Iron status of schoolchildren (6-15 years) and associated factors in rural Nigeria.

BACKGROUND: Schoolchildren are vulnerable to anaemia because of their higher iron need to meet the demands of puberty and adolescence. OBJECTIVE: The survey determined the haemoglobin levels of schoolchildren aged 6-15 years and the factors affecting their haemoglobin status. DESIGN: Data were obtained through a cross sectional survey of 450 randomly selected schoolchildren in Ede-Oballa, Nsukka, Enugu State, Nigeria. Ninety were selected for clinical examination, biochemical tests, and nutrient intake study. Haemoglobin, malaria, and stool analysis were carried out by the cyanmethaemoglobin, thin blood film, and wet mount direct methods, respectively. Iron intake was determined by a three-day weighed food intake. RESULTS: Results showed that the schoolchildren had pallor (35.6%), brittle hair (31.1%), koilonychia (2.2%), oedema (4.4%) and sore/smooth tongue (7.8%). The children also had malaria (58.9%) and Entamoeba histolytica (42.2%), hookworm (36.7%), tapeworm (35.6%), whipworm (34.5%), and roundworm (27.9%) infestations. Iron intake was inadequate (<100% of recommended nutrient intake) for most of the children. The mean haemoglobin levels of the schoolchildren were low. The 6-9, 10-12, and 13-15 year olds had 9.0, 9.1, and 9.3 g/dl, respectively. Most (85.5%) of them had anaemia. Moderate anaemia was prevalent in 62.2%. Severe anaemia affected the 6-9 year olds more. Malaria (P<0.001), Entamoeba histolytica (P<0.01), hookworm (P<0.05), tapeworm (P<0.01), and whipworm (P<0.001) caused significant reduction in haemoglobin level. Age (b=1.284, P<0.05), birth order (b=-0.629, P<0.01), frequency of illness attack (b=-1.372, P<0.01), household size (b=-0.526, P<0.05), and frequency of skipping breakfast (b=-1.542, P<0.001) were factors that influenced the haemoglobin status of the children. CONCLUSION: The schoolchildren had poor iron status as a result of consumption of plant sources of iron with low bioavailability, parasitic infections, birth order, skipping of breakfast, large household size, and frequent bouts of illnesses.