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. 2025 Jul 1;15(1):21431.
doi: 10.1038/s41598-025-04298-5.

Prevalence and clinical impact of severe anaemia in referral hospitals in southern Benin

Landry Assongba  1   2 , Oumou Boukari  3 , Jules Maroufou Alao  4 , Natacha Nouwakpo  5 , Jeanne Perpétue Vincent  6 , Adrian J F Luty  6 , Feiko O Ter Kuile  7 , Achille Massougbodji  3 , Jenny Hill  7 , Valérie Briand  8   9 , Manfred Accrombessi  3
Affiliations

Prevalence and clinical impact of severe anaemia in referral hospitals in southern Benin

Landry Assongba et al. Sci Rep. .

Abstract

Severe anaemia is a critical public health issue worldwide, disproportionately affecting children in Africa, where approximately 40% of children aged 6 to 59 months are impacted. It leads to significant hospital and post-hospital complications. However, there is a notable lack of research on its burden and clinical impact, particularly in Benin, where existing data are outdated. This study aims to assess the prevalence and impact of severe anaemia in two areas of perennial transmission in southern Benin. We conducted a retrospective cross-sectional study at two referral hospitals in Benin, Lagune Mother and Child University Hospital Centre (CHU-MEL) and the Departmental Hospital Centre-Zou (CHD-Z). Sociodemographic, clinical and biological information were extracted from medical records of patients admitted to paediatric ward in 2023, using a standardised questionnaire. Clinical severe anaemia was defined as anaemia with decompensation requiring blood transfusion, and biological severe anaemia as haemoglobin < 5 g/dl. A total of 7152 paediatric hospital records were included in the analysis (CHU-MEL = 4388; CHD-Z = 2764). The median (IQR, range) age was 32 (13-61; 1-228) months. Severe malaria (N = 3653/7152 [51.1%]) and clinical severe anaemia (3586/7152 [50.1%]) were the most common diagnoses with four out of five children (2836/3586 [79.0%]) clinically diagnosed with severe anaemia cases had malaria. In children with severe anaemia, the risk of death decreased slightly with year of age (aOR 0.95, 95% CI 0.92-0.99, p = 0.019). In contrast, severe malnutrition increased the risk of death (aOR 1.80, 95% CI 1.33-2.43, p < 0.001) being significant risk factors. Severe anaemia is a major contributor to paediatric hospital admissions, with severe malaria being a leading cause in these regions. This study highlights the critical need for a comprehensive management strategy for severe anaemia, particularly in the youngest children. An integrated strategy of effective malaria chemoprevention, such as post-discharge malaria chemotherapy combined with targeted nutritional interventions, are essential to mitigate mortality rates in areas with high malaria transmission, where the dual burden of malaria and nutritional deficiencies exacerbates paediatric morbidity and mortality.

Keywords: Benin; Children; Cross sectional survey; In-hospital mortality; Prevalence; Severe anaemia.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent of participants: The study protocol was approved by the Ethics and Research Committee of the Institute of Applied Biomedical Sciences (CER-ISBA, N°191 of 18/12/2023). Data were extracted from the records of previously hospitalised patients, and administrative approval was obtained from the hospital directors. Consent for publication: Not applicable.

Figures

Fig. 1
Fig. 1
Distribution of severe anaemia in the two referral paediatrics hospitals according to age.
Fig. 2
Fig. 2
Co-occurrence matrix for diagnoses of children admitted to paediatric hospitals in 2023.
Fig. 3
Fig. 3
Temporal variation in severe clinical anaemia in paediatrics hospitals in 2023.
Fig. 4
Fig. 4
Clinical outcome of children according to priority diagnoses.
See this image and copyright information in PMC

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