI
SIMON K. KARIUKI
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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KATHLEEN A. WANNEMUEHLER
KATHLEEN A. WANNEMUEHLER
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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AMOS ODHACHA
AMOS ODHACHA
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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WILLIAM A. HAWLEY
WILLIAM A. HAWLEY
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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YA PING SHI
YA PING SHI
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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BERNARD L. NAHLEN
BERNARD L. NAHLEN
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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FEIKO O. TER KUILE
FEIKO O. TER KUILE
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Biochemistry, Faculty of Health Sciences, Moi University, Eldoret, Kenya; Office of Preventive Health, Kenyan Ministry of Health, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland
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In sub-Saharan Africa, the etiology of anemia in early childhood is complex and multifactorial. Three community-based cross-sectional surveys were used to determine the prevalence and severity of anemia. Regression methods were used to compare mean hemoglobin (Hb) concentrations across covariate levels to identify children at risk of low Hb levels in an area with intense malaria transmission. In a random sample of 2,774 children < 36 months old, the prevalence of anemia (Hb < 11g/dL) was 76.1% and 71%, respectively, in villages without and with insecticide-treated bed nets (ITNs); severe-moderate anemia (Hb < 7 g/dL) was observed in 11% (non-ITN) and 8.3% (ITN). The prevalence of anemia, high-density malaria parasitemia (21.7%), microcytosis (34.9%), underweight (21.9%), and diarrhea (54.8%) increased rapidly from age three months onwards and remained high until 35 months of age. Multivariate analyses showed that family size, history of fever, pale body, general body weakness, diarrhea, soil-eating, concurrent fever, stunting, and malaria parasitemia were associated with mean Hb levels. Prevention of severe anemia should start early in infancy and include a combination of micronutrient supplementation, malaria control, and possibly interventions against diarrheal illness.
Author Notes
- INTRODUCTION
- MATERIALS AND METHODS
- Study area and population.
- Bed net study design.
- Participant recruitment and study design.
- Household characteristics.
- Clinical data.
- Laboratory methods.
- Data analyses.
- Anemia.
- Microcytic anemia.
- Malaria.
- Nutritional parameters.
- Upper gastrointestinal problem.
- Hookworm infection.
- Vaccination.
- Ethical clearance and informed consent.
- RESULTS
- DISCUSSION
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EndNote
-
1
DeMaeyer E, Adiels-Tegman M, 1985. The prevalence of anaemia in the world. World Health Stat Q 38 :302–316.
-
2
Bain BJ, 1997. The haematological features of HIV infection. Br J Haematol 99 :1–8.
-
3
van Eijk AM, Ayisi JG, ter Kuile FO, Misore A, Otieno JA, Kolczak MS, Kager PA, Steketee RW, Nahlen BL, 2002. Malaria and human immunodeficiency virus infection as risk factors for anemia in infants in Kisumu, western Kenya. Am J Trop Med Hyg 67 :44–53.
-
4
Lengeler C, 2000. Insecticide-treated bednets and curtains for preventing malaria. Cochrane Database Syst Rev: CD000363.
-
5
ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):68–77.
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