Anemia最新文献

Introduction: Sickle cell disease (SCD) is one of the most common genetic diseases in the world. It combines, in its homozygous form, chronic hemolytic anemia, vasoocclusive complications, and susceptibility to infections. It is well known that the combination of pregnancy and sickle cell disease promotes the occurrence of complications that are sometimes fatal for the mother and/or the fetus.

Objective: The objective of the current study was to compare pregnancy outcomes among women with SCD with those of women without the diagnosis of SCD. Materials and methods. It was a case-control study carried out in four maternity hospitals in Brazzaville in 2 years (July 2017-June 2019). It concerned 65 parturients with SS homozygous SCD. The mode of childbirth and maternal and perinatal morbidity and mortality were compared with those of 130 non-sickle cell pregnant women.

Results: The average age was 27 years for SCD women and 31 years for non-SCD women. The average gestational age at delivery was 35 weeks for SCD women and 38 weeks for non-SCD women. From the logistic regression analysis using the comparison group as the reference group, there was excessive risk in SCD compared to non-SCD of infection (29.3% vs. 4.6%, OR = 21.7, 95% CI [7.6-62.7]; p=0.001), cesarean (63% vs. 35.4%, OR = 3.1, 95% CI [1.6-5.7]; p=0.001), prematurity (75.4% vs. 30.8%, OR = 8, 95% CI [3.0-23.2]; p=0.001), low birth weight (52.3% vs. 16.1%, OR = 4.7, 95% CI [2.4-9.4]; p=0.001), neonatal requiring admission to the intensive care unit (40.3% vs. 17.5%, OR = 3.2, 95% CI [1.6-6.3]; p=0.01), and neonatal death (21.5% vs. 4.8%, OR = 4.3, 95% CI [1.5-12.2]; p=0.01).

Conclusion: The risk of pregnancy in patients with homozygous sickle cell anemia remains high, on both the maternal and fetal sides.

Background: Blood transfusion is an essential component in the care of patients with sickle cell disease (SCD), but it might be associated with serious acute and delayed complications. This study was aimed to describe red cell transfusion patterns and indications among hospitalized SCD children in a low-resource setting. Patients and Methods. A retrospective, descriptive study of all children (≤16 years) with SCD who received blood transfusion therapy during their hospital admissions in the pediatric department at Al-Sadaqa Teaching Hospital in Aden, Yemen, for a period of one year.

Results: Out of 217 hospitalized children with SCD, 169 (77.9%) were transfused and received 275 RBC transfusion episodes. The mean age of transfused children was 6.9 ± 4.6 years and 103 (60.9%) were males, with a male/female ratio of 1.6 : 1 (p=0.004). Hemoglobin (Hb) levels were significantly lower in the transfused than in the nontransfused (Hb 5.5 ± 1.5 vs. 7.7 ± 1.5 g/dL, p=0.03). Pretransfusion Hb levels were ˂7.0 g/dL in 86.2% and ˂5.0 g/dL in 39.3% of patients. Single transfusion was given to 122 (72.2%) and 5 or more transfusions in 9 (4.15%) of patients on different occasions. Simple (top-up) transfusion was used in all transfusion events. Commonest indications for transfusion were anemic crises (41.1%), vasoocclusive crises (VOC) (13.8%), VOC with anemic event (11.3%), acute chest syndrome (8.7%), and stroke (7.3%).

Conclusion: Intermittent blood transfusion remains a common practice for the management of children with acute SCD complications. Main indications were acute anemic crises, severe pain crises, ACS, and stroke. In limited resource settings, such as Yemen, conservative transfusion policy appears to be appropriate.

Background: Globally, anemia affects one-fourth of the world population including 30% of nonpregnant reproductive-aged women. It has a number of causes including micronutrient deficiencies and chronic infections, inherited or acquired disorders of hemoglobin synthesis and red blood cell production, or survival alterations. The aim of this study was to assess the prevalence and associated factors of anemia among reproductive-aged women in Sayint Adjibar town, South Wollo Zone, Northeast Ethiopia.

Methods: A community-based cross-sectional study was conducted from February to April among 359 reproductive-aged women (RAW). Systematic random sampling technique was implemented to select study participants. Sociodemographic, socioeconomic, and reproductive histories of study participants were collected using the structured and pretested questionnaire. Capillary blood and stool samples were collected from each study participant for hemoglobin and parasitological analysis, respectively. Data were entered into Epi Info version 7 and transferred to SPSS version 20 for analysis. Both bivariable and multivariable binary logistic regression models were fitted to identify associated factors of anemia. p value <0.05 was considered as statistically significant.

