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1.
Indian J Med Res ; 150(4): 385-389, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823920

RESUMO

Background & objectives: The haemoglobin (Hb) cut-off is a single value for all populations. It is possible that different populations might have slightly different cut-off values; but, this needs to be evaluated in healthy populations with low possibility of inadequate dietary intakes of haematopoietic nutrients. This study was conducted to assess the existence of race-specific Hb cut-offs for mild anaemia in healthy populations and their potential implications. Methods: In this study the Hb distributions of healthy White, Black, Mexican and Hispanic and Asian non-pregnant women obtained from nine rounds of the National Health and Nutrition Examination Survey (NHANES) and two rounds of National Diet and Nutrition Survey (NDNS), was examined to check the existence of race-specific Hb cut-off for mild anaemia, by standard statistical methods. Results: The mean Hb of Blacks, Mexicans and Hispanics and Asians were lower than Whites, consistent with previous literature. The Hb cut-off for mild anaemia in Asians was lower at 11.22 g/dl. Interpretation & conclusions: Using the Hb cut-off derived in this study in place of the World Health Organization, cut-off of 12 g/dl would result in a 17.9 per cent decrease in the prevalence of anaemia in India. This points to the need for re-examining race-specific cut-off for mild anaemia and points to the need for alternative methods, perhaps linked to risk of unhealthy outcomes.


Assuntos
Anemia/sangue , Hemoglobinas/análise , Inquéritos Nutricionais , Adolescente , Adulto , Anemia/epidemiologia , Anemia/etnologia , Feminino , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
2.
Isr Med Assoc J ; 21(8): 546-551, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474018

RESUMO

BACKGROUND: The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin.


Assuntos
Anemia/etnologia , Hemoglobina A Glicada/análise , Hemoglobinopatias/etnologia , Desnutrição/etnologia , Complicações na Gravidez/etnologia , Anemia/sangue , Anemia/complicações , Árabes , Feminino , Hemoglobinopatias/sangue , Hemoglobinopatias/complicações , Humanos , Islamismo , Israel/etnologia , Masculino , Desnutrição/sangue , Desnutrição/complicações , Gravidez , Complicações na Gravidez/sangue , Reprodutibilidade dos Testes , Fatores Socioeconômicos
3.
Clin Lab ; 65(6)2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31232029

RESUMO

BACKGROUND: Anemia is a common cause among the elderly for increased mortality. Hemoglobin concentration can be affected by many factors, but the reference interval defined by the World Health Organization has not been adjusted for the previous half century. METHODS: Through using the dataset generated by the National Health Insurance (NHI) health screening program of Republic of Korea, here we attempt to present a close to actual hemoglobin concentration of the Korean population. Between January 2009 and December 2013, a total of 57,409,872 health screening events were registered in the NHI database. Following the exclusion criteria, 6,759,566 participants were enrolled for analyses. RESULTS: Significant portion of the study population was considered 'anemic', while the mean value (2.5% ~ 97.5%) of hemoglobin concentration from the study was 14.8 (12.5 ~ 16.8) g/dL in men and 12.8 (10.6 ~ 14.7) g/ dL in women. Concordant results of hemoglobin concentration declining with age were observed as previous studies have described, supporting the need for separate, possibly lower cutoff in the elderly. CONCLUSIONS: A considerable portion of the participants being categorized as anemia contests the accuracy of the current lower cutoff for anemia. From a large representative dataset, the need for adjustment to the lower cutoff for anemia is suggested.


Assuntos
Anemia/sangue , Hemoglobinas/análise , Programas de Rastreamento/métodos , Programas Nacionais de Saúde/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/diagnóstico , Anemia/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , República da Coreia , Adulto Jovem
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(3): 330-333, 2019 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-30841678

RESUMO

In this study, 1 065 infants and young children aged 24 months below in ethnic minorities gathering in poor rural areas in poor rural areas of Liangshan Yi Autonomous Prefecture of Sichuan Province and Gannan Tibetan Autonomous Prefecture of Gansu Province were investigated for their anemia status from October to November 2014, and the association between anemia and the utilization of maternal and child health services was analyzed. The prevalence of anemia in this area was 52.68%(561/1 065). After the adjustment of socio-demographic characteristics of mothers and infants, compared with infants aged 2-5 months, Han ethnic group, and infants whose mother was not anemic, the OR(95%CI) values of infant anemia for infants aged 6-12 months, 13-8 months, 19-24 months, ethnic minorities group, and infants whose mother was anemic were 11.65 (7.09-19.14), 9.91 (5.99-16.38), 5.87 (3.39-10.16), 1.55 (1.10-2.18) and 1.52 (1.14-2.04), respectively; Compared with infants whose child examination times not up to standard, and who were not only non-hospital delivered but also received inadequate number of inoculation, the OR (95%CI) values of infant anemia for infants whose child examination times up to standard, and who were not only hospital delivered but also received adequate number of inoculation were 0.60 (0.38-0.94) and 0.71 (0.52-0.98), respectively. The infants anemia is associated with the utilization of maternal and child health services.


