Double burden of malnutrition: Prevalence of anemia among children with severe acute malnutrition in Tharparkar, Pakistan

BACKGROUND: Severe acute malnutrition (SAM) is one of the most critical forms of childhood malnutrition and remains a major contributor to morbidity and mortality in low-resource settings. Anemia frequently coexists with SAM and further compromises child health by increasing susceptibility to infection and delaying recovery. Evidence on the burden of anemia among children with SAM in drought-prone regions of Pakistan remains limited. METHODS: A hospital-based cross-sectional study was conducted from March to June 2024 at the outpatient therapeutic program (OTP) of the district headquarters hospital in Tharparkar, Sindh, Pakistan. Children aged 6–59 months diagnosed with SAM were consecutively enrolled. Hemoglobin concentration was measured to assess anemia, while anthropometric indicators were used to confirm SAM. Descriptive statistics were used to estimate the prevalence and severity of anemia. RESULTS: A total of 129 children with SAM were included. The prevalence of anemia among children with SAM was 90.7% (n = 117; 95% CI: 85.6–95.7). The mean (± SD) hemoglobin level was 9.0 ± 1.4 g/dL. Most anemic children had moderate anemia, indicating a substantial compounded health burden. CONCLUSION: Anemia is highly prevalent among children with severe acute malnutrition in Tharparkar, highlighting the convergence of multiple nutritional deficiencies in this vulnerable population. These findings underscore the need for integrated nutrition and anemia control strategies within SAM management programs, particularly in disaster-prone and underserved regions.