Establishing the Nexus Between Iron Status and Markers of Immune Functions Among School Age Children in Ogun State, Nigeria


  • Quadri J.A Ladoke Aknitola University of Technology, Ogbomoso, Oyo State, Nigeria
  • Onabanjo O.O Ladoke Aknitola University of Technology, Ogbomoso, Oyo State, Nigeria
  • Oladunjoye Z. M Federal University of Agriculture Abeokuta, Ogun State, Nigeria
  • Olusanya A.G Ogun State College of Health Technology, Ilese-Ijebu, Ogun State, Nigeria



Serum Ferittin, Malaria, Packed cell volume, Eosinophills, Anaemia


Iron deficiency as a public health problem is based on the seriousness of its consequences on human health suggesting that certain indices of iron status are associated with anthropometric measures which are used independently as markers of immune functions. This study established the relationship between the iron status, and markers of immune functions among school age children in selected Local Government Areas (LGAs) of Ogun state. A multistage sampling technique was used to select three hundred and twelve school age children from the three senatorial districts of Ogun State, Nigeria. A pre-tested and structured questionnaire was used to obtain information on socio-economic characteristics as well as information on Water, Sanitation and Hygiene (WASH) among the respondents. Blood samples of the children were analyzed for biochemical [serum ferritin (SF), C-reactive protein (CRP), Heamoglobin (Hb), reticulocyte count] parameters. Selected immune function markers [CD4, white blood cell differentials (Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils)] and parasitic infections (stool examination and Malaria screening) were also measured using standard procedures. Data were analyzed using frequency counts, percentages, means, standard deviations, correlation, T-test and Chi-Square. Results showed that 36.5% of the respondent families earned less than two hundred thousand naira annually. Also, 43.0% and 62.0% of the mothers had secondary and tertiary education respectively. WASH practices showed that 61.1% of the respondents did not have a place for handwashing. The study further revealed that the prevalence of iron deficiency was 23.7%, aneamia was 16.3% while 13.1% of the anaemic children were due to  iron deficiency aneamia with significant sector (p=0.003) and gender (p=0.032) differences. Malaria (17.6%) and helmintes (18.3%) infection also showed a significant difference in the sector (p=0.020, p=0.042). The range of CD4 counts, Neutrophils, Lymphocytes, Monocytes, Basophils and Eosinophils were 708.85 to 727.11, 3.31 to 3.88, 3.03 to 4.38, 0.53 to 0.59, 0.03 to 0.04, 0.33 to 0.38 respectively. CRP positively correlated with household size (r= 0.155), Heamoglobin(r= 0.238), serum ferittin (r= 0.101), and PCV (r= 0.103). CD4 also positively correlated with mothers age and education (r= 0.252; r= 0.142) but negatively related to PCV(r= -0.102) while malaria and Household size (r=0.109) also shows a positive relationship. This study concluded that a significant relationship exists between socio economic status, makers of iron status and infections in the children. Hence, appropriate investigations for iron status and inflammation/infection screening, need to be integral in the evaluation of anaemia, and Interventions that target the multifactorial nature of anaemia in school-aged children need to be strengthened.



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Abah, A. E. Temple, B. (2015). Prevalence of Malaria Parasite among Asymptomatic Primary School Children in Angiama Community, Bayelsa State, Nigeria. Tropical Medicine and Surgery 4(1), 203-207

Abebe, Z, Takele, W.W, Anlay, D.Z, et al. (2018). Prevalence of anemia its associated and factors among children in Ethiopia: a protocol for systematic review and meta-analysis. EJIFCC, 29, 138–145.

Achouri I, Aboussaleh Y., Sbaibi R., Ahami A. and El Hioui M, (2015). Prevalence of Iron Deficiency Anaemia Among School Children in Kenitra, Northwest of Morocco. Pakistan Journal of Biological Sciences, 18, 191-195.

Ademowo O.G, Falusi A.G, Mewoyeka O.O (1995). Prevalence of asymptomatic parasitaemia in an urban and rural community in south-western Nigeria. Central Afr. Med., 41, 18–21.

Adeyemo A.A, Olumese P.E, Amodu O.K, Gbadesin R.A (1999). Strengthening health infrastructure: Correlates of hepatomegaly and splenomegaly among healthy school children in malaria-endemic village. Niger. J. Paediatr. 26, 1–3.