Result: The median age of the study participants was 25 years. The overall prevalence of anemia was 24.2%. Among those anemic individuals, 49 (56.3%) were mildly anemic. Age category 36-49 years (AOR = 2.64; 95% CI: 1.05, 6.60), no formal educational status (AOR = 2.28; 95% CI: 1.06, 4.92), food insecurity (AOR = 1.92; 95% CI: 1.01-3.65), and body mass index of above 25 kg/m² (AOR = 0.27; 95% CI: 0.08-0.87) were found to be statistically significant with anemia.

Conclusion: The prevalence of anemia in this study was found as a moderate public health problem. The prevalence was significantly associated with women who had no formal education and were of older age group and those women living with household food insecurity and with higher body mass index. Therefore, it is better to design appropriate interventional strategies to reduce reproductive-aged women anemia. These include information, education, and communication activities focused on reproductive-aged women with no formal education and life-cycle-focused food security rather than targeted to only infants and young children or pregnant women.

Background: Anemia is a widespread public health problem associated with increased risk of morbidity and mortality. Infants, under-5-year-old children, and pregnant women have greater susceptibility to anemia. The magnitude and associated risk factors for anemia vary in different settings. The study aimed to assess the magnitude, severity, and associated factors of anemia at Hawassa University Teaching and Referral hospital, Hawassa, southern Ethiopia.

Methods: In a hospital-based cross-sectional study, a total of 422 under-five children were included. Sociodemographic data and other predisposing factors were collected by structured questionnaire. Venous blood samples were collected and analyzed for hemoglobin determination using a Cell-Dyn 1800 automated analyzer. Stool samples were collected and processed using direct wet mount and formol-ether concentration method to detect intestinal parasites. Data were entered and analyzed using SPSS version 20 statistical packages. Binary and multiple logistic regressions were computed to assess factors associated with anemia. p value less than 0.05 was taken as statistically significant.

Result: The overall prevalence of anemia was found to be 41.7%. The mean hemoglobin level was 10.59 g/dl. Anemia was of mild, moderate, and severe type in 6.6%, 19%, and 16.1% of the children, respectively. Children in the age group 6-23 months (AOR = 2.04 (95% CI: 1.13, 3.69)), and mothers having no formal education (AOR = 1.73 (95% CI: 0.99, 3.02)) were identified as associated factors for anemia.

Conclusion: The prevalence of anemia among the study subjects was 41.7% indicative of the fact that anemia is an important public health problem. It was associated with the child's age, residence, mother's education level, and intestinal parasite (Ascaris lumbricoides). It clearly indicates that there should be well integrated public health interventions to improve the health status that needs to be prioritized to prevent anemia among children under five years of age.

Anemia and iron deficiency (ID) can impair quality of life and socioeconomic development. We evaluated the prevalence of anemia and ID in the adult Portuguese population in real-life contexts by gender, age, and pregnancy status. We performed a cross-sectional screening in adult individuals in mainland Portugal from 2013 to 2017. Participants completed a survey about demographics and signs or symptoms compatible with anemia, and ID and hemoglobin and ferritin concentrations were determined by point-of-care tests. We estimated and compared prevalence ratios (PR) of anemia and ID using Poisson regression with robust variance and the Wald chi-square test. We collected data from 11,030 individuals (26% men, 64% nonpregnant women, and 10% pregnant women). We found anemia in 51.8% (95% CI 50.1-53.4%) of nonpregnant women in fertile age, 46.6% (95% CI 44.7-48.6%) of nonpregnant women >51 years, 38.2% (95% CI 35.4-41.1%) of pregnant women, and 33.3% (95% CI 31.6-35.1%) of men. The prevalence of ID was 72.9% (95% CI 71.4-74.4%) in nonpregnant women in fertile age, 50.5% (95% CI 48.5-52.4%) in nonpregnant women >51 years, 94.8% (95% CI 93.3-96.0%) in pregnant women, and 28.9% (95% CI 27.3-30.6%) in men. We found significant associations between the prevalence of anemia or ID and nonpregnant women (PR: 1.50, 95% CI 1.42-1.59 or PR: 2.21, 95% CI 2.09-2.35, respectively), manifestation of signs or symptoms (PR: 1.19, 95% CI 1.53-1.23 or PR: 1.22, 95% CI 1.18-1.26), pregnant women (PR: 0.74, 95% CI 0.68-0.80 or PR: 1.30, 95% CI 1.27-1.33), and nonpregnant women ≤51 years (PR: 1.11, 95% CI 1.06-1.17 or PR: 1.42, 95% CI 1.36-1.48). In conclusion, anemia and ID represent moderate to severe public health problems, particularly among women in fertile age and in 3rd trimester, of pregnancy emphasizing the need to raise the public and health professionals' awareness of these problems and their prevention, diagnosis, and treatment.

