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Published on: January 19, 2024
Anemia Among Hospitalized Children in a Ghanaian Pediatric Emergency Unit: A Prospective Observational Study of
Serwah Bonsu Asafo-Agyei1,2, Emmanuel Ameyaw1,2, Samuel Blay Nguah1,2
1School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana.
Insights
Anemia is highly prevalent in Ghanaian pediatric emergency units, affecting two-thirds of children. Severe anemia, often linked to iron deficiency, sickle cell disease, and malaria, frequently requires blood transfusions.
Area of Science:
- Pediatric Emergency Medicine
- Hematology
- Global Health
Background:
- Anemia is a significant cause of child illness and death in sub-Saharan Africa.
- Data on anemia in pediatric emergency settings, especially for older children, are scarce.
- This study addresses the knowledge gap in Ghana.
Purpose of the Study:
- To determine the prevalence and factors associated with anemia in children admitted to a pediatric emergency unit in Ghana.
- To describe the hematological characteristics and clinical outcomes of anemic children.
- To inform targeted interventions for anemia in this population.
Main Methods:
- Prospective observational study of 318 children (2 months to 17 years) admitted to a pediatric emergency unit in Kumasi, Ghana.
- Data collected via caregiver interviews and medical records.
- Anemia defined by WHO criteria; logistic regression used to identify associated factors.
Main Results:
- Anemia prevalence was 66.7% among admitted children.
- Moderate anemia was most common, but severe anemia was more frequent in older children.
- Microcytic anemia, suggestive of iron deficiency, was prevalent and associated with sickle cell disease and malaria.
Conclusions:
- Anemia is highly prevalent and severe in Ghanaian pediatric emergency settings, often necessitating blood transfusions.
- Interventions should focus on early detection of hemoglobinopathies, malaria control, and nutritional support.
- Strengthened strategies are needed in pediatric emergency and inpatient care.
Background And Aims:
Anemia remains a major contributor to pediatric morbidity and mortality in sub-Saharan Africa, yet contemporary data from tertiary pediatric emergency settings are limited, particularly among children older than 5 years. This study assessed the prevalence, factors associated with anemia, hematological characteristics, and short-term clinical outcomes among children admitted to a pediatric emergency unit (PEU) in Kumasi, Ghana.
Methods:
This prospective observational study enrolled children aged 2 months to 17 years admitted to the PEU of Komfo Anokye Teaching Hospital, Ghana, between November 2024 and January 2025. Sociodemographic, dietary, and clinical data were obtained through caregiver interviews and medical record review. Anemia was defined and graded using age- and sex-specific World Health Organization hemoglobin thresholds. Red cell indices were used to describe anemia morphology. Logistic regression analysis was employed to identify factors independently associated with anemia.
Results:
Among 318 children enrolled, 66.7% had anemia. Mild, moderate, and severe anemia accounted for 14.8% (47/318), 34.6% (110/318), and 17.3% (55/318) of cases, respectively. Among children aged 6-59 months, 65.3% (113/173) were anemic. Moderate anemia predominated across age groups, while severe anemia was more frequent among older children. Microcytic anemia with elevated red cell distribution width was the most common morphological pattern, suggesting a high burden of iron deficiency. Anemia was independently associated with clinically presumed iron deficiency, sickle cell disease, and malaria rapid diagnostic test positivity. Nearly one-quarter of participants required blood transfusion, reflecting the severity of presentations.
Conclusion:
Anemia was highly prevalent among children admitted to a tertiary pediatric emergency unit in Ghana and was frequently associated with severe disease requiring blood transfusion. Strengthened strategies focusing on early identification of hemoglobinopathies, prompt malaria control, and improved nutritional assessment and counseling are urgently needed within emergency and inpatient pediatric care.
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