Magnitude Of Anemia And Associated Factors Among Children With Acyanotic Cardiac Disease Admitted To Pediatrics Ward Of Ambo University Referral Hospital, 2025

Abstract

Background: Anemia is a condition in which the number of red blood cells or the hemoglobin concentration within them is lower than normal. Congenital heart diseases (CHDs) pose a significant global public health concern, affecting approximately 1 in 100 live births. Acyanotic cardiac diseases are frequently linked to anemia, with notably high prevalence rate. Anemia in these children detrimentally affects their growth, cognitive development, and overall health. Moreover, anemia escalates healthcare expenses and raises the likelihood of complications such as prolonged hospital stays and postponed surgeries. Despite its great public health importance, there is lack of evidence regarding the magnitude of anemia among children with acyanotic cardiac disease admitted to Ambo University Referral Hospital. Objective: To determine the magnitude of anemia and associated factors among children under fifteen admitted to Ambo University Referral Hospital with acyanotic cardiac disease from January 1/2021, to December 31/2024. Method: Institution-based cross-sectional study design was employed among 312 medical records of children under 15 years old admitted to Ambo University Referral Hospital (AURH) in the past four years from January 1/2021 to December 31/2024. The data collection period was from May 03-17/2025. Before commencing data collection, a structured data extraction checklist was prepared after reviewing the variables recorded on the patient chart in the AURH. The checklist included sociodemographic data, clinical diagnosis, laboratory findings, and treatment history relevant to anemia and acyanotic congenital heart disease. Data were entered into Kobo Toolbox and analyzed by SPSS version 26 software. Descriptive Statistics were used to show the prevalence of anemia. Hosmer- Lemeshow and variance inflation factor (VIF) were used to test the model's fitness and multicollinearity, respectively. Both bi-variable and multivariable binary logistic regression analyses were conducted to identify factors associated with anemia. Variables with a p-value <0.25 in the bi-variable analysis were included in the multivariable model. The strength of association was interpreted using Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI). A p-value of <0.05 was considered statistically significant. Results: A total of 284 records were reviewed in the study with a response rate of 91%. This study found that the overall magnitude of anemia was 99(34.9%), (95%CI=29.2%-40.5%). Having recurrent infection (AOR=4.25; 95%CI=1.40-12.89), comorbidity during admission (AOR=4.04; 95%CI=1.15-14.13), Malnutrition (AOR=1.73; 95% CI=1.02-2.93), and renal dysfunction (AOR=1.96, 95%CI=1.06-3.62) were positively and significantly associated with Anemia among children admitted with acyanotic Cardiac Disease. Conclusion: This study shows that almost one-third of children admitted with acyanotic cardiac diseases had anemia. The factors statistically significantly associated with the anemia include having recurrent infection, comorbidity during admission, malnutrition, and renal dysfunction were factors associated with anemia. We recommend screening and treating VII anemia, management of comorbidity, nutritional counseling and renal function monitoring in children with acyanotic cardiac diseases as routine care for these populations to avert the preventable factors.