Anemia and delayed nutritional recovery in children with malnutrition in Dakar. Results of a survey in children enrolled in the community nutrition program in Senegal

The objective of this study was to investigate the role of anemia in poor n utritional recovery in 35% of the children with malnutrition enrolled in th e Community Nutrition Program in Dakar, Senegal, during the first six month s after its creation. A cross-sectional design was used to compare a group of 125 children whose growth curves returned to normal (Group I) with a gro up of 200 children who had persistent malnutrition despite nutritional ther apy (Group II). The two groups were similar regarding socioeconomic status, maternal age, age at weaning, and immunization status. Low birth weight wa s more common in Group II than in Group 1 (24.6% vs 7.5%, P < 0.001). Group II children had lower mean values for hematocrit (29 +/- 3 vs 30 +/- 3 in Group I, P < 0.05) and hemoglobin (8.9 +/- 1.8 g/dl vs 9.5 +/- 1.4 g/dl in Group I, P < 0.003). The prevalence of anemia defined as a hemoglobin level of less than 11 g/dl was 89.4% overall, with no difference between the two groups. However, severe anemia (Hb < 7 g/dl) was moro common in group II ( 14.4% vs 4.2%, P < 0.005). Thus, persistent severe anemia may be a major fa ctor in poor nutritional recovery. The main cause of severe anemia was prob ably iron deficiency due to a low birth weight, a high rate of intestinal p arasitic infections (47% of cases), and the malnutrition itself. Severe ane mia should receive adequate attention in nutritional programs.