Prevalence of anaemia and iron deficiency in urban Haïtian children two to five years of age.

This study was undertaken to assess the prevalence of anaemia and iron deficiency (ID) in 305 urban Haïtian children, 142 boys and 163 girls from low socioeconomic class, ranging in age from 2 to 5 years. Haemoglobin (Hb), serum ferritin (FERR), serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), and red blood cell indices were measured by standard techniques. Although the means of these indices were within normal range, 58.4 per cent of children had at least one of the measurements in the abnormal range (FERR < 12 micrograms/l, TS < 12, HB < 10.7 g/l in 2 year old and < 10.9 g/dl in 3-5 year old children). The overall prevalence of anaemia (40 per cent) was slightly higher in boys (42 per cent) than in girls (36 per cent). Approximately 45 and 31 per cent of children had FERR < 12 micrograms/l TS < 12 per cent, respectively, with no difference between boys and girls. Despite the decrease in the prevalence of anaemia and ID with age, about one-third of the 5 year old children were either anaemic or iron deficient. Hypochromia and microcytosis were present in 60 and 66 per cent of children respectively. Although ID was the major cause of anaemia, protein-energy malnutrition as judged by low TIBC contributed to the high prevalence of anaemia. Megaloblastic anaemia and haemoglobinopathies did not significantly contribute to the high prevalence of anaemia. The frequency of fruit consumption, hence vitamin C, was lower in anaemic than non-anaemic children. We conclude that the eradication of anaemia and ID in this population will require improvement in overall nutritional status.

Coagulation factor concentrate usage and the risk of lymphadenopathy: a prospective study.

A prospective evaluation of 115 patients with hemophilia was performed between July 1982 and July 1983. During that period, 24 patients were seen with unexplained, generalized lymph node enlargement. The date lymphadenopathy occurred was recorded. No lymphadenopathy was found in 22 patients who did not receive coagulation factor concentrate. Factor usage was most closely related to the risks of lymphadenopathy (p = 0.004) even after controlling for age. A patient's age affected the risk of lymphadenopathy when the data were analyzed categorically (p = 0.008). A tendency was seen for heavily treated patients to develop lymph node enlargement earlier in the study period. Twenty-one of twenty-four (88%) patients with lymphadenopathy eventually developed HTLV-III/LAV antibodies and had abnormal T4/T8 ratios. These studies emphasize a close relationship between patients with hemophilia using coagulation factor concentrates and those with other risks for immune deficiency and lymphadenopathy. Close follow-up, optimal use of blood products, and further efforts to understand the importance of such changes are indicated in patients with hemophilia.