Assuntos
Anemia/etnologia , Grupos Étnicos/estatística & dados numéricos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Áreas de Pobreza , População Rural/estatística & dados numéricos , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Prevalência
5.
J Matern Fetal Neonatal Med ; 32(17): 2897-2904, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29534635

RESUMO

Objective: As anemia in pregnancy is associated with adverse perinatal outcomes, we sought to define the mean and the fifth percentile of Hb and Ht using a contemporary multiethnic large cohort of low-risk pregnancies, and assess potential racial differences. Methods: We conducted a retrospective cohort study on women who delivered between 1 January 2008 and 31 December 2013 in Reggio Emilia County, Italy. Linear mixed effects models were used to describe changes in mean Hb and Ht, while quantile regression with matrix-design bootstrap defined changes in the fifth percentile of Hb and Ht, controlling for race, maternal age, smoking, and pregnancy number. Results: We analyzed 23,657 hemograms from 7318 pregnancies and 6870 women. Multivariate analysis showed that when compared to Caucasians', African women's mean Hb and Ht were respectively 0.24 (95%CI 0.3-0.17) g/dl and 0.7 (95%CI 0.8-0.5) % lower, while Asian mothers' were 0.11 (95%CI 0.19-0.03) g/dl and 0.3 (95%CI 0.5-0.1) % inferior. Similarly, both African and Asian women had lower fifth Ht percentiles (-1, 95%CI -1.3 to -0.6, and -0.4, 95%CI -0.7 to -0.04) than Caucasians, while African mothers also had lower fifth Hb percentile (0.3, 95%CI 0.5-0.1). The fifth percentile for Hb and Ht were, respectively, 11.3 (95%CI 11-11.5) g/dl and 32.8 (95%CI 32.3-33.4) % in the first trimester, 10.4 (95%CI 10.1-10.6) g/dl and 30.2 (95%CI 29.6-30.8) % in the second trimester, 10.1 (95%CI 9.8-10.3) g/dl and 30.6 (95%CI 30-31.1) % in the third trimester. Conclusions: We provided contemporary references to define anemia in pregnancy, and we confirmed that even in pregnancy, African and Asian women have lower Hb and Ht than Caucasian. Racial and population-specific references may have significant clinical and public health implication for more accurate disease diagnosis and appropriate treatment.


Assuntos
Anemia/etnologia , Hematócrito , Hemoglobinas/metabolismo , Complicações Hematológicas na Gravidez/etnologia , Adulto , Grupo com Ancestrais do Continente Africano , Anemia/sangue , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Itália/epidemiologia , Paridade , Gravidez , Complicações Hematológicas na Gravidez/sangue , Valores de Referência , Estudos Retrospectivos
6.
São Paulo; s.n; 2019. 109 p.
Tese em Português | LILACS | ID: biblio-1006649

RESUMO

Introdução: A anemia é extremamente relevante no contexto da saúde pública. As prevalências em países em desenvolvimento, como o Brasil, são altas e, a despeito de todo o avanço no conhecimento, no diagnóstico e no tratamento, ainda são subestimadas pelo poder público no seu impacto. Objetivo: Avaliar a prática alimentar e determinantes sociais na anemia em mães atendidas pela Estratégia Saúde da Família no estado do Maranhão. Método: Estudo transversal de base populacional que fez parte do projeto \"Prevalência e Determinantes da Anemia em Mulheres e Crianças no Estado do Maranhão\". Foram utilizados dados do questionário socioeconômico e demográfico, do questionário de frequência alimentar (QFA), dados bioquímicos referentes à dosagem de hemoglobina das mulheres e escore de altura para idade das crianças. Para a análise das informações com base no QFA das mulheres (n=779), verificou-se a associação das variáveis com a presença ou ausência de anemia e seus determinantes sociais, a presença de marcadores de alimentação saudável (n=779) e o crescimento linear e anemia com os determinantes sociais (n=966). Resultados: As condições socioeconômicas das famílias não favoreceram o consumo regular de alimentos fonte de ferro e a proteção contra a anemia. A presença frequente de marcadores de alimentação saudável foi destacada pelo consumo de feijão (83,4%), peixe (53,7) e laranja (55,2%). A prevalência de baixa estatura para a idade foi de 9,7% para o estado e entre as variáveis estudadas apenas o Programa Bolsa Família atuou como uma proteção contra a anemia (p<0,003). Conclusão: A elevada demanda de ferro seria facilmente alcançada pela dieta desde que os alimentos considerados fonte fossem consumidