High Levels of Iron Deficiency Anaemia (IDA) and Stunting by 6-11 Months of Age in Northern Zambia: Evidence of the Need for Early-Life Intervention Scale-Up

Abstract

Objectives: Anaemia and stunting are widespread in Zambia with developmental implications from the individual to the national level. To address these conditions, an integrated Home Fortification with Micronutrient Powders (MNP) and Infant and Young Child Feeding (IYCF) programme has been introduced in Mbala district, Northern Province, Zambia. Here we present key findings from a baseline survey conducted to inform the project and investigate relationships among morbidity, biochemical and anthropometrics in children 6-11 months. Methods: A convenience sample of 631 child-caregiver pairs was recruited from health centres and outposts in Mbala District. We collected demographic, health, biochemical and anthropometric data. Children with severe anaemia or severe acute malnutrition were excluded and referred for treatment. Results: Stunting was 30% and 57% of the children were anaemic (haemoglobin <110 g/L), 42% were iron deficient (serum ferritin <30 µg/L) and 22% had IDA. Children with fever in the previous two weeks had higher rates of anaemia (65% versus 49%, p <0.001) and lower mean haemoglobin (104 g/L versus 107 g/L; p =0.005). 5% were Vitamin A deficient based on retinol binding protein <0.7 µmol/L. Furthermore, 74% of children had signs of inflammation (C-reactive protein >5mg/L and/or alpha-1-glycoprotein >1 g/L). Conclusions: The high rates of anaemia, stunting, and inflammation all indicate a high burden of disease and/or malnutrition among these young children. Children with recent fever were more likely to be anaemic which might have implications for physical and cognitive development. Interventions must target early life to prevent irreversible consequences.