Prevalence of thalassaemia, iron-deficiency anaemia and glucose-6-phosphate dehydrogenase deficiency among Arab migrating nomad children, southern Islamic Republic of Iran

This study investigated the prevalence of iron-deficiency anaemia, glucose-6-phosphate dehydrogenase [G6PD]deficiency and beta-thalassaemia trait among Arab migrating nomad children in southern Islamic Republic of Iran. Blood samples were analysed from 134 schoolchildren aged < 18 years [51 males, 83 females]. Low serum ferritin [< 12 ng/dL] was present in 17.9% of children [21.7% in females and 11.8% in males]. Low haemoglobin [Hb]correlated significantly with a low serum ferritin. Only 1 child had G6PD deficiency. A total of 9.7% of children had HbA2 >/= 3.5 g/ dL, indicating beta-thalassaemia trait [10.8% in females and 7.8% in males]. Mean serum iron, serum ferritin and total iron binding capacity were similar in males and females.Serum ferritin index was as accurate as Hb index in the diagnosis of iron-deficiency anaemia. A high prevalence of beta-thalassaemia trait was the major potential risk factor in this population

La présente étude a évalué la prévalence de l'anémie ferriprive,du déficit en glucose-6-phosphate déshydrogénase et de la bêta-thalassémie mineure chez des enfants nomades et migrants arabes dans le sud de la République islamique d'Iran. Des échantillons de sang de 134 écoliers de moins de 18 ans ont été analysés [51 garçons, 83 filles]. Des taux de ferritine sérique faibles [< 12 ng/dL] ont été observés chez 17,9 % des enfants [21,7 % chez les filles et 11,8 % chez les garçons]. Un faible taux d'hémoglobine [Hb] était significativement corrélé à un faible taux de ferritine sérique. Seul un enfant était atteint de déficit en glucose-6-phosphate déshydrogénase. Au total,9,7 % des enfants présentaient un taux d’HbA2 supérieur ou égal à 3,5 g/dL, signe d'une bêta-thalassémie mineure [10,8 % des filles et 7,8 % des garçons]. Le taux moyen de fer sérique, de la ferritine sérique et la capacité de liaison du fer total étaient similaires chez les deux sexes. Le taux de ferritine sérique était aussi précis que le taux d’Hb pour le diagnostic de l'anémie ferriprive. La forte prévalence de la bêta-thalassémie mineure représentait le principal facteur de risque dans cette population

Quantitative estimation of interferon-gamma levels among Egyptian polytransfused haematology cases

This study was designed to estimate interferon-gamma [INF-gamma] levels among polytransfused haematology cases. Cases were selected from the haematology unit of Alexandria main university hospital, Egypt. Complete blood counts, estimation of INF-gamma and hepatitis B and C virus [HBV and HCV] status were conducted on 20 unsplenectomized patients with thalassaemia major and 20 patients with acute myeloid leukaemia [AML] in the maintenance phase and 20 healthy subjects. Mean haemoglobin levels and red blood cell counts were significantly higher in the control group than the AML and thalassaemia groups, while white blood cell counts were significantly lower in the control group than the case groups. Two AML patients [10%] and 1 thalassaemia patient [5%] were HBV-positive, while 5% of both case groups were HCV-positive. Mean values of INF-? were significantly different between AML, thalassaemia major and control groups: 5517 [SD 1142] pg/mL, 1024 [SD 249] pg/mL and 2980 [SD 604] pg/mL respectively

Relationship between maternal characteristics and neonatal birth size in Egypt

This study in Egypt investigated the influence of selected maternal factors on neonatal birth size. Data were collected after delivery from 782 apparently healthy pregnant women and their neonates. A questionnaire on personal, medical, socioeconomic status, smoking habits and exposure to smoking was completed. Maternal weight and height, food frequency intake during pregnancy and haemoglobin levels were recorded for 594,234 and 246 of the mothers respectively. Neonatal birth weight, length and head circumferences were measured. A significant positive correlation between maternal anthropometric variables with neonatal birth dimensions was observed and the effect was more evident in girls than boys for BMI and head circumference. Statistically significant negative correlations were found between maternal haemoglobin levels and birth size. Birth size was strongly correlated with maternal consumption of micronutrient-rich food at all stages of gestation. Passive smoking significantly affected birth weight and BMI of girls more than boys