Alom, M. T. ., Rahman, M. Z., & Chowdhury, M. R. . (2022). Nature of Physical Growth for 9-11 Years Boys. American Journal of Education and Technology, 1(2), 1–5.

Alavi S, Ahmadi F, Farhadi M. (2009). Correlation between total Lymphocyte count, hemoglobin, Hematocrit and CD4 count in HIV/AIDS patients. Acta MedicaIranica 47, 1–4.

Alexandre M.A.A, Benzecry S.G, Siqueira A.M, Vitor-silva S, Melo G.C (2015). The association between nutritional status and malaria in children from a rural community in the Amazonian Region: A longitudinal study, PLOS Neglected Tropical Diseases 9(4).

Anderson DJ, Sexton DJ, Kanafani ZA (2013). Severe surgical site infection in community hospitals: epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 28, 1047–1053.

Anderson R. M, Truscott J. E, Pullan R. L, Brooker S. J. (2013). Hollingsworth TD. How effective is school-based deworming for the community-wide control of soil-transmitted. helminths? PLoSNegl Trop Dis 7.

Angyo L.A, Pam C.D, Szlachetba R. (1996). Clinical pattern and outcome in children with acute severe plasmodium falciparum malaria at Jos University Teaching Hospital, Nigeria. East African Medical Journal. 73, 823-826.

Ani O.C. (2004). Endemicity of malaria among primary school children in Ebonyi State, Nigeria. Animal research International. 1(3), 155-159.

Armed F, Khan M.R, Jackson A.A. (2012). Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. Am J Clin Nutr. 74, 108-115.

Armed F, Khan M.R, Jackson A.A. (2012). Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. Am J Clin Nutr. 74, 108-115.

Awasthi S, Bundy D.A.P. (2007). Intestinal nematode infection and anaemia in developing countries. British Medical Journal. 334, 1065–1066.

Barduagni P. et al., (2004). Anaemia among schoolchildren in Qena Governorate, Upper Egypt. Eastern Mediterranean Health Journal. 10, 916–920.

Beard J. L. (2001); Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr 131(2), 568S − 80S. 10.1093/jn/131.2.568S.

Benthony J, Brooker S, Albonico M, Geiger S.M, Loukas A. (2006). Soil transmitted helminth infections: Ascariasis, Trichuriasis, and hookworm. Lancets, 367, 1521-1532.

Bielsaski, H.K. and Erhardt J.G. (2007). Diagnosis of Nutritional Anaemia; Laboratory Assessment of Iron Status. In: Kraemer, K. and Zimmermann, M.B. (2007). Nutritional Anaemia Book. SIGHT AND LIFE 2007.Burger Druck, Waldkirch, Germany.Sight and Life Press, Copyright© ISBN 3-906412-33-4.

Brooker S. (2010). Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers – a review. Int J Parasito. 40(10), 1137–1144.

Brugnara, Carlo. (2003). Sickle Cell Disease: From Membrane Pathophysiology to Novel Therapies for Prevention of Erythrocyte Dehydration. Journal of pediatric hematology/oncology. 25, 927-33.

Campbell D.I, Elia M, Lunn P.G. (2003). Growth faltering in rural Gambian infants is associated with impaired small intestinal barrier function, leading to endotoxemia and systemic inflammation. J Nutr. 133, 1332–1338.

Campbell D.I, Murch S.H, Elia M, Sullivan PB, Sanyang MS, et al. (2003). Chronic T cell-mediated enteropathy in rural west African children: relationship with nutritional status and small bowel function. Pediatr Res. 54, 306–311.

Colantonio L.D, Rikki M.T, David G.W, Orlando M.G, Suzanne J. (2012). The role of cystatin-C in the confirmation of reduced glomerular filtration rate among the oldest old. Archives of Medical Science 12(1) 55-67.

Commey J.O, Dekyem P. (1995); Childhood deaths from anaemia in Accra, Ghana. West Afr J Med, 14(2), 101-4.

Cook, J.D. & Reddy, M.B. (2000). Effect of ascorbic acid intake on heme-iron absorption from complete diet. American journal of clinical nutritio. 73(93).

