Anemia最新文献

Sickle cell disease (SCD) is a major public health concern in Africa. SCD healthcare expenses are covered by personal finances in the Congo due to the absence of universal public health insurance. Various strategies have been implemented to minimize this economic burden, including an outpatient management strategy. The present study evaluated the costs associated with outpatient management of uncomplicated sickle cell crises. Patients presenting to the National Sickle Cell Center's emergency room between December 2023 and February 2024 were included in this study for a total of 114 subjects with uncomplicated crises from SCD. Chief complaint, diagnosis, treatment, health insurance coverage, and cost of care were recorded for each subject. We further assessed the consistency of treatment with published standards of care. Mean patient age was 16 ± 13 years, where more than one-third were adults (36.5%). The ratio of males to females was 1.09. Only 26.2% were employed. Monthly income was lower in individuals with SCD ($310.32 ± 120.93) compared to those without SCD ($386.92 ± 471). Managing uncomplicated SCD as an outpatient costs an average of $99.86 ± 49, where medications represented 55.7% of the total expense. Sixty-six patients (57%) received prescription medications and investigation with no rational basis, resulting in an inflated cost of $15.96 per person. The present study did not demonstrate any financial benefits to managing uncomplicated SCD in outpatient settings.

Introduction: Thalassemia trait generally has minimal clinical impact, but physiologic changes during pregnancy may increase the risk of anemia, transfusion requirements, and hypertensive disorders. Existing evidence on pregnancy outcomes in this population is limited, with some conflicting data. This study aims to evaluate pregnancy-related outcomes in patients with thalassemia trait using a large, multicenter database.

Methods: For this retrospective cohort study, we used data from the TriNetX US Collaborative Network. Females aged 18-45 with ICD-10 codes indicating pregnancy (Z33.1, O00-O9A, Z34, or Z3A) were included. Patients with pregnancy and coexisting thalassemia trait (D56.3) were assigned to the thalassemia cohort (n = 22,913), while those without any thalassemia diagnosis comprised the nonthalassemia cohort (n = 5,611,147). Propensity score matching was performed to balance age, race/ethnicity, obesity, smoking status, essential hypertension, and Type 2 diabetes mellitus. After 1:1 matching, 22,770 patients remained in each cohort (total N = 45,540). Outcomes were assessed within 1 year of the index date, including anemia during pregnancy, blood transfusion, preeclampsia/eclampsia, cesarean delivery, venous thromboembolism (VTE), heart failure/cardiomyopathy, preterm delivery, intrauterine growth restriction (IUGR), and intrauterine fetal demise (IUFD). Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.

Results: Thalassemia trait was associated with higher risks of anemia during pregnancy (RR: 3.00 and 95% CI: 2.87-3.13), needing blood transfusion (RR: 1.90 and 95% CI: 1.69-2.20), preeclampsia/eclampsia (RR: 1.54 and 95% CI: 1.47-1.61), cesarean delivery (RR: 1.43 and 95% CI: 1.36-1.51), preterm delivery < 37 weeks (RR: 1.40 and 95% CI: 1.31-1.65), and IUGR (RR: 1.96 and 95% CI: 1.72-2.23), all were statistically significant with a p < 0.001. Increased risk was also observed for VTE (RR: 1.57 and 95% CI: 1.12-2.20, p < 0.001) and IUFD (RR: 1.37 and 95% CI: 1.087-1.75, p < 0.001). No significant association was found with heart failure/cardiomyopathy (RR: 1.28 and 95% CI: 0.93-1.76, p = 0.124).

Conclusion: Thalassemia trait in pregnancy was associated with increased rates of anemia, transfusion, and adverse maternal and fetal outcomes. Such adverse outcomes include pre-eclampsia/eclampsia, cesarean delivery, preterm birth and IUGR. These findings underscore the need for tailored peripartum care strategies in this high-risk population.

