Anemia

Introduction. The risk of developing transfusion-related complications, especially alloimmunization, is an ongoing concern for transfusion-dependent patients. It is important to determine the rate of alloimmunization and autoimmunization in Al-Ahsa Region, Saudi Arabia, where sickle cell disease (SCD) and thalassemia incidence rates are the highest in Saudi Arabia. Methods. A cross-sectional study was conducted to review the transfusion history of patients with SCD and thalassemia at the King Fahad Hospital (KFH) in Al-Ahsa, Saudi Arabia. 364 transfusion-dependent patients were included in this study. Results. Alloimmunization rates in patients with SCD and thalassemia were 16.7% and 11.97%, respectively, while autoimmunization rates in patients with SCD and thalassemia were 5.3% and 0.7%, respectively. The most frequent alloantibodies among the study participants were against Kell, Rh blood group systems. Conclusion. Blood transfusion-related alloimmunization and autoimmunization compromise the proper management of chronically transfused patients. Ideally, extended matched phenotyping should be implemented to prevent alloimmunization and reduce the risk of developing blood transfusion-related alloantibodies.

Background. Anemia in children is still an important public problem in China and can have a profound impact on the physical and mental health of children. The purpose of this study was to explore the risk factors for anemia among Chinese children aged 3–7 years old and to provide some basis for the prevention and control of anemia. Methods. A matched case-control study was conducted and 1104 children (552 cases and 552 controls) were recruited in this study. Cases were children who were diagnosed with anemia by the doctor of physical examination and checked by one deputy chief physician of pediatrics, and controls were healthy children without anemia. Data were collected using a self-designed structured questionnaire. Univariable and multivariable analyses were used to identify independent determinants of anemia. values less than 0.05 were used to declare statistical significance. Results. In the multivariable analyses, maternal anemia before or during pregnancy and lactation (OR = 2.14, 95% CI: 1.10∼4.15; OR = 2.86, 95% CI: 1.66∼4.94; OR = 2.51, 95% CI: 1.13∼5.60), gestational weeks (OR = 0.72, 95% CI: 0.53∼0.96), having G6PD deficiency or thalassemia (OR = 8.12, 95% CI: 2.00∼33.04; OR = 36.25, 95% CI: 10.40∼126.43), having cold and cough in previous two weeks (OR = 1.56, 95% CI: 1.04∼2.34), family income (OR = 0.80, 95% CI: 0.65∼0.97), and being a picky eater (OR = 1.80, 95% CI: 1.20∼2.71) were determinants of anemia in children aged 3–7 years old. Conclusions. Some of the identified factors are modifiable and could be targeted to reduce childhood anemia. More emphasis should be given by the concerned bodies to intervene in the anemia problem by improving the maternal health education, screening for disease-related anemia, requesting medical services in a timely manner, improving the economic status of households, promoting dietary habits, and improving sanitation and hygiene practices.

Introduction. Identifying the root causes of iron deficiency anaemia is a prerequisite for effective management and prevention in adolescents. This systematic review assessed risk factors of iron deficiency anaemia among adolescents living in developing countries. Method. Electronic databases such as PubMed, Cochrane Library, Science Direct, Google Scholar, and SCOPUS were comprehensively searched for studies published between 1990 and 2020 that involved risk factors of iron deficiency anaemia among adolescents living in developing countries. The quality of the included studies was assessed using the American Dietetic Association Quality Criteria Checklist. Results. A total of 2,252 publications were reviewed, and only fifteen cross-sectional studies were eligible for inclusion, eight of which focused on female adolescents and seven on both genders. Direct risk factors contributing to anaemia among adolescents included food intake practices (n = 10 studies), female adolescents (n = 8 studies), menstruation (n = 5 studies), and parasitic infection (n = 6 studies). Indirect risk factors found to be associated with anaemia among adolescents included low educational status (n = 4 studies) and low socioeconomic status (n = 3 studies). All fifteen studies were of good quality. Conclusion. Food intake practices, female adolescents, menstruation, parasitic infection, and low educational status were the leading risk factors of iron deficiency anaemia among adolescents. Further research should concentrate on assessing the effectiveness and efficacy of existing interventions aimed at preventing iron deficiency among vulnerable groups in developing countries.

