Assessment of Iron Deficiency Anemia in Children Aged 6–24 Months at the Follow-Up Clinic of Abia State Children's Specialist Hospital, Umuahia, Nigeria: A Cross-Sectional Study

Abstract

Background Iron deficiency anemia (IDA) is a major public health concern among children under two years of age, particularly in developing countries such as Nigeria. During this critical period of growth and brain development, undiagnosed and untreated IDA can lead to long-term cognitive, behavioral, and physical impairments. Timely identification and intervention are therefore essential to improving health outcomes and reducing the burden of childhood anemia. Aim The aim of the study was to assess the prevalence, severity, and associated factors of IDA among children aged 6-24 months attending the follow-up clinic at Abia State Children's Specialist Hospital, Umuahia, Nigeria. Methods This hospital-based cross-sectional study involved 215 systematically selected children aged 6-24 months. Data were collected using structured interviewer-administered questionnaires covering sociodemographics, feeding practices, medical history, caregiver knowledge, and healthcare-seeking behavior. Anthropometric measurements followed WHO guidelines. Hemoglobin concentration, serum ferritin, and C-reactive protein (CRP) levels were measured. IDA was defined as hemoglobin <11.0 g/dL and serum ferritin <12 µg/L, or <30 µg/L with elevated CRP. Data were analyzed using IBM SPSS Statistics for Windows, version 20 (IBM Corp., Armonk, NY), employing chi-square tests, bivariate analysis, and multivariable logistic regression. Statistical significance was set at p<0.05. Results The prevalence of IDA was 13.6%, while the overall anemia prevalence was 37.7%. Among anemic children, 19.1% had mild, 14.0% had moderate, and 4.7% had severe anemia. Microcytic hypochromic anemia accounted for 59.3% of cases. Significant predictors of IDA included low dietary diversity (adjusted odds ratio (AOR)=2.42; 95% confidence interval (CI): 1.17-4.99; p=0.017), maternal education ≤ primary level (AOR=1.98; 95% CI: 1.03-3.79; p=0.041), and household income <₦30,000 (AOR=2.11; 95% CI: 1.09-4.10; p=0.027). Caregiver knowledge was poor in 28.8%, and only 36.7% reported prior use of iron supplements. Conclusion IDA remains a notable concern among children aged 6-24 months in Umuahia, driven by socioeconomic and nutritional factors. Strengthening caregiver education, promoting dietary diversity, and encouraging early screening are essential to reducing the burden of IDA in this vulnerable population.