Background: Anemia in pregnancy is defined as a hemoglobin (Hb) concentration of less than 11 grams (gm)/deciliter (dl) in venous blood. Globally, it affects 1.62 billion people. In developing countries, anemia is a major cause of maternal and child morbidity and mortality. Globally, anemia contributes to 20% of all maternal deaths. Nearly 50% of the world's population is estimated to be infected with Helicobacter pylori (HP). High prevalence of HP among pregnant women was also reported in developing countries than developed ones. The association between HP infection and occurrence of anemia is not well known in Ethiopia. Therefore, the aim of this study was to determine the association between anemia and Helicobacter pylori infection among pregnant women attending antenatal care follow-up in Kulito Health Center, Halaba Zone, South Ethiopia.

Methods: Institution-based cross-sectional study was employed. Systematic random sampling procedure was employed to select 236 pregnant women who attended antenatal care at Kulito Health Center. An interviewer-administered questionnaire supplemented by laboratory tests was used to obtain the data. The collected data were analyzed by using SPSS version 20.0.

Results: The prevalence of anemia among antenatal care attendant pregnant women of Kulito Health Center was 27.5% with 36 (15.2%) of mild, 29 (12.3%) of moderate, and no severe cases of anemia. The overall prevalence of HP infection among study participants was found to be 129 (54.7%) (95% CI: 47.9-61.4). Factors significantly associated with anemia were presence of HP infection (AOR = 3.064, 95% CI: 1.336 7.027), low interpregnancy gap (AOR = 2.863, 95% CI: 1.245-6.582), being on the third trimester (AOR = 6.457; 95% CI: 1.276-32.729), and mid-upper arm circumference (MUAC) level <21 cm (AOR = 2.595, 95% CI: 1.044-6.450).

Conclusion: This study revealed that anemia and HP infection were highly prevalent among pregnant women attending the antenatal follow-up clinic in Kulito Health Center. HP infection, low interpregnancy gap, being on the third trimester, and MUAC less than 21 cm were the independent factors associated with anemia. Recommendation. Pregnant women should be aware that anemia is a problem that can be prevented by early prevention and treatment of HP infection and undernutrition, using family planning to widen the interpregnancy gap. Further experimental studies are warranted to determine the cause and effect of the association between anemia and HP infection.

Introduction: Thalassemia bone disease is one of the disease-related complications in patients with thalassemia. Prevalence of fractures and the role of a trabecular bone score (TBS) as a predictive factor for fractures were evaluated in patients with thalassemia.

Methods: A cross-sectional study was conducted in patients with thalassemia aged ≥18 years at Srinagarind Hospital, Khon Kaen University, Thailand. A lateral thoracolumbar radiograph and bone mineral density (BMD) at the lumbar spine and hip, as well as the TBS measured by dual-energy X-ray absorptiometry (DXA), were evaluated in all patients.

Results: Among 86 patients, 14 patients were found to have radiographic vertebral fracture yielding a prevalence of 16.3%. All patients who had fractures were β-thalassemia/Hb E. Combined low BMD and TBS at lumbar spines and a presence of endocrinopathies were significantly associated with vertebral fractures.

Conclusions: The prevalence of vertebral fractures in patients with thalassemia was not uncommon. A combined low BMD and TBS and a presence of endocrinopathies were associated with vertebral fractures. These findings suggested that BMD testing and TBS measurement have a clinical implication as a screening tool for evaluating the risk of vertebral fractures in thalassemic patients, particularly in β-thalassemia/Hb E who have endocrinopathies.

Background: Anaemia is a major global health problem, especially in developing countries. Postpartum anaemia hurts both maternal and newborn baby health. Anaemia in pregnancy is sufficiently emphasized; however, very little attention has been paid to postpartum anaemia in Ethiopia. Therefore, this study aimed to investigate the proportion of immediate postpartum anaemia and associated factors among postpartum mothers in Debre Markos Referral Hospital.

Methods: Institutional-based cross-sectional study was conducted among 424 study participants from August 1^st to October 30^th, 2019. A systematic random sampling technique was employed to select the study participants. Data were collected through both face-to-face interview and maternal chart review by using a pretested questionnaire. Data were cleaned, coded, and entered using Epi Data version 4.6.0.0 and then exported to SPSS version 24 for analysis. First, binary logistic regression was applied to identify candidate variables for multivariable regression. Then, variables at p value <0.2 were entered into a multivariable logistic regression to control possible confounders. Finally, variables at p value <0.05 were considered as statistically significant.

Results: The proportion of immediate postpartum anaemia was 24.3%. Frequency of antenatal care (ANC) visits <4 times [AOR = 2.40; 95% CI (1.29, 4.43)], antepartum haemorrhage (APH) [AOR = 5.08; 95% CI (1.91, 13.55)], postpartum haemorrhage (PPH) [AOR = 4.47; 95% CI (2.25, 8.88)], giving birth assisted by instruments (vacuum or forceps) [AOR = 3.99; 95% CI (1.42, 11.23)], poor adherence to iron and folic acid (IFA) [AOR = 2.52; 95% CI (1.06, 6.04)], and midupper arm circumference (MUAC) <23 cm [AOR = 3.25; 95% CI (1.87, 5.65)] were the predictors.

