Environmental Enteropathy and Anaemia Status Among Under-Five Children, in Slum Areas of Jimma Town, Ethiopia

Abstract

Background

The most important anemia next to iron deficiency is anemia of inflammation. Micronutrient deficits, such as those in zinc and iron, can be caused by intestinal permeability and gut inflammation brought on by environmental enteric dysfunction. This study was aimed to evaluate the prevalence and association of anemia with Environmental Enteropathy.

Methods

Data on water sanitation and hygiene indicators and sociodemographic characteristics were collected using structured questionnaire. The lactulose to mannitol ratio (L:M) was calculated from the concentration of both sugars in the urine. Level of Hemoglobin was detected by using Hemocue−301 digital photometer. Blood and urine sample was collected from three hundred children aged 12–59 months to determine the status of Anaemia and Environmental Enteropathy respectively.

Results

Data were analyzed by using Descriptive statistics, cross-tabulation, and logistic regression model to indicate prevalence and association of anemia with environmental Enteropathy in children less than five years old. The prevalence of anemia in children with environmental enteropathy was 63.8% (95% CI: 57.6, 71.7), and there was a significant association (p = 0.0001, AOR 3.502, 95% CI: 1.929–6.371) between anemia and environmental enteropathy. In a multivariate analysis, children aged 1–3 years with caretakers who had no or only primary education and with monthly income of less than 3000 ETB were more likely to develop anemia.

Conclusion

The result of this study indicated that two-thirds of children less than five with environmental enteropathy had developed anemia, and there is a significant association between environmental enteropathy and anemia. Even though there are other causes of anemia, based on the findings of this study, more research is needed to identify factors associated with environmental enteropathy to mitigate anemia due to intestinal permeability or malabsorption and its impact in children under the age of five.

Keywords:

• environmental enteropathy
• environmental enteric dysfunction
• inflammation
• lactulose mannitol test
• Anaemia
• WASH
• Malnutrition

Data and Materials Availability

Even though the data is for a Ph.D. project with many objectives, it can be accessed from the corresponding author on reasonable request, depending on the private policy of the journal.

Acknowledgments

The authors acknowledge health extension workers in the selected kebeles and the parents of the study participants, to Bio-Chemical Testing Laboratory Directorate Director and staffs in the laboratory of Ethiopian Conformity Assessment Enterprise in which the urine analysis was done.

Disclosure

The authors declare that they have no conflicts of interest.