Haematological Profile of Children with Protein Energy Malnutrition at the Paediatric Unit, Federal Medical Centre, Birnin Kebbi, North West Nigeria

This study characterises the haematological profile of children with protein energy malnutrition (PEM) attending the paediatric unit at the Federal Medical Centre, Birnin Kebbi, Kebbi State, North West Nigeria. PEM produces profound haematological derangements through multiple mechanisms including reduced protein synthesis for haemoglobin and clotting factors, micronutrient deficiencies, and increased susceptibility to infections. A cross-sectional study recruited 120 children aged 6 months to 59 months with confirmed PEM classified as marasmus, kwashiorkor, or marasmic-kwashiorkor, alongside 60 well-nourished controls from the same facility. Full blood count, peripheral blood film morphology, serum albumin, ferritin, and C-reactive protein were assessed. Findings revealed anaemia in 85 percent of PEM children, with kwashiorkor cases showing the lowest haemoglobin levels (mean 7.1 g/dL). Normocytic normochromic morphology predominated (52%), reflecting combined nutritional and inflammatory contributions. Leukopenia was observed in 31 percent of kwashiorkor patients. Thrombocytopenia was present in 27 percent of severely malnourished children. Reticulocyte counts were inappropriately low relative to anaemia severity, suggesting suppressed erythropoiesis. The study underscores the haematological consequences of severe malnutrition and recommends integrated nutritional rehabilitation with haematological monitoring, prophylactic iron and micronutrient supplementation during recovery, and malaria co-infection management as components of PEM care protocols at the facility. Keywords: protein energy malnutrition, haematological profile, anaemia, kwashiorkor, Kebbi State.