Conclusion: The proportion of immediate postpartum anaemia was a moderate public health concern. ANC, APH, PPH, mode of delivery, adherence to IFA supplementation, and MUAC measurement were the factors affecting the magnitude of anaemia. Therefore, interventions that would address the above mentioned factors need to be implemented.

In Ethiopia, anemia during pregnancy is a major public health problem and affects both the mother's and their child's health. There is a scarcity of community-based evidence on determinants of anemia among pregnant women in the country. Therefore, this study aimed to assess the determinants of anemia among pregnant women in Ethiopia. Method. This study was based on the 2016 Ethiopian Demographic Health Survey (EDHS) that used a two-stage stratified cluster sampling technique. A cross-sectional study was conducted among 3080 pregnant women. Data analysis was done using STATA v.14. Variables with P value <0.05 in the bivariate analysis were candidates for the multivariable analysis to identify independent determinants of anemia among pregnant mothers. Odds ratios (OR) were calculated at 95% confidence interval (CI). Results. The overall prevalence of anemia among pregnant women was 41% of which 20% were moderately anemic, 18%, mildly anemic, and 3%, severely anemic. The following were significantly associated with anemia during pregnancy: an age of 30-39 years, receiving no education (AOR = 2.19; 95% CI 1.45, 2.49), belonging to the poorest wealth quintile (AOR = 1.29; 95% CI 1.22, 1.60), being a Muslim (AOR = 1.59; 95% CI 1.69, 2.65), number of house members being 4-6 (AOR = 1.44; 95% CI 1.05, 1.97), number of under-five children being two (AOR = 1.47; 95% CI 1.10, 1.97), head of the household being a female (AOR = 2.02; 95% CI 1.61, 2.54), current pregnancy wanted later (AOR = 1.75; 95% CI 1.23, 1.63), no terminated pregnancy (AOR = 1.49; 95% CI 1.15, 1.93), and an age of 13-17 years at the first sexual intercourse (AOR = 1.97; 95% CI 1.291, 3.00). Conclusions. The study revealed that more than one-third of the pregnant women in Ethiopia were found anemic. Its prevalence varied among regions in which the highest (62.7%) and the lowest (11.9%) were from Somali and Addis Ababa, respectively. Hence, efforts should be made by concerned bodies to intervene in terms of the identified risk factors.

Sickle cell anaemia (SCA) is an inherited disease resulting from mutations in the β-globin chain of adult haemoglobin that results in the formation of homozygous sickle haemoglobin. It is associated with several complications including an altered blood picture and damage in multiple organs, including the kidneys. Kidney disease is seen in most patients with SCA and may affect glomerular and/or tubular function, thereby putting these patients at risk of urinary tract infections. However, there is a paucity of data on the prevalence of urinary tract infections (UTIs) among SCA patients in Zambia. This study aimed to determine the prevalence of UTIs and haematological and kidney function profiles among SCA patients at the University Teaching Hospitals, Lusaka, Zambia. This was a cross-sectional study conducted between April and July 2019 involving 78 SCA patients who presented at the UTH. Blood and midstream urine samples were collected from each participant using the standard specimen collection procedures. Full blood counts and kidney function tests were determined using Sysmex XT-4000i haematology analyser and the Pentra C200 by Horiba, respectively. Bacterial profiles of the urine samples were determined using conventional microbiological methods. We found that all the measured patients' haemoglobin (Hb) levels fell below the WHO-recommended reference range with a minimum of 5 g/dl, a maximum of 10.5 g/dl, and a mean of 8 ± 1 g/dl. Fifty percent of the participants had moderate anaemia, while the other 50% had severe anaemia. The minimum WBC count of the participants was 0.02 × 10⁹/L with a maximum of 23.36 × 10⁹/L and a mean of 13.48 ± 3.87 × 10⁹/L. Using the one-way analysis of variance test, we found no significant difference in mean WBC count and Hb concentration across various age-group categories that we defined. Bacteriuria was found in 25% of participants. The most common bacterial isolates were Staphylococcus aureus (32%) and coagulase-negative Staphylococci (32%). Klebsiella pneumoniae was 16%. We found no significant association between bacterial isolates and white blood cell count, age groups, sex, and anaemia severity p = 0.41. None of the participants were diagnosed with kidney disease. There was a high prevalence of asymptomatic UTIs among SCA patients at UTH, which, when coupled with the marked leukocytosis and anaemia, may negatively impact the clinical outcome of the patients. Therefore, we recommend close monitoring of sickle cell patients in Zambia for such conditions to improve patients' outcomes.