Anaemia is a frequent finding in type 2 diabetes, but it is typically seen with established chronic kidney disease and renal insufficiency. Cases, where anaemia predates renal insufficiency, are associated with a worse prognosis for the type 2 diabetes patient and an increased susceptibility to complications. This study aims to determine the prevalence and type of anaemia in persons living with type 2 diabetes without established chronic kidney disease in our environment. The study was a hospital-based cross-sectional study that involved 141 people with known type 2 diabetes as the study group and 140 healthy persons as controls. The study population and the controls were selected using a multistage sampling technique. Data were collected using an interviewer-administered semistructured questionnaire at the Endocrinology clinic, Bowen University Teaching Hospital, Ogbomosho. The data obtained were analyzed using the IBM SPSS version 23.0 ( value ≤0.05 was considered significant). The biochemical (fasting lipids, HBA1C, FBG, serum albumin, creatinine, urea, uric acid, and insulin) and haematological (FBC and red cell indices; PVC, MCV, MCH, MCHC, and RCDW) parameters of the respondents were analyzed using standard methods. The study showed a statistically significant difference in the prevalence of anaemia among subjects, 69.2% as compared to 30.8% of the control group. Normochromic normocytic anaemia was predominant among the subjects, whereas microcytic hypochromic anaemia was the predominant type in the controls. There was no statistically significant difference between MCV and MCHC of both subjects and controls. There was a positive correlation between the incidence of anaemia and the duration of diabetes among the subjects. More people with type 2 diabetes are now living longer, and the addition of haematological parameters should be part of their baseline investigations to aid in the early detection of complications.

Introduction. Globally, anemia among under-five children is a serious public health problem. Even if there are pocket studies here and there, there is limited evidence on the pooled prevalence of anemia among under-five children in Africa. Therefore, the aim of this study was to determine the pooled prevalence and determinants of anemia. Methods and Analysis. This systematic review and meta-analysis was done following the PRISMA guidelines. A comprehensive search was made in PubMed/MEDLINE, Cochrane Library, HINARI, and Ethiopian Journal of Health Development for studies published since 2009. It was supplemented with Google Scholar search. Study selection, data extraction, and quality of studies were assessed by eight reviewers. The Cochrane Q test and I² test statistic were used to test the heterogeneity of studies. A random-effects model of DerSimonian-Laird method was used. Result. A total of 37 articles were included in this systematic review and meta-analysis. The pooled prevalence of anemia among under-five children in Africa was 59% (95% CI: 55, 63). Being female (AOR = 0.71; 95% CI: 0.57, 0.87), maternal education (AOR = 1.47; 95% CI: 1.31, 1.66), residence (AOR = 0.80; 95% CI: 0.67, 0.95), and family size (AOR = 0.93; 95% CI: 0.89, 0.98) were the determinants of anemia among African under-five children. Conclusion and Recommendation. This pooled study revealed that anemia was a severe public health problem. Sex, maternal education, residence, and family size were the determinants of anemia. Therefore, anemia prevention strategy should include sex consideration, educating mothers through youth education, area specific intervention, and encouraging birth spacing.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder and is caused by G6PD gene mutations. To date, more than 400 variants in the G6PD gene have been discovered, and about 160 identified variants are associated with a significant decrease in the G6PD enzyme activity. However, the molecular characterization and epidemiological study of G6PD deficiency are still limited in Vietnam. Therefore, we conducted this study to determine the G6PD variants among the Vietnamese populations and evaluate their correlation to G6PD enzyme activity. A total of 339 patients (302 males and 37 females) were enrolled in this study. The G6PD variants were identified by Sanger sequencing. Our results indicate that males are more severely deficient in G6PD than females. This enzyme activity in males (1.27 ± 1.06 IU/g·Hb) is significantly lower than in females (2.98 ± 1.57 IU/g·Hb) (). The enzyme activity of the heterozygous-homozygous females and heterozygous females-hemizygous males was found to be significantly different (), which is interpreted due to random X-inactivation. For G6PD molecular characteristics, Viangchan (c.871G>A), Canton (c.1376G>T) and Kaiping (c.1388G>A) variants were the most dominant, accounting for 24.48%, 17.70%, and 22.42%, respectively, whereas the highest frequency of complex variants was observed in Viangchan/Silent with 20.35%. In terms of G6PD activity, the Union variant presented the lowest mean value (1.03 IU/g·Hb) compared to the other variants (). Computational analysis using Polyphen-2 tool investigated that all variants were relative to G6PD deficiency and separated the levels as benign and damaged. The result will establish effective methods to screen G6PD variants in Vietnam.