Prevalence of Anaemia and Malnutrition in Children ≤ 5 Years of Age with Different Feeding Habits in Some Conflict Hit Zones of Fako Division in the South West Region of Cameroon: A Cross-Sectional Study on Roles of Nutritional Status
The risk of malnutrition and anaemia in the first 5 years of life is still a severe public health problem. Addressing the influence of complementary feeding practice of mothers on nutritional status of children may be an important approach towards reducing the burden of child malnutrition and other health challenges, such as anaemia. Data on different infant feeding habits and its influence on the growth and health of children under five years are limited. The main objective of this study was to investigate the influence of infant feeding practices on the occurrence of malnutrition, anaemia and haematological profiles. A descriptive cross-sectional study was conducted from August 2016 to August 2018. A total of 1227 children ≤ 5 years of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed by the use of semi-structured questionnaire. Nutritional status was assessed by the use of anthropometric measurements and an auto haematology analyser was used to measure haematological parameters. Anaemia was classified based on the haemoglobin level measured according to WHO standards. The prevalence of exclusive breast feeding was 22.6%, mixed feeding 60.1% and 17.3% of the children were not breastfed at all. The prevalence of malnutrition and anaemia was 32.6% and 77.3% respectively. The prevalence of anaemia was significantly higher (P < 0.001) in children with mixed feeding (80.5%) and was lowest for children who were exclusively breast fed (67.5%). Younger age, single parents, and parents with no formal education were associated with increased odds of anaemia in the children. Exclusive breast feeding should be encouraged in children up to 6 months of age.
References
[1]
Stevens, G.A., Finucane, M.M., De-Regil, L.M., Paciorek, C.J., Flaxman, S.R., Branca, F., et al. (2013) Global, Regional, and National Trends in Haemoglobin Concentration and Prevalence of Total and Severe Anaemia in Children and Pregnant and Non-Pregnant Women for 1995-2011: A Systematic Analysis of Population-Representative Data. The Lancet Global Health, 1, e16-e25. https://doi.org/10.1016/s2214-109x(13)70001-9
[2]
World Health Organization (2015) The Global Prevalence of Anaemia in 2011. WHO.
[3]
McLean, E., Cogswell, M., Egli, I., Wojdyla, D. and de Benoist, B. (2008) Worldwide Prevalence of Anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutrition, 12, 444-454. https://doi.org/10.1017/s1368980008002401
[4]
WHO (2010) Infant and Young Child Feeding. WHO.
[5]
Pasricha, S., Atkinson, S.H., Armitage, A.E., Khandwala, S., Veenemans, J., Cox, S.E., et al. (2014) Expression of the Iron Hormone Hepcidin Distinguishes Different Types of Anemia in African Children. Science Translational Medicine, 6, 235re3. https://doi.org/10.1126/scitranslmed.3008249
[6]
World Health Organization (2000) New Perspectives in Malaria Diagnosis. World Health Organization.
[7]
Kramer, M.S. and Kakuma, R. (2004) The Optimal Duration of Exclusive Breastfeeding. In: Dong, H.D., Rezaei, N., Steinlein, O., et al., Eds., Advances in Experimental Medicine and Biology, Springer, 63-77. https://doi.org/10.1007/978-1-4757-4242-8_7
[8]
WHO (2014) Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene. World Health Organization.
[9]
UNICEF, United Nations Children’s Fund (2025) Sudan: Humanitarian Situation Report No. 28. https://resourcecentre.savethechildren.net/document/sudan-humanitarian-situation-report-no-28
[10]
Sumbele, I.U.N., Kimbi, H.K., Ndamukong-Nyanga, J.L., Nweboh, M., Anchang-Kimbi, J.K., Lum, E., et al. (2015) Malarial Anaemia and Anaemia Severity in Apparently Healthy Primary School Children in Urban and Rural Settings in the Mount Cameroon Area: Cross Sectional Survey. PLOS ONE, 10, e0123549. https://doi.org/10.1371/journal.pone.0123549
[11]
Nyasa, R.B., Zofou, D., Kimbi, H.K., Kum, K.M., Ngu, R.C. and Titanji, V.P.K. (2015) The Current Status of Malaria Epidemiology in Bolifamba, Atypical Cameroonian Rainforest Zone: An Assessment of Intervention Strategies and Seasonal Variations. BMC Public Health, 15, Article No. 1105. https://doi.org/10.1186/s12889-015-2463-1
[12]
Wanji, S., Tanke, T., Atanga, S.N., Ajonina, C., Nicholas, T. and Fontenille, D. (2003) Anopheles Species of the Mount Cameroon Region: Biting Habits, Feeding Behaviour and Entomological Inoculation Rates. Tropical Medicine & International Health, 8, 643-649. https://doi.org/10.1046/j.1365-3156.2003.01070.x
[13]
Ndamukong-Nyanga, J., Kimbi, H., Sumbele, I., Bertek, S., Lafortune, K., Larissa, K., et al. (2015) Comparison of the Partec Cyscope Rapid Diagnostic Test with Light Microscopy for Malaria Diagnosis in Rural Tole, Southwest Cameroon. British Journal of Medicine and Medical Research, 8, 623-633. https://doi.org/10.9734/bjmmr/2015/17927
[14]
WHO (2025) The Global Health Observatory: Child Mortality and Causes of Death 2025. https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/child-mortality-and-causes-of-death
[15]
Kateera, F., Ingabire, C.M., Hakizimana, E., Kalinda, P., Mens, P.F., Grobusch, M.P., et al. (2015) Malaria, Anaemia and Under-Nutrition: Three Frequently Co-Existing Conditions among Preschool Children in Rural Rwanda. Malaria Journal, 14, Article No. 440. https://doi.org/10.1186/s12936-015-0973-z
[16]
World Health Organization (2016) Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 6 (2014-2016).
