Factors Affecting Ferritin Level in Children of 6 to 59 Months in the Eastern Region of Cameroon

Abstract

Aim: Ferritin reflects total iron storage and is also the first laboratory index to decline with iron deficiency. It may be less accurate in children with infectious or inflammatory conditions as an acute phase reactant. Considering the fact that Cameroonian children live in malaria endemic and high risk hookworm infection area, our objective was to study factors affecting Ferritin level including socio-demographic data, child nutrition, anaemia and inflammatory status. Study Design: A case control study was carried out with anaemic children as cases and non-anaemic as controls. Place and Duration: Paediatric and laboratory units of the Bertoua regional Hospital, from November 2018 to January 2019. Methodology: A case control study was carried out in children of 6 to 59 months attending the Bertoua regional hospital. Data were collected and blood distributed in EDTA and dry tubes for full blood count, C - reactive protein (CRP) and Ferritin analysis. Obtained data were analysed with SPSS 21.0 using Pearson’s Chi Square test. Results: 126 children were included, 63 anaemic (Haemoglobin<11 g/dL) as cases and 63 non anaemic as controls. The Mean age of children was 27.3+/- 15.4 months, the mean haemoglobin was 10.4+/- 1.6 g/dL. Ferritin as state by WHO for the diagnosis of iron deficiency anaemia, was below 30 μg/L in 3.2% independently of anaemic status. Inflammation tested by CRP occurred in 37.3% of children. When the ferritin cut-off value was shifted to 50 μg/L, Ferritin was low in 9.5% thus approaching the stated frequency of iron deficiency obtained recentlyin Cameroon. Mean Ferritin level was 346.5 μg/L. Conclusion:  The relatively high level of Ferritin showed that iron storage seems to remain intact in most children despite anaemic or inflammatory status. The level of Ferritin in children is highly dependent on haem iron consumption and food diversification also has a role to play.