NAIROBI, Kenya, July 13 – Children aged between five and 14 years are accounting for a growing share of severe anaemia hospital admissions in Kenya despite a sharp decline in malaria-related cases among children under five, a new study has found.
The 26-year study, led by researchers from the KEMRI-Wellcome Trust Research Programme, tracked more than 84,000 paediatric admissions at Kilifi County Hospital involving children aged between one month and 14 years.
It found that school-aged children accounted for an increasingly larger share of severe anaemia admissions, with their proportion rising from 16.4 percent during the high malaria transmission period between 1998 and 2003 to 44.7 percent during the low malaria transmission era between 2010 and 2024.
Researchers attributed the shift partly to declining malaria prevalence, noting that while malaria remains a leading cause of severe anaemia, other conditions including malnutrition, sickle cell disease, HIV infection and bacterial bloodstream infections are becoming increasingly important contributors.
“The prevalence of severe anaemia remains unacceptably high globally, and progress to meet global targets remains suboptimal. In our setting, the aetiology of severe anaemia is multifactorial, and the burden of severe anaemia has shifted from younger children to older age groups over time,” the researchers said.
Although the prevalence of severe anaemia fell from 34.7 percent in 1998 to 11.1 percent in 2024, the study found that affected children remained at greater risk of death and serious bacterial infections. Hospital mortality among children with severe anaemia stood at 7.8 percent compared to 4.3 percent among those with mild or no anaemia.
The researchers also found stronger links between severe anaemia and invasive bacterial infections caused by organisms such as non-typhoidal Salmonella, Escherichia coli, Haemophilus influenzae and Streptococcus pneumoniae.
Published in The Lancet Global Health, the study calls for health interventions to be expanded beyond children under five to include older school-going children.
Researchers also recommend earlier screening for bacterial infections, prompt antibiotic treatment where appropriate and closer monitoring of high-risk patients to improve survival outcomes.