Anaemia prevalence and associated sociodemographic and dietary factors among Palestinian adolescents in the West Bank

Anaemia still persists among children and women of childbearing age in Palestine. We investigated the prevalence of anaemia and associated factors among Palestinian school adolescents [aged 13-15 years] in Ramallah and Hebron governorates. Haemoglobin levels were measured to assess the prevalence of anaemia. The prevalence of anaemia was significantly higher in Hebron than in Ramallah among boys [22.5% versus 6.0% respectively], while among girls the figures were similar [9.2% and 9.3% respectively]. Linear binomial regression analysis showed that among boys, anaemia was independently associated with residence in Hebron and higher standard of living, while among girls, anaemia was associated with higher father's education. Consumption of iron-rich foods, as recorded in food frequency questionnaires, had no significant effects on anaemia prevalence in both boys and girls

Prevalence of anaemia in 2-12- year-old Iranian children

Haemoglobin levels were used to estimate the prevalence of anaemia in children 2- 12 years old in the Islamic Republic of Iran. The study was part of the National Health and Disease Survey in 1999 that used a cluster sample of 1 in 1000 of the Iranian population. Of 4170 children aged 2- 6 years, 7.3% were diagnosed with mild anaemia, 2.5% moderate anaemia and 1.0% severe anaemia [WHO definitions]. Of 8461 children aged 7- 12 years, 10.9% were diagnosed with mild anaemia, 3.0% moderate anaemia and 1.1% severe anaemia. The prevalence of anaemia was significantly higher in rural than urban areas

International collaborative assessment study of the AHD [575] method for the measurement of blood haemoglobin

Accurate, economical methods for haemoglobin determination by laboratories in countries with limited resources are not available. This report provides the results of an international collaborative study evaluating the alkaline haematin detergent [AHD[575]] method as a reference method for laboratory services with limited resources. The study included 6 laboratories; 3 in East Mediterranean countries, 1 in East Africa and 3 in Europe. The [AHD[575]] method was evaluated against the HiCN method, with blood samples drawn from healthy and sick subjects. The results indicate that the AHD[575] method is suitable for measuring haemoglobin in laboratories at all levels

Is vitamin A deficiency a problem among pregnant Emirati women in Al-Ain City?

Vitamin A deficiency [VAD] can have a negative impact on pregnancy but there have been no studies in Al-Ain on the vitamin A status of pregnant women. We studied 198 pregnant Emirati women aged 15-49 years attending antenatal clinics in Al-Ain Medical District [1999-2000] to assess the prevalence of VAD. Sociodemographic and health information about the women was collected by questionnaire and they all underwent blood and serum analysis. Of the 198 women, only 6 [3%] had vitamin A deficiency [plasma vitamin A < 20 micro g/dL], indicating only a mild problem according to WHO criteria. There was no significant association between the occurrence of VAD and any of the characteristics studied. While the mean values of all the haematological indices were slightly lower in the vitamin A deficient group, this was not significant

Anaemia among schoolchildren in Qena Governorate, Upper Egypt

A study was carried out during January/February 2001 in Deshna and Armant Districts of Qena Governorate, Upper Egypt, to establish the prevalence of anaemia among schoolchildren aged 6 to 11 years and define appropriate control interventions in the area. Haemoglobin levels were measured directly in schools using a portable spectrophotometer. The mean [SD] level of haemoglobin in 1844 schoolchildren in 37 schools was 12.79 [1.15] g/dL. Only 12% of children were below the WHO cut-off for anaemia for this age group [< 11.5 g/dL] and no cases of severe anaemia [< 7.0 g/dL] were detected. The low prevalence of mild to moderate anaemia indicates that mass iron supplementation is not justifiable, but routine monitoring of haemoglobin levels should be part of the public health activities in the schools

