Anemia最新文献

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.

Introduction: Anaemia in pregnancy affects about half of all pregnant women globally and constitutes an important reproductive health issue. The World Health Organization estimates that the prevalence of anaemia in pregnancy varies from 53.8% to 90.2% in developing countries and 8.3% to 23% in developed countries. Anaemia in pregnancy is common in developing countries and prevalence statistics required for its effective management and control is not adequately available in Nigeria. Thus, this study seeks to provide prevalence statistics of anaemia in pregnancy for the study region and its severity and highlight some possible correlates.

Methods: A total of 218 pregnant women were recruited from the antenatal clinic of Central Hospital Warri using simple random technique after approval from the institutional review board and consent from the participants. Data on sociodemographics, economic status, and clinical history were collected using a pretested structured interviewer's questionnaire. Participant's haematocrit levels were estimated using standard laboratory techniques and anaemia was diagnosed using WHO-recommended cutoff.

Results: The overall prevalence of anaemia was 37.6%. This prevalence dropped to 10.6% when a cutoff of less than 30% haematocrit was used. There was a direct relationship between haematocrit values and the participants' age while mild anaemia accounted for the bulk (72%) of the anaemic cases. Participants younger than 20 years of age gave the highest age-based prevalence while parity-based prevalence was even among subgroups. Participants without formal education and those who were unemployed accounted for the highest prevalence in their different categories.

Conclusion: Based on the findings from our study, anaemia in pregnancy is still of primary public health concern if WHO cutoff is used for the diagnosis. However, the reduction observed when less than 30% haematocrit was used tags our study zone to be of moderate severity. Although all variables lacked statistical significance, younger age, no formal education, and unemployment were highlighted to be predisposing factors.

Malaria, which is responsible for a substantial amount of deaths in endemic countries, has been shown to have both direct and indirect effects on the hematological parameters. Notwithstanding, some hematological parameters among populations living in malaria endemic regions have not been described consistently, as a standard for measuring malaria burden. Based on the above fact, this study was designed to assess some hematological changes and their diagnostic values in malaria infected patients. A total of 160 malaria positive adult patients, together with 81 healthy control adults were recruited for the study. For the malaria positive group, the female to male ratio was 1.38 : 1. Specifically, 74.38%, 10.00%, and 15.62% of those in the malaria positive group had mild, moderate, and severe parasitaemia, respectively. Leukemia, anemia, and thrombocytopenia were found to be significantly associated with malaria and were all estimated to be specific for the diagnosis of malaria. Anemia was, however, estimated to be both sensitive and specific for malaria diagnosis. Therefore, anemia offers the most diagnostic value in the malaria infected patients of this study.

Background: Pure red cell aplasia (PRCA) is less common blood disorder; the causes and the treatments of PRCA are varied.

Methods: We conducted a retrospective study during January 2010-December 2017, to explore the etiologies and to evaluate the response and treatment burden in adult patients with PRCA.

Results: Of 32 PRCA patients, median age was 57 years (18-90 years). Median hemoglobin level and reticulocyte count at the time of diagnosis were 5.6 g/dL (3.3-7.3 g/dL) and 0.3% (0.1-0.7%), respectively. Median time to hematologic recovery was 12 weeks (3-72 weeks), and median number of red blood cell transfusion (RBC) was 20 units (4-100 units). Causes of PRCA were erythropoiesis-stimulating agent (ESA) (47%), parvovirus B19 infection (19%), thymoma (13%), zidovudine (6%), primary autoimmune PRCA (6%), Kaposi's sarcoma (3%), systemic lupus erythematosus (3%), and ABO-mismatched stem cell transplantation (3%). Only 9 out of 24 treated patients achieved hematologic response within 8 weeks of treatment. Intravenous immunoglobulin therapy provided 100% response rate in patients with parvovirus B19-associated PRCA and primary autoimmune PRCA. Low response rate was found in patients receiving immunosuppressants and chemotherapy for the treatment of ESA and thymoma-associated PRCA, respectively.

Conclusions: Treatment outcome of PRCA depended upon the causes and the types of treatment, and the burden of RBC transfusion was very high in patients with ESA and thymoma-associated PRCA.

Introduction. Anemia is one of the most commonly observed hematological abnormalities and an independent poor prognostic marker of HIV disease. The rate of progression and mortality in this subgroup of patients is high compared to nonanemic patients. WHO estimates that over two billion people are anemic worldwide and young children bear the world's highest prevalence rate of anemia. In Ethiopia, there is limited information about the determinant factors associated with anemia among HIV positive children. Thus, this study aimed to determine the determinant factors of anemia among HIV-infected children on HAART.

Objective: The main purpose of this study was to assess the determinants of anemia among children on highly active antiretroviral therapy attending hospitals of North Wollo Zone, Amhara Region, Ethiopia.

Methods: A case-control study was conducted on 350 HIV-infected children on HAART attending Hospitals of North Wollo Zone, from February 1 to March 30, 2019. The study participants were selected with a consecutive sampling technique. An adapted, interviewer-administered, and pretested questionnaire and chart review were employed to collect the data. Besides, blood and stool samples were investigated to determine hematologic indices and malaria and to investigate intestinal parasites, respectively. Data were analyzed by using the SPSS version 24 statistical software and bivariate and multivariate logistic regression was used to identify predictors.

