Anaemia as seen in children admitted to the paediatric observation ward of the Kenyatta National Hospital

Abstract

In this prospective study, the pattern of anaemia seen in children admitted to the paediatric observation ward (POW) of Kenyatta National Hospital was investigated, between November,1979 and March, 1980. There were 294 (7.3%) documented cases of anaemia out of a total of 4,044 admissions to the POW. Of these 75% had come to the hospital primarily with some other disease problem, and clinical presentation varied according to the underlying condition. Luos and Luyias formed 75.5% of all the patients; half of these resided in Nairobi and the rest came from their indigenous areas in Western Kenya. Basically all children belonged to the low social-income group. Children under 3 years of age were the most affected and formed 62.4% of the series. The main causes of anaemia ia the series were haemolysis from malaria and/or sickle cell anaemia (30.2%) and iron deficiency of nutri tior..alorigin (26.2%). Both haemolysis and iron deficiency accounted for 12.2% of the cases. Hookworm infestation played a significant role in aggravating iron deficiency, especially in older children. Megaloblastic anaemia was seen infrequently and was also nutritional in origin. Other causes of anaemia included bone marrow failure from various causes, and bleeding tendencies, mainly from primary bleeding diatheses. Many cases were undiagnosed because of problems involving every sector of attending staff. Management of the patients with severe anaemia was essentially the same, i.e. transfusion and discharge. The problems encountered, and the implications of the present form of patient care of anaemic "children in POW are discussed. Recommendations are made regarding areas where improvement can be made to effect better patient care.