Iron deficiency anemia among children with moderate acute malnutrition (MAM) presents a significant challenge that can negatively impact treatment outcomes. This burden and its contributing factors among children with MAM in Tanzania prompted the current study, which aimed to assess the efficacy of ready-to-use food (RUF) supplements in increasing hemoglobin levels specifically among children with MAM aged 6-59 months. A total of 271 children (RUF: 91; CSB+: 90; standard of care: 90) recruited for the study, and the randomized controlled trial employed a three-parallel-arm design; the first arm received corn soy blend plus (CSB+) with infant and young child feeding (IYCF) counseling, the second arm received RUF and IYCF counseling, and the third arm served as a control group. The intervention was administered over 3 months, following the WHO guidelines for intervention studies. Results indicated a mean increase of 2.70 g/dL in mean hemoglobin (Hb) concentration (at p ≤ 0.01) among the RUF intervention arm. Similarly, the CSB arm showed an increase in mean Hb concentration from 9.88 g/dL to 11.88 g/dL (p ≤ 0.01). In contrast, the standard of care arm experienced a decrease in mean Hb levels by 0.25 g/dL (p  >  0.05) at the end line. Additionally, the prevalence of anemia was significantly reduced from 65.90% to 27.20% at baseline and at the end of the study, respectively, with a notably lower prevalence of 14.3% in the RUF arm as compared to the standard of care arm of 44%. The study provides strong evidence that RUF is efficacious in improving Hb concentration, a key biomarker for nutritional anemia among children with MAM, and successfully reduces the prevalence of anemia.

Anemia is a global public health concern, affecting approximately one-quarter (24.8%) of the global population, with adolescent girls and women being particularly vulnerable to iron deficiency anemia (IDA) and malnutrition. This study aimed to assess the prevalence of IDA among schoolgirls aged 10-17 in Southern Jordan and identify the associated factors. In this cross-sectional school-based study, participants completed a questionnaire that collected demographic data, while laboratory tests were conducted to measure hematological parameters. The results revealed an overall prevalence of IDA at 21.5%, encompassing both mild and moderate cases. A significant association between IDA and age was observed (p∼0.001), with the highest prevalence of both moderate and mild anemia found among 16-year-olds. These findings underscore the importance of implementing school-based health promotion programs that focus on improving dietary habits and regular screening to address and prevent IDA).

Background: Beta-thalassemia major (β-TM) is a severe hereditary blood disorder, common in Palestine due to high consanguinity rates. Lifelong iron chelation therapy (ICT) is vital for managing iron overload from regular transfusions, but adherence remains a major challenge.

Objective: This study investigates factors influencing ICT adherence among β-TM patients in Palestine, focusing on sociodemographic, clinical, psychological, and healthcare-related aspects.

Methods: A cross-sectional study was conducted at the National Thalassemia Center, Nablus, from July 2024 to the end of October 2024, including 120 β-TM patients aged 3-33. Data were collected through structured interviews using a validated questionnaire covering demographics, disease knowledge, adherence, and satisfaction with healthcare. Adherence was based on missed doses and ferritin levels, analyzed using SPSS V21.0.

Results: 62.5% of patients were adherent, with ferritin levels ≤ 2500, while nonadherent patients had levels ≥ 2501 (p < 0.001). Although 98.7% of adherent and 100% of nonadherent patients had good disease knowledge, it did not predict adherence. Barriers included psychological distress (21.7%), medication side effects (16.7%), and inconsistent medication supply. Satisfaction with healthcare staff (p < 0.001) and socioeconomic status, particularly income (p = 0.014), significantly affected adherence.

Conclusion: Adherence is influenced more by psychological, economic, and healthcare service factors than knowledge. A multidisciplinary approach-providing psychological support, stable medication access, and stronger patient-provider relationships-is essential to improve adherence and outcomes for β-TM patients in Palestine.

Background: Identifying early response to oral iron supplementation in anaemic patients is key. This study aims to assess the onset-of-action of oral liquid solution of ferrous gluconate, copper and manganese gluconate in adults with moderate iron deficiency anaemia.

Methods: This prospective, open-label study was conducted in France, Bulgaria and Kenya. All patients received 150 mg of oral ferrous gluconate/day for 12 weeks. Eleven blood samples were taken at Day 7 and at Days 0, 3, 5, 7, 10, 14, 21, 28, 56 and 84. The primary endpoint was to assess treatment duration required to observe a +0.5 g/dL haemoglobin (Hb) level increase.