Results: A total of 350 HIV positive children (117 cases and 234 controls) were included in this study with an overall response rate of 100%. On multivariate analysis, variables which have spastically significant association with anemia were as follows: had amebiasis (AOR = 7.29, 1.22-43.56), had history of opportunistic infections (AOR = 9.63, 1.94-47.85), had malaria infection (malaria pf) (AOR = 4.37, 1.16-16.42), eating nondiversified food (AOR = 10.39, 2.25-48.0), WGT-Age Z score value between -2_-3 (AOR = 9.80, 2.46-39.14), level of adherence (AOR = 2.31, 1.92, 7.77), and being from a rural area (AOR = 8.8, 2.07-37.79).

Conclusion: In this study, having parasitic infections, having a history of opportunistic infections, being malnourished, having poor adherence to ART, caregivers living in the rural area, and eating nondiversified foods were significantly associated with hemoglobin status. Therefore, intervention aimed at prevention, early diagnosis, and treatment of anemia is essential in these patients.

Background: Anemia of chronic disease (ACD) also termed as the anemia of inflammation has been found to be associated with inflammations, chronic infections, and cancers, particularly in old age. Recent studies revealed that interleukin-6 (IL-6), a proinflammatory cytokine, and hepcidin, an antimicrobial hepatic peptide, play a key role in ACD pathogenesis. Patients and Methods. The study included 40 subjects with chronic diseases and 40 normal subjects of the same age group. Red cell indices, levels of IL-6 and hepcidin, and iron profile were measured in all participants using Bayer ADVIA 120, VITROS 5600, Integrated System/2008, and ELISA assay, respectively.

Results: The level of hemoglobin was considerably less in patients of chronic diseases referred to as "cases" than the normal subjects or "controls" (8.7 ± 1.5 vs. 13.2 ± 0.9). Red blood corpuscle (RBC) count, hematocrit (HCT) level, serum iron, mean corpuscular hemoglobin concentration (MCHC), and serum total iron-binding capacity (TIBC) were found to be significantly lower in the cases as compared to controls (p < 0.001). Serum IL-6 and hepcidin levels were substantially higher in the cases than in the controls (p < 0.001). Serum IL-6 and hepcidin levels were substantially higher in the cases than in the controls (p < 0.001). Serum IL-6 and hepcidin levels were substantially higher in the cases than in the controls (.

Conclusion: This study detected a significant increase in serum IL-6 and hepcidin levels in patients with ACD than the controls. These findings offer an insight into the role played by both cytokine and peptide in the pathogenesis of ACD and thus provide a rationale for future use of novel drugs inhibiting their effects on iron metabolism.

Societal determinants of health are of recognized importance for understanding the causal association of society and health of an individual. Iron deficiency anemia (IDA) is a challenging public health problem across the globe instigating from a broader sociocultural background. It is more prevalent among pregnant women, children under the age of five years, and adolescent girls. Adolescent girls are vulnerable to develop IDA because of additional nutritional demand of the body needed for growth spurt, blood loss due to onset of menarche, malnourishment, and poor dietary iron intake. In this study, we explore the societal determinants of anemia among adolescent girls in Azad Jammu and Kashmir (AJK), Pakistan. A cross-sectional study was conducted in the Muzaffarabad division of AJK on randomly selected 626 adolescent girls. The data were collected using a pretested self-administered interview schedule comprising mainly closed-ended questions with a few open-ended questions. Descriptive statistics was computed for describing the data, and bivariate regression and logistic regression were used to determine the association of anemia with its societal determinants. Multiple linear regression is used to determine the relationship of different determinants (independent variables) with the hemoglobin level (dependent variable) of the respondents. The prevalence of anemia among adolescent girls is 47.9%, of which 47.7% have mild anemia, 51.7% have moderate anemia, and 5.7% have severe anemia, which reveals that anemia is a severe public health problem among adolescent girls in the study area. The findings aver that anemia occurrence was significantly associated with the respondent's and her parental education, economic well-being, prevalence of communicable diseases, menstrual disorder, exercise habits, meals regularity, and type of sewerage system.

Background: Anaemia in children is a significant health problem that receives little attention. This study aimed at determining the factors significantly associated with anaemia in children aged 6 to 59 months in Kenya, Malawi, Tanzania, and Uganda while accounting for the spatial heterogeneity within and between the districts of the four countries. In addition, the performance of the districts with regard to their impact on anaemia was assessed and ranked.

Methods: A generalised additive mixed model with a spatial effect based on the geographical coordinates of the clusters was used. A district-level random effect was included to further account for the heterogeneity as well as to rank the performance of the districts based on the best linear unbiased prediction (BLUP).

Results: The results depicted significant spatial heterogeneity between and within the districts of the countries. After accounting for such spatial heterogeneity, child-level characteristics (gender, malaria test result, and mother's highest education level), household-level characteristics (household size, household's wealth index Z-score, the type of toilet facility available, and the type of place of residence), and the country of residence were found to be significantly associated with the child's anaemia status. There was a significant interaction between the type of place of residence and the country of residence. Based on the BLUP for the district-level random effect, the top 3 best- and worst-performing districts within each country were identified.

Conclusion: The ranking of the performance of the districts allows for the worst-performing districts to be targeted for further research in order to improve their anaemia control strategies, as well as for the best-performing districts to be identified to further determine why they are performing better and then to use these districts as role models in efforts to overcome childhood anaemia.