Prevalence of Hypocalcaemia in Term Neonates and the Clinical Characteristics of the Affected Neonates Admitted to the Neonatal Intensive Care Unit at the University Teaching Hospital in Lusaka, Zambia
Keywords:
Anaemia, Prevalence, Risk Factors, Zambia, Africa
Abstract
Anaemia is a public health problem globally affecting 293.1 million children and 28.5% of these children are in the sub Saharan Africa. The aim of this study was to determine the prevalence of anaemia and the associated risk factors of anaemia in children aged 6 months to 15 years admitted to the University Teaching Hospital. There have been no studies done at University Teaching Hospital to establish the burden of anaemia in children. A cross sectional study was conducted from July 2016 to December 2016. 351 children were recruited through convenient sampling methods. Data collection sheet was used to collect socio demographic and anthropometry data. The prevalence, associated risk factors of anaemia, and morphological types of anaemia were determined after blood investigations were done. Data analysis was done using SPSS version 21.0. The association between predictors and outcome variables were measured by using by logistic regression and bivariate analysis. Ethical permission was obtained, consent from parents/guardians was taken and confidentiality was maintained. A total of 351 children were studied. The mean age was 3 years (IOR 2-7 years). 45.9% were females and 54.1% were males (P=0.12). The mean cell volume was 74. 5fL.Malnourised children were 37.9% among those who were anaemic as compared to 33.7% in the non-anaemic group.7.4% children had positive malaria by rapid diagnostic test (RDT). 23.8% had a positive sickling test. The prevalence of anaemia was 161/351 (45.9%). Mild, moderate, severe anaemia was 47/161(29%), 86/161(53%) and 28/161(17%) respectively. The age group 6 months to 5 years was the most affected with 59% mildly, 69.8% moderately and 71.4% severely anaemic. On bivariate analysis malnutrition, HIV, malaria, age and sex were not associated with anaemia and there was no statistical difference. Logistic regression analysis revealed that presence of haemoglobin S was the only risk factor independently strongly associated with Anaemia (CI-0.2-0.7), p value-0.001. Anaemia is a health problem at University Teaching hospital and the under-five age group is the most affected. Predictors of mild, moderate and severe anaemia is sickle cell disease. Therefore, improving on early screening of sickle cell disease and investigating the role of iron deficiency anaemia are some of the strategies to be advocated.References
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2. Wandrup J. Critical Analytical and Clinical Aspects of Ionized Calcium in Neonates. Clinical Chemistry, 1989; 35/10, 2027-2033.
3. Loughead JL, Mimouni F, Tsang RC. Serum ionized calcium concentrations in normal neonates. American Journal Diseases of Childhood, 1988; 142:516.
4. Husain SM, Veligati N, Sims DG, et al. Measurement of ionized calcium concentration in neonates. Archives of Diseases of Childhood, 1993; 69:77.
5. Tsang R, Steichen J.J, Chan G.M. Neonatal Hypocalcaemia; Mechanism of Occurrence and Management. Critical care medicine, 1977; 5; 1; 56-61.
6. Tsang R.C, William O. Neonatal Hypocalcaemia in Low Birth Weight Infants. Paediatrics, 1970; 45; 773.
7. Tsang RC, Chen IW, Friedman MA, Chen I. Neonatal parathyroid function: role of gestational age and postnatal age. J Pediatr 1973;83:728-38.
8. Jain A, Agarwal R, Sankar M. J, Deorari A. K, Vinod K. P. Hypocalcaemia in the Newborn. Indian Journal of Paediatrics, 2008;75 (2): 165-169.
9. Zhou P, Markowitz M. Hypocalcemia in Infants and Children.Pediatrics in Review 2009; 30; 190.
10. Roberton N.R.C, Smith M.A. Early Neonatal Hypocalcaemia. Archives of disease in childhood.1975; 50: 604 – 609.
11. Medical Records, Department of Paediatric and Child Health, University Teaching Hospital, 2013 – 2015.
12. WHO, 2011. Guidelines on neonatal seizures. ISBN 978 92 4 154830 4.
13. Cho W, Yu HW, Chung HR, Yang SW, Choi CW, Kim BI. Clinical and Laboratory Characteristics of neonatal hypocalcaemia. Ann Pediatr Endocrinol Metab. Journal, 2015;20(2):86 – 91.
14. Sankar JM, Agarwal R, Deorari A, Paul VK. Management of Neonatal Seizures. Indian J Pediatr 2010;77:1129-35.
15. Cruikshank DP, Pitkin RM, Reynolds WA, Williams GA, Hargis GK. Effects of Magnesium Sulphate Treatment on Perinatal Calcium Metabolism. 1. Maternal and Fetal Responses. Am J Obstet Gynecol, 1979 Jun 1;134(3):243-9.
16. Bergman L, Kjellmer I, Selstam U. Calcitonin and Parathyroid Hormone – Relation to Early Neonatal Hypocalcaemia in Infants of Diabetic Mothers. Biol Neonate 1974;24:151-160.
17. Kovacs CS, Vitamin D in Pregnancy and Lactation: maternal, fetal, and neonatal outcomes from human and animal studies. The American Journal of Clinical Nutrition,2008;88 (suppl):520S-8S.
18. Shuman R, O’Gorman CS, Sochett EB. Case 1: Neonate with Seizures and Hypocalcaemia. Paediatric Child Health, 2008;13(3): 197 – 200.
Published
2020-03-31
How to Cite
1.
Zyambo K, Sinyangwe S, Chabala C. Prevalence of Hypocalcaemia in Term Neonates and the Clinical Characteristics of the Affected Neonates Admitted to the Neonatal Intensive Care Unit at the University Teaching Hospital in Lusaka, Zambia. Journal of Agricultural and Biomedical Sciences [Internet]. 31Mar.2020 [cited 2Aug.2025];4(1):1-. Available from: https://journals.unza.zm/index.php/JABS/article/view/349
Section
Biomedical Sciences
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