[17]
Awogbenja, M.D. and Ugwuona, F.U. (2010) Feeding Practices and Nutritional Status of Under-Five Children in Nasarawa State, Nigeria. Polymers for Advanced Technologies, 6, 23-35.
[18]
Grummer-Strawn, L.M., Scanlon, K.S. and Fein, S.B. (2008) Infant Feeding and Feeding Transitions during the First Year of Life. Pediatrics, 122, S36-S42. https://doi.org/10.1542/peds.2008-1315d
[19]
Hendricks, K., Briefel, R., Novak, T. and Ziegler, P. (2006) Maternal and Child Characteristics Associated with Infant and Toddler Feeding Practices. Journal of the American Dietetic Association, 106, 135-148. https://doi.org/10.1016/j.jada.2005.09.035
[20]
Webb, A.L., Sellen, D.W., Ramakrishnan, U. and Martorell, R. (2009) Maternal Years of Schooling but Not Academic Skills Is Independently Associated with Infant-Feeding Practices in a Cohort of Rural Guatemalan Women. Journal of Human Lactation, 25, 297-306. https://doi.org/10.1177/0890334408330449
[21]
WHO/UNICEF (2003) Global Strategy for Infant and Young Child Feeding. WHO Press.
[22]
Sowunmi, A., Fatunmbi, B., Akano, K., Wewe, O.A., Agomo, C., Finomo, F., et al. (2017) Factors Contributing to Anaemia after Uncomplicated Falciparum Malaria in under Five Year-Old Nigerian Children Ten Years Following Adoption of Artemisinin-Based Combination Therapies as First-Line Antimalarials. BMC Infectious Diseases, 17, Article No. 781. https://doi.org/10.1186/s12879-017-2876-9
[23]
Sumbele, I.U.N., Nkuo-Akenji, T., Samje, M., Ndzeidze, T., Ngwa, E.M. and Titanji, V.P.K. (2010) Haematological Changes and Recovery Associated with Treated and Untreated Plasmodium falciparum Infection in Children in the Mount Cameroon Region. Journal of Clinical Medicine Research, 2, 143-151.
[24]
Oliveira, R.S.D., Diniz, A.D.S., Benigna, M.J.C., Miranda-Silva, S.M., Lola, M.M., Gonçalves, M.C., et al. (2002) Magnitude, distribuição espacial e tendência da anemia em pré-escolares da Paraíba. Revista de Saúde Pública, 36, 26-32. https://doi.org/10.1590/s0034-89102002000100005
[25]
Rocha, D.D.S., Lamounier, J.A., Capanema, F.D., Franceschini, S.D.C.C., Norton, R.D.C., Costa, A.B.P., et al. (2008) Estado nutricional e prevalência de anemia em crianças que freqüentam creches em Belo Horizonte, Minas Gerais. RevistaPaulista de Pediatria, 26, 6-13. https://doi.org/10.1590/s0103-05822008000100002
[26]
Tagbo, B. and Ughasoro, M. (2012) Complementary Feeding Pattern of Infants Attaining the University of Nigeria Teaching Hospital, Ituku, Ozalla. Enugu Nigerian Journal of Peadiatrics, 36, 51-59.
[27]
Safari, J.G., Kimambo, S.C. and Lwelamira, J.E. (2013) Feeding Practices and Nutritional Status of Infants in Morogoro Municipality, Tanzania. Tanzania Journal of Health Research, 15, 178-185. https://doi.org/10.4314/thrb.v15i3.5
[28]
UNICEF (2012) Programming Guide, Infant and Young Child Feeding, Nutrition Section, Programmes. UNICEF.
[29]
World Bank (2006) Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action—Overview. Directions in Development. World Bank.
[30]
Zlotkin, S. (2012) More Proof That Home Fortification Is of Value in Children with Iron Deficiency Anemia. Archives of Pediatrics & Adolescent Medicine, 166, 869-870. https://doi.org/10.1001/archpediatrics.20112.1514
[31]
Chantry, C.J., Howard, C.R. and Auinger, P. (2007) Full Breastfeeding Duration and Risk for Iron Deficiency in U.S. Infants. Breastfeeding Medicine, 2, 63-73. https://doi.org/10.1089/bfm.2007.0002
[32]
Casals-Pascual, C., Kai, O., Cheung, J.O.P., Williams, S., Lowe, B., Nyanoti, M., et al. (2006) Suppression of Erythropoiesis in Malarial Anemia Is Associated with Hemozoin in Vitro and in Vivo. Blood, 108, 2569-2577. https://doi.org/10.1182/blood-2006-05-018697
[33]
Wilunda, C., Massawe, S. and Jackson, C. (2013) Determinants of Moderate-to-Severe Anaemia among Women of Reproductive Age in Tanzania: Analysis of Data from the 2010 Tanzania Demographic and Health Survey. Tropical Medicine & International Health, 18, 1488-1497. https://doi.org/10.1111/tmi.12199
[34]
Ngnie-Teta, I., Kuate-Defo, B. and Receveur, O. (2009) Multilevel Modelling of Sociodemographic Predictors of Various Levels of Anaemia among Women in Mali. Public Health Nutrition, 12, 1462-1469. https://doi.org/10.1017/s1368980008004400
[35]
Ghosh, S. (2009) Exploring Socioeconomic Vulnerability of Anaemia among Women in Eastern Indian States. Journal of Biosocial Science, 41, 763-787. https://doi.org/10.1017/s0021932009990149
