Prevalence of anemia in schools of the metropolitan region of Curitiba, Brazil

ABSTRACT Background: Anemia during childhood is one of the biggest public health problems worldwide, including Brazil. Insufficient or abnormal production of hemoglobin, loss of iron and excessive destruction of red blood cells are the most common causes of anemia. Among the reasons of anemia, iron deficiency accounts for 50% of anemia cases in developing countries. Affected individuals present a wide range of clinical problems, including delayed neuropsychomotor progression, impaired cellular immunity and reduction of intellectual capacity. This study aimed to evaluate the prevalence of anemia in children attending public schools in the metropolitan region of Curitiba, Paraná, Brazil. Method: A retrospective study was conducted of 409 children aged 8-12 years old included in an extension project of the Universidade Federal do Paraná. The results of complete blood count and hemoglobin electrophoresis of all children were evaluated. Anemia was considered when the hemoglobin levels were <11.5 g/dL. Results: The prevalence of anemia was found to be 2.2% of the population studied, with hypochromic microcytic anemia being the most common type. Seven children had sickle cell trait and one had β-thalassemia. Conclusion: The prevalence of anemia in this study was considered normal according the World Health Organization classification, which is different from the data found in other Brazilian regions.

Serum Ferritin and Severity Scores in Sickle Cell Disease Patients in Nnewi (South East Nigeria).

Background: Sickle cell disease (SCD) patients have mechanisms that are thought to protect them more than apparently normal individuals from iron deficiency. However, evidence exists that in SCD, hypoferritinaemia may be more prevalent than hyperferitinaemia, especially in developing countries. Methods: Serum ferritin (SF) levels were measured - using an ELISA based kit (Biocheck, USA), and disease severity calculated in fifty- two asymptomatic steady state (ASS) SCD patients; who were iron chelation naive and both parameters correlated. Erythrocyte morphology and malaria parasitaemia were assessed, patients with parasitaemia were excluded. 64 apparently normal individuals in the same environment and socioeconomic group were also assessed as above and served as controls. Statistical analysis was done using SPSS version 20. Results were expressed as means and standard error of mean. Level of significance was set at p= 0.05. Results: 30.7% and 7.6% of the test subjects had hypoferritinaemia and hyperferritinaemia respectively compared to controls, where 56% had hypoferritinaemia and none had hyperferritinaemia. Erythrocyte morphology showed hypochromia and microcytosis to different degrees in all test subjects assessed: 1+ (10.5%), 2+ (63.2%) and 3+ (26.3%), while only 5% of controls had hypochromia and microcytosis. Blood transfusion and age did not seem to significantly affect SF levels (p= 0.65 and 0.93) respectively. SF levels increased progressively with disease severity but didn’t reach statistical significance (p=0.29). Conclusion: The results suggest that hypoferritinaemia is more prevalent than hyperferitinaemia, and that SF levels may be a useful index for computing an objective severity score in SCD management. Anaemia of chronic inflammation may cause a significant part of the anaemia in SCD.

Iron-deficiency anemia in children: from diagnosis to treatment

Iron-deficiency anemia (IDA) is the most frequent hematologic and nutritional disorder in children. The risk factors associated with IDA in children are rapid growth with inadequate dietary iron, low birth weight, premature birth, perinatal bleeding, early cow's milk intake, and breastfeeding beyond 6 months without iron supplementation. Blood loss is also an important cause of IDA. Most children with IDA are asymptomatic and may go undiagnosed. The diagnosis of IDA is confirmed by microcytic hypochromic anemia and a low level of serum ferritin. Monitoring the response to iron supplementation is a reasonable intervention for a clinically stable child with mild anemia and inadequate iron intake. IDA must be differentiated from the anemia that arises from chronic disease and thalassemia. Oral iron is usually recommended as first-line therapy. Parenteral iron is indicated in cases of poor compliance or failure of oral iron, intestinal malabsorption, or chronic bleeding.