Crompton D.W.T, Stephenson L.S. (2010). Hookworm infection, nutritional status and productivity. In: Schad GA, Warren KS, editors. Hookworm Disease, Current Status and New Directions. London: Taylor and Francis, pp. 231–265.

Custodio E, Miguel A.D, Eduardo V, Laura M., Ignacio S., Magdalena L, Cristina B, Jesus R. (2009). Nutritional and socio-economic factors associated with Plasmodium falciparum infection in children from Equitorial Guinea: results from a nationally representative survey. Malaria Journal. 8(225).

Dinku S.M (2017). Prevalence of Intestinal Parasitic Infections and Associated Risk factors among School children in Adigrat town, Northern Ethiopia. International Journal of Emerging Trends & Technology in Computer Science 04(01), 4943-4948.

Emuchay C, Okeniyi S, Okeniyi J. (2014). ‘Correlation between total lymphocyte count, hemoglobin, hematocrit and CD4 count in HIV patients in Nigeria’. PJBS 4.

Federal Ministry of Health. (2009). Malaria situation analysis document, Federal ministry of health: p.14.

Feleke B.E, Beyene M.B, Feleke T.E, Jember T.H, Abera B. (2016). Intestinal parasitic infection among household contacts of primary cases, a comparative cross-sectional study. PLoS One. 2019 Oct 7, 14(10).

Flemming A.F. (1981). Tropical obstetrics and gynaecology. Anaemia in pregnancy in tropical Africa. Society of Tropical Medicine and Hygiene, 83(4) 441-448.

Ford J. (20003). Red blood cell morphology. Int J Lab Hematol. 35, 351-357.

Foy H, Athena K. (2015). Hookworms in the aetiology of tropical iron deficiency anaemia. Royal society of tropical medicine and hygiene: 54(5), 419-433.

Fuseni G, Dominic E, Bugre G.M, Dave K. (2009). Plasmodium and intestinal helminths distribution among pregnant women in the Kassena–Nankana District of Northern Ghana. Journal of Entomology and Nematology, 1(2), 019-024.

Ghiwot Y, Abraham D, and Berhanu E. (2014). Prevalence of Intestinal Parasitic Infections among Children under Five Years of Age with Emphasis on Schistosoma mansoni in WonjiShoa Sugar Estate, Ethiopia. PLoS One. 9(10), e109793.

Hall, A.. (1998). “The anthropometric status of schoolchildren in five countries in the Partnership for Child Development,” Proceedings of the Nutrition Society, 57(1), 149–158.

Harhay M.O, Horton J, OlliaroP.L.(2010). Epidemiology and control of human gastrointestinal parasites in children. Expert Review of Anti-infective Therapy. pp 8219–234.

Herbert, V., Jayatileke, E., Shaw, S., Rosman, A.S., Giardina, P., Grady, R., Bowman, B. & Gunter, E.W. (1992). Serum ferritin iron, a new test, measures human body stores unconfounded by inflammation. Stemcells, 15, 291.

Hotez PJ, Brooker S, Bethony J.M, Bottazzi M.E, Loukas A, Xiao S. (2009). Hookworm infection. New England Journal of Medicine.351, 799–807

Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrlich Sachs S, Sachs JD. (2006).Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, and malaria. PLoS Medicine, 3, 102. (accessed June 26, 2019).

Hughes, S. M., Amadi, B., Mwiya, M., Nkamba, H., Mulundu, G., Tomkins, A., & Goldblatt, D. (2009). CD4 counts decline despite nutritional recovery in HIV-infected Zambian children with severe malnutrition. Pediatrics, 123(2), e347-e351.

Krivienė, I., & Ragelienė, L. (2006). The prevalence of anemia among schoolchildren in Šiauliai region of Lithuania. Acta Medica Lituanica, 13(1), 56-59.

Jeremiah Z.A, Emmanuel K.U, Essien A.U (2008). Relation of nutritional status, sickle cell trait, glucose-6- phosphate dehydrogenase deficiency, iron deficiency and asymptomatic malaria infection in the Niger Delta, Nigeria. Journal of Medical Sciences, 8(3), 269-274.

