Abstract:
Background: Anaemia remains a major public health challenge among children under five years of age in low-resource settings including Bangladesh. While nutritional deficiencies are widely recognized as primary causes, the contribution of inherited haemoglobin disorders to the overall anaemia burden remains underexplored in Bangladesh, particularly in rural populations.
Objective: To determine the prevalence and pattern of inherited haemoglobin disorders among under-five children in rural northern Bangladesh and to assess their contribution to the overall burden of childhood anaemia.
Methods: A community based cross-sectional study included 428 children aged 6–59 months recruited from 11 upazilas across five northern districts of Bangladesh between July 2018 and June 2021 using a multi-stage community-based sampling approach. Among 263 anaemic children, 154 underwent detailed etiological evaluation including CBC, serum ferritin, zinc levels, and haemoglobin electrophoresis. Statistical analysis included chi-square tests and multivariable logistic regression through SPSS 23 software. Statistical significance was set at p < 0.05 with 95% confidence interval.
Results: The overall prevalence of anaemia was 61.5%. Among anaemic children, iron deficiency accounted for 34.4%, inherited haemoglobin disorders for 32.5%, and zinc deficiency for 24.0%. Inherited haemoglobin disorders accounted for 32.5% of anaemia cases, comparable to iron deficiency (34.4%). Estimated population prevalence was 19.8%. HbE-related disorders predominated (66%). Parental consanguinity was strongly associated (aOR 13.9; 95% CI: 5.8–33.4; p < 0.001).
Conclusion: Inherited haemoglobin disorders represent a major and under recognized contributor to childhood anaemia. Current anaemia control strategies’ focusing predominantly on nutritional interventions is insufficient. Integration of early genetic screening, mass awareness, and community genetic counseling into national child health programmes is essential to achieve sustainable reduction of childhood anaemia in Bangladesh.
Keywords: Anaemia; Thalassemia; Hemoglobin E; Hemoglobinopathies; Inherited Hemoglobin disorder; Under-five children; Bangladesh; Public health
