Hematological abnormalities and associated factors among undernourished underfive children attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia

Abstract

ABSTRACT Background: Protein-energy malnutrition is a pathological condition that affects all systems and organs in human bodies. The hematopoietic system is one of the systems which can be affected by malnutrition, leading to impaired production of all blood cell lines in the hematopoietic organs. Undernourished children with hematological abnormalities, like anemia are at higher risk of mortality. Objectives: The aim of this study was to determine the magnitude and associated factors of hematological abnormalities among undernourished under-five children attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia, 2020. Method: An institutional-based cross-sectional study was conducted on a total of 251 undernourished under-five children at University of Gondar Specialized Referral Hospital from January to May 2020. A convenient sampling technique was employed to select study participants. Socio-demographic and clinical characteristics were collected using a structured questionnaires via face-to-face interviews and reviewing medical records respectively. Complete blood count was performed by Sysmex KX-21N hematology analyzer. The stool sample was processed via direct wet mount. Thin and thick blood films were examined to assess the malaria parasite. Data was entered using EpiData version 4.6.0.0 and analyzed using SPSS version 23 software. Bivariable and multivariable binary logistic regression were fitted to identify factors associated with hematological abnormalities. The odds ratio and 95% CI were calculated to assess the strength of the association and P-value<0.05 in the multivariable was considered as statistically significant. Results: The median (IQR) age of the study participant was 19 (10-35) months. Half, 126 (50.2%) of study participants were male. The overall magnitude of anemia, leukocytosis, thrombocytosis, thrombocytopenia and leukopenia were 53.4%, 26.7%, 23.9%, 8% and 2.8% respectively. Male sex, age 6-23 months, high birth order, intestinal parasite infection, edema, not eating vegetables and fruits and paternal occupation (daily laborer) were found to be associated with anemia. Only age of the child was associated with leukocytosis in undernourished under-five children. Conclusion: The current study demonstrated that predominant existence of anemia, leukocytosis and thrombocytosis in undernourished under-five children. Therefore, early diagnosis, monitoring and setting intervention strategies for anemia especially children under two years old are required before further complication occurred. Key words: anemia, leukocytosis, th