Johannessen, A., Naman, E., Ngowi, B. J., Sandvik, L., Matee, M. I., Aglen, H. E., ... & Bruun, J. N. (2008). Predictors of mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania. BMC infectious diseases, 8(1), 1-10.

Johns, T., & Sthapit, B. R. (2004). Biocultural diversity in the sustainability of developing-country food systems. Food and nutrition bulletin, 25(2), 143-155.

Keusch, G. T., Rosenberg, I. H., Denno, D. M., Duggan, C., Guerrant, R. L., Lavery, J. V., ... & Brewer, T. (2013). Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low-and middle-income countries. Food and nutrition bulletin, 34(3), 357-364.

Kimbi H.K, Sumbele I.U, Nweboh M. (2005). Malaria and hematological parameters of pupils at different altitudes along the slope of mount Cameroon: a cross-sectional study. Malar J. 12(1), 193.

Maketa V, Hypolite M.M, Raquel I.L, Josue Z, Joachim L, Albert K, Pascal L, Jean-Perre V. (2015). The relationship between Plasmodium infection, anaemia and nutritional status in asymptomatic children aged under five years living in stable transmission zones in kinshasa, Democratic Republic of Congo. Malaria Journal 14, 83.

Melku, M., Takele, W. W., Anlay, D. Z., Ekubagewargies, D. T., Getaneh, Z., Abebe, M., & Abebe, Z. (2018). Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis. Italian journal of pediatrics, 44(1), 1-11.

Mumtaz, S., Siddiqui, H., & Ashfaq, T. (2009). Frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital in Karachi. J Pak Med Assoc, 87, 32.

Odunukwe N.N, Salako L.A, Okanny C. (2001). Serum ferritin and other hematological measurements in apparently healthy adults with malaria parasitaemia in Lagos, Nigeria. Trop. Med. Int. Health, 5(8), 582-586

Ogunrin A.O. (2001). Cerebral Malaria: A masquerading public health hazard. The resident doctor, 5(1) 35-40.

Okeahialam T.C, Kilama W.E, Ramji B.D (1972): Clinical significance of malaria parasitemia in children. East. African Med. J., 49, 962-969.

Onabanjo O.O, Balogun, O.L (2014). Anthropometric and Iron Status of Adolescents from Selected Secondary Schools in Ogun State, Nigeria. ICAN 6(2)109-118.

Onimawo, L.A, Ukegbu, P.O, Asumugha, V.U, Anyika, J.U, Okudu H, Echendu, C.A. (2010). Assessment of anaemia and iron status of school age children (aged 7–12 years) in rural communities of Abia State, Nigeria. Afr J Food Agric Nutr Dev., 10(5), 2570–86.

Osten V.A, Walker S.R, Storrie A, Widderick M, Moylan P, Robinson G.R and Galea K. (2007). Survey of weed flora and management relative to cropping practices in the north-eastern grain region of Australia. Journal of Experimental Agriculture 47, 57-70.

Paracha P.I, Hameed A, Simon J, Jamil A, Nawab G. (2000). Prevalence of Anaemia in semi urban areas of Peshawar , Pakistan: A challenge for Health Professionals and policy makers. Journal of Pakistan Medicine Association. 47(2), 49-53.

Pittet D, Donaldson L. (2006). Challenging the world: patient safety and health care-associated infection. Int J Qual Health Care. 18, 4–8.

Pittet D. (2006). Improving adherence to hygiene practice: a multidisciplinary approach. Emerg Infect Dis. 7, 234–240.

Rodoo P., Aldrimer M, Ridefelt P, ,Niklasson F, Gustafsson J, et al. (2013). Reference intervals on the Abbot Architect for serum thyroid hormones, lipids and prolactin in healthy children in a population-based study. Scand J Clin Lab Invest 72, 326–332

Ayogu, R. N., Okafor, A. M., & Ene-Obong, H. N. (2015). Iron status of schoolchildren (6–15 years) and associated factors in rural Nigeria. Food & nutrition research, 59(1), 26223.

Sachdev H, Gera T, Nestel P. (2005). Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials. Public Health Nutr 8(2), 117−32. 2

Sana T. G, et al. (2016). Internalization of Pseudomonas aeruginosa strain PAO1 into epithelial cells is promoted by interaction of a T6SS effector with the microtubule network.