Maternal anaemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan

Maternal anaemia is a common problem in pregnancy, particularly in developing countries. We investigated the relationship between maternal anaemia and perinatal outcome in a cohort of 629 pregnant women from October 2001 to 2002. Of these, 313 were anaemic [haemoglobin < 11 g/L]. Perinatal outcomes included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low Apgar scores and intrauterine fetal death. Univariate and multivariate analyses were performed. The risk of preterm delivery and low birth weight among the anaemic women was 4 and 1.9 times more respectively than the non-anaemic women. The neonates of anaemic women also had 1.8 times increased risk having low Apgar scores at 1 minute and there was a 3.7 greater risk of intrauterine fetal death among the anaemic women than the non-anaemic women

Plasmodium falciparum infection during pregnancy in an unstable transmission area in eastern Sudan

A 1-year prospective community-based study of malaria during pregnancy was conducted in an area of seasonal and unstable malaria transmission in eastern Sudan. At a village antenatal clinic, 89 non-pregnant controls and 86 pregnant women were enrolled and followed every 2 weeks until 6 weeks after delivery. The incidence of Plasmodium falciparum infection was significantly higher among pregnant than control women [17.4% versus 5.6%] with no difference between primigravidae and multigravidae [22.2% versus 15.2%].There was no significant difference in the mean haemoglobin concentration between infected and uninfected mothers [9.1 +/- 1.3 versus 9.5 +/- 0.6 g/dL] but the mean birth weight of their babies was significantly lower [2.72 +/- 0.26 versus 2.95 +/- 0.05 kg] despite prompt case management of infected women

Evaluation of erythropoiesis in protein energy malnutrition

This study evaluated erythropoiesis in 50 infants hospitalized with protein energy malnutrition and in 50 control infants. The red cell count, mean corpuscular haemoglobin and reticulocyte index were significantly lower, while the white blood cell count, median corpuscular fragility and red cell distribution width were significantly higher on admission than in controls. Total serum protein, albumin, fasting blood glucose, and serum folate were significantly lower on admission than in controls. Serum ferritin was significantly higher and total iron-binding capacity was significantly lower on discharge compared to controls. The serum erythropoietin was significantly higher on admission and discharge than in controls. The anaemia of protein energy malnutrition is due to mixed deficiencies resulting in ineffective erythropoiesis despite an increased level of erythropoietin

Nutritional stunting in Egypt: which nutrient is responsible?

We looked at the relationship between linear growth retardation and deficiencies of certain nutrients in Egyptian children. A group of 107 stunted children aged between 10 and 18 years were subjected to history-taking, physical examination and laboratory investigations. Selected cases were referred to radiology for assessment of bone age. Thirty-nine children were enrolled as controls. Serum haemoglobin, alpha-tocopherol, retinol and magnesium levels were significantly decreased in stunted children compared with the controls. Serum zinc levels were also lower in the stunted group but not significantly so. We conclude that several nutrient deficiencies occur simultaneously in stunted children and all of them may be responsible for stunting

Malaria in pregnancy in Hodiedah, Republic of Yemen

In the Republic of Yemen, Plasmodium falciparum is the predominant causative agent of malaria and is associated with adverse consequences for pregnant women and their babies. The prevalence and clinical manifestations of malaria among 500 pregnant [260] and non-pregnant [240] women were compared. Clinical examinations, laboratory investigations and a structured questionnaire were used to collect data. The prevalence of malaria was higher among pregnant women [55%] than non-pregnant women [20%]. Anaemia was significantly more prevalent among pregnant woman than non-pregnant women and also more prevalent in pregnant women with malaria than non-pregnant women with malaria

Iron status and socioeconomic determinants of the quantity and quality of dietary iron in a group of rural Iranian women

Iron intake and status were investigated in 471 mothers [age range: 16-53 years] from rural areas in Khorramabad, Islamic Republic of Iran. Although average total iron intake was acceptable, only 6.4% of women derived at least 4% of their total intake from animal iron. Average energy and protein intakes were inadequate. Low iron status was seen in 8.2%-28.7%, depending on the parameter used, with 28.3% experiencing iron-deficiency anaemia. Significantly higher animal iron intakes were found in literate or employed women, or those of family size fewer than six people. Increasing employment opportunities, income levels and literacy rates for women will result in better iron intake and status and should receive particular attention in national planning

