Assongba L. auteur aut IRD Boukari O. auteur aut IRD Alao J. M. auteur aut IRD Nouwakpo N. auteur aut IRD Vincent Jeanne Perpétue auteur aut IRD Luty Adrian auteur aut IRD ter Kuile F. O. auteur aut IRD Massougbodji A. auteur aut IRD Hill J. auteur aut IRD Briand Valérie auteur aut IRD Accrombessi M. auteur aut IRD text journalArticle eng text/pdf reformatted digital access 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there is a notable lack of research on its burden and clinical impact, particularly in Benin, where existing data are outdated.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. specialized Prevalence Cross sectional survey Severe anaemia In-hospital mortality Children Benin BENIN 050 15 1 21431 [10 p.] 2025 2045-2322 https://www.documentation.ird.fr/hor/fdi:010094329 10.1038/s41598-025-04298-5 2045-2322 [F B010094329] https://www.documentation.ird.fr/hor/fdi:010094329 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-08/010094329.pdf IRD - Base Horizon / Pleins textes 2025-08-27 2025-08-27 fdi:010094329 fre