Socio-emotional and adaptive behaviour in children treated for severe anaemia at Lira Regional Referral Hospital, Uganda: a prospective cohort study

Document Type



Paediatrics and Child Health (East Africa)


Background: Severe anaemia is a global public health challenge commonly associated with morbidity and mortality among children<5 years of age in Sub-Saharan Africa. However, less is known about the behavioural performance of children<5 years surviving severe anaemia in low resource settings. We investigated social-emotional and adaptive behaviour in children<5 years diagnosed with severe anaemia in Northern Uganda.

Methods: We conducted a hospital based prospective cohort study among children 6—42 months who were treated for severe anaemia (n=171) at Lira Regional Referral Hospital, Uganda. Socio-emotional and adaptive behaviour were assessed 14 days post discharge using the Bayley Scales of Infant and Toddler Development, 3rd edition. Age-adjusted z-scores for each domain were calculated using scores from healthy community children (n=88) from the same environment for each age category. Multiple linear regression was used to compare z-scores in the socialemotional and adaptive behaviour scales between the two groups after adjusting for weight-for-age z-score, social economic status, mother’s education, father’s education and father’s employment on all the scales.

Results: Compared with healthy community controls, children with severe anaemia had poorer [adjusted mean scores (standard error)], socio-emotional [−0.29, (0.05) vs. 0.01, (0.08), P=0.002]; but not overall/ composite adaptive behaviour [−0.10, (0.05) vs. −0.01, (0.07), P=0.343]. Within the adaptive behaviour subscales, children with SA displayed signifcantly poorer scores on the community use [adjusted mean score (standard error)], [−0.63, (0.10) vs. −0.01, (0.13), P<0.001]; and leisure [−0.35, (0.07) vs. −0.02, (0.07), P=0.036] skills.

Conclusion: This study suggests that severe anaemia in children<5 years is associated with poor social-emotional scores in the short-term post clinical recovery in Northern Uganda. We recommend long-term follow-up to determine the course of these problems and appropriate interventions to reduce the behavioural burden among children<5 years surviving severe anaemia in Uganda.


This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

BioMed Central

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.