Sana T. G, et al. (2016). Internalization of Pseudomonas aeruginosa strain PAO1 into epithelial cells is promoted by interaction of a T6SS effector with the microtubule network. MBio 6(3), e00712. 31.

Sen, S., Vyas, A., Sanghi, S., Shanmuganandan, K., Gupta, R. M., Kapila, B. K., ... & Batra, R. B. (2011). Correlation of CD4+ T cell count with total lymphocyte count, haemoglobin and erythrocyte sedimentation rate levels in human immunodeficiency virus type-1 disease. Medical Journal Armed Forces India, 67(1), 15-20.

Shell-Duncan, B., & McDade, T. (2005). Cultural and environmental barriers to adequate iron intake among northern Kenyan schoolchildren. Food and Nutrition Bulletin, 26(1), 39-48.

Soller, J. A., Schoen, M. E., Bartrand, T., Ravenscroft, J. E., & Ashbolt, N. J. (2010). Estimated human health risks from exposure to recreational waters impacted by human and non-human sources of faecal contamination. Water research, 44(16), 4674-4691.

Spacek, L. A., Griswold, M., Quinn, T. C., & Moore, R. D. (2003). Total lymphocyte count and hemoglobin combined in an algorithm to initiate the use of highly active antiretroviral therapy in resource-limited settings. Aids, 17(9), 1311-1317.

Sukanya, S. L., Sudisha, J., Hariprasad, P., Niranjana, S. R., Prakash, H. S., & Fathima, S. K. (2009). Antimicrobial activity of leaf extracts of Indian medicinal plants against clinical and phytopathogenic bacteria. African journal of biotechnology, 8(23).

Taljaard, C. (2011). Iron status, anthropometric status and cognitive performance of black African school children aged 6–11 years in the Klerksdorp area (Doctoral dissertation, North-West University).

Gwetu, T. P., Chhagan, M. K., Taylor, M., Kauchali, S., & Craib, M. (2017). Anaemia control and the interpretation of biochemical tests for iron status in children. BMC Research Notes, 10(1), 1-9.

Thierfelder, W., Dortschy, R., Hintzpeter, B., Kahl, H., & Scheidt-Nave, C. (2008). Biochemical measures in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) 1. Laboratoriums Medizin, 32(2).

Uzoegwu, P. N., & Onwurah, A. E. (2003). Prevalence of haemoglobinopathy and malaria diseases in the population of old Aguata Division, Anambra State, Nigeria. Biokemistri, 15(2), 57-66.

WHO(2008). Reducing risk , promoting healthy life,1999htm

WHO, (2003). Iron Deficiency Anemia: Assessment, Prevention and Control. A Guide for Programme Managers. World Health Organization, WHO/NHD/01.3.

WHO/UNICEF/UNU. (2001). Iron deficiency anaemia: Assessment, prevention and control. A guide for programme manager.

World Health Organization. (2007). Conclusions and recommendations of the WHO Consultation on prevention and control of iron deficiency in infants and young children in malaria-endemic areas. Food and nutrition bulletin, 28(4 Suppl), S621-S627.

World Health Organization. (2011). Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. 1–6. pdf (accessed May 19, 2019).

World Health Organization. (2018). World Malaria Report. 1–210.

World Health Organization. (2012). World malaria report. Geneva, Switzerland: World Health Organization.

Yip, R., Binkin, N. J., Fleshood, L., & Trowbridge, F. L. (1987). Declining prevalence of anemia among low-income children in the United States. Jama, 258(12), 1619-1623.

Ziegelbauer K, Speich B, Mausezahl D, Bos R, Keiser J, Utzinger J. (2012). Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Med. 9(1), e1001162.

Zuk M, Mckean K.A. (1992). Sex differences in parasite infections: patterns and processes. International Journal of Parasitologyn, 26, 1009-1023.




How to Cite

Quadri, J., Onabanjo , O., Oladunjoye, . Z. M., & Olusanya , A. (2022). Establishing the Nexus Between Iron Status and Markers of Immune Functions Among School Age Children in Ogun State, Nigeria. American Journal of Multidisciplinary Research and Innovation, 1(4), 51–66.