The prevalence and risk factors of anaemia and nutritional status of children aged 6 - 59 months in Kakuma refugee camp, Turkana district, Kenya

Abstract

Anaemia is one of the most prevalent micronutrient deficiency disorders of major public health concern in Kakuma refugee camp. Little or no efforts have been made to identify the associated risk factors and their relative importance and interactions with the prevalence of anaemia. A cross-sectional study was conducted to determine the risk factors associated with the occurrence of anaemia and the type of relationships between the identified factors and anaemia. The population ofKakuma Refugee Camp is heterogeneous in composition comprising of more than ten nationalities. A total of300 children aged 6-59 months were selected for the study using a combination of proportionate allocation of stratified sampling and systematic random sampling. The number of children aged 6-59 months selected from each nationality was as follows: Sudanese (181), Somali Bantu (70), Somali (33) and other minorities (16). The haemocue technique was used to determine the anaemia status of the children, from whom capillary whole blood was drawn. A pre-tested and structured questionnaire was administered to obtain household demographic and socio-economic characteristics. Anthropometries measurements, data on morbidity and food consumption habits of the children were also collected. The overall prevalence of anaemia was 93.0% with the following severity ranges; 1.0% of very severe «4 g/dl), 28.3% severe (4.0-6.9 g/dl), 52.7% moderate (7.0-10.0 g/dl) and 11.0% (l 0.1-10.9 g/dl) mild cases. The following factors were significantly (p < 0.05) associated with anaemia by linear regression: age, birth weight, weight, mid-up per-arm circumference, duration of exclusive breast-feeding, age of introducing complementary foods, stunting and under weight. Using the logistic regression the following factors were significantly (p < 0.05) associated with anaemia: ethnicity of household head, mothers and fathers education, fathers occupation, accessibility to therapeutic feeding program and iron supplement, having a current episode (within 2 weeks) of malaria and diarrhoea and tea consumption. In conclusion, supply of food ration, duration of exclusive breastfeeding, underweight, birth weight, stunting and consumption of tea are the most predictors and, hence, determinants of iron deficiency for the under-five year old child population living in the refugee camp. To reduce the prevalence of anaemia in the area, a holistic approach is required. To achieve this, the study recommends: a review of the policy in minimum standards guiding food rations; adoption of improving the general ration, both in quantity and quality, to the refugee community; initiation of nutrition education programmes at community level aimed at improving child feeding practices, vegetable gardening, and meal preparation; public health measures to control malaria and diarrhoeal disease such as sanitation, hygiene, treatment and use of mosquito nets and strengthening of the existing selective feeding (therapeutic feeding programme and supplementary feeding programme) programmes as some of the possible ways of managing the problem.