Gall bladder sludge and stones in multitransfused Egyptian thalassaemic patients

One hundred Egyptian beta-thalassaemic patients on a long-term transfusion/chelation programme were evaluated for the prevalence of all bladder sludge and stones and the associated risk factors. Fifty healthy individuals served as controls. Abdominal ultrasonography revealed that 14% of the thalassaemic patients had gall bladder sludge or stones [6% stones and 8% sludge]. The thalassaemic patients with this complication were older, had a higher prevalence of gall bladder symptoms, higher levels of pretransfusion haemoglobin, larger amounts of transfused red cells, and more were regularly transfused. Multiple logistic regression analysis revealed that the presence that gall bladder symptoms and the amount of transfused red cells were the only significant predictors of the occurrence of gall bladder sludge or stones

Nutritional status of Yemeni schoolchildren in Al-Mahweet Governorate

The nutritional status of 948 children selected randomly from Al-Mahweet Governorate schools was investigated. Age range was 5-18 years with a mean of 10.6 +/- 2.8 years. Among the children, 3.4% had depleted iron and 43.4% had below average skin-fold thickness. Approximately half of the children were either stunted or chronically underweight and 1 child in 20 was underfed. Depleted fat stores affected two-fifths of the children and approximately one-fifth were anaemic. Urban residents scored significantly higher on nutritional parameters than rural children. Serum ferritin levels were significantly greater among males than females whereas mean height-for-age, weight-for-age and skin-fold thickness were lower

Correlation between normal glucose-6-phosphate dehydrogenase level and haematological parameters

The study involved 143 individuals and aimed to correlate normal glucose-6-phosphate dehydrogenase [G6PD] level with haematological parameters. A statistically significant negative correlation was found between G6PD level and haemoglobin, packed cell volume, red blood cell count, mean corpuscular haemoglobin and mean corpuscular volume. A statistically significant positive correlation was found between G6PD level and white blood cell count and reticulocyte count, but no significant correlation was found between G6PD level and mean corpuscular haemoglobin concentration. The negative correlation between G6PD level and haemoglobin suggests that anaemic people have higher G6PD levels than normal individuals. The positive correlation between G6PD level and white blood cell count indicates that white blood cells may play an important role in contributing to G6PD level

Glutathione reductase deficiency in Saudi Arabia

Glutathione reductase [GR] is a ubiquitous enzyme required for the conversion of oxidized glutathione [GSSG] to reduced glutathione [GSH] concomitantly oxidizing reduced nicotinamide adenine dinucleotide phosphate [NADPH] in a reaction essential for the stability and integrity of red cells. Mutations in the GR gene and nutritional deficiency of riboflavin, a co-factor required for the normal functioning of GR, can cause GR deficiency. We conducted a study on 1691 Saudi individuals to determine the overall frequency of GR deficiency and to identify whether the deficiency results from genetic or acquired causes or both. The activity of GR was measured in freshly prepared red cell haemolysate in the presence and absence of flavin adenine dinucleotide [FAD] and the activity coefficient [AC] was determined. Samples with low GR activity [> 2.0 IU/g haemoglobin] both in the presence and absence of FAD and an AC between 0.9 and 1.2 were considered GR-deficient. Samples with AC >/= 1.3 were considered riboflavin-deficient. The overall frequency of partial GR deficiency was 24.5% and 20.3% in males and females respectively. In addition, 17.8% of males and 22.4% of females suffered from GR deficiency due to riboflavin deficiency. This could be easily corrected by dietary supplementation with riboflavin. No cases of severe GR deficiency were identified

Chronic lymphocytic leukaemia in Egyptian farm workers exposed to pesticides

We aimed to explore the relationship between chronic lymphocytic leukaemia and pesticide exposure among farm workers. Blood samples were obtained from 932 male Egyptian farm workers exposed to pesticides and from a control group of 932 males of similar age and socioeconomic status who were not involved in farming and did not normally deal with pesticides. The farm workers had significantly higher lymphocyte, white blood corpuscle and platelet counts. About 5% of the farm workers over 40 years had immature cells. Two of the farm workers and none of the control group had chronic lymphocytic leukaemia, giving an undefined relative risk and an attributable risk of 2.1 per 1000, which was not statistically significant