Results: Ninety-five moderately anaemic patients were included in the analysis. Hb increase ≥ 0.5 g/dL was observed within 9-10 days of treatment (0.51 g/dL at Day 10, 95% CI: 0.45-0.57 and p < 0.0001). Serum iron increased within the first 3 days (mean change from baseline: 67.21 ± 91.57 μg/dL). An improvement of quality of life (physical component mean change: 8.20 ± 7.34 and mental component: 6.72 ± 6.67) was reported after treatment. The safety profile was very good.

Conclusion: This study demonstrates for the first time the rapid onset-of-action of oral liquid solution of ferrous gluconate and confirms its good tolerability.

Trial registration: ClinicalTrials.gov identifier: NCT04309669.

Iron deficiency anaemia (IDA) remains highly prevalent among children in India and many Southeast Asian countries. Experts in maternal and child health have developed a consensus on IDA in children. This consensus aims to improve awareness of IDA, provide recommendations on the screening and management of children at risk of IDA and offer insights into strategies to prevent IDA in children. The consensus was developed using the Delphi method, where eight primary expert members initially formulated questions on IDA screening and management based on a comprehensive literature review, followed by feedback and voting from 18 secondary expert members, achieving consensus with at least 70% agreement. Twelve statements achieved consensus to provide guidance and recommendations on several key areas: the recommended age for initial and annual anaemia screening, the use of noninvasive haemoglobin measurement devices for screening, further evaluations to rule out thalassaemia and IDA in children with anaemia and preventative measures to reduce the risk of IDA. The experts agreed that early detection of anaemia is crucial to mitigate related health consequences in children. It is recommended that all children undergo their first screening for anaemia between the ages 9 and 12 months, followed by annual screenings from the ages 1 to 5 years. In addition, the experts emphasised the importance of nutritional intervention, particularly the fortification of food and milk, to assist in reducing the risk of childhood IDA. By integrating relevant recommendations based on current clinical data and best practices, these consensus statements serve to guide screening, treatment and prevention of IDA among children.

Background: Anemia is a global burden, with women and children being most at risk. Moreover, anemia during pregnancy has been reported to be associated with adverse outcomes for both the mother and the offspring. In India, anemia is considered a national health issue and is estimated to have the highest prevalence in the world.

Objectives: To report on the prevalence of anemia in pregnant women in India, to determine offspring outcomes that have been assessed for an association with maternal anemia in India, and to identify gaps in current knowledge.

Methods: Four databases (Scopus, MEDLINE, Embase, and Web of Science) were searched using a systematic search strategy to identify relevant studies conducted in India. The search was limited to studies published between 1990 and 2023 and written in English. The exposure of interest was maternal anemia. The review was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

Results: A total of 15 studies were included in this review. The reported prevalence of maternal anemia ranged from 21.26% to 90.46%. A total of 37 offspring outcomes were assessed for an association with maternal anemia, and the most widely reported outcomes related to offspring birthweight.

Conclusion: Maternal anemia during pregnancy appears to adversely affect the physical and cognitive development of Indian children. However, it remains unclear as to whether such adverse effects persist into adolescence and adulthood. Further research is needed to assess the long-term effects of maternal anemia to develop suitable health interventions.

Alpha-thalassemia is a hereditary hemoglobin disorder characterized by reduced or absent α-globin gene, and its severity is associated with the number of affected alleles. Several methods are available for detecting α-thalassemia, such as multiplex ligation-dependent probe amplification (MLPA) and PCR-based hybridization strip assay. Multiplex PCR offers a faster, more convenient, and cost-effective alternative. In this study, we aimed to optimize a current PCR-based method for α-thalassemia screening and evaluate its utility using clinical samples. We also investigated the prevalence and spectrum of common mutations responsible for α-thalassemia in Thailand and Korea. A total of 1261 samples from Thailand, 560 samples from different ethnic groups residing in Korea, and 300 samples from native Koreans were collected and tested. The concordance rate between the data collected in Thailand and in this study was 99.92%. Further, approximately 5.9% of the non-Korean individuals living in Korea were identified as healthy carriers, whereas no mutations were observed in Koreans. Comparing the data with MLPA or Sanger sequencing data showed 100% agreement rate in both cases. We successfully developed a PCR method for the diagnosis of α-thalassemia that is fast, less labor-intensive, and cost-effective. Given the performance results of this method, it has great potential for application in α-thalassemia diagnosis.

[This retracts the article DOI: 10.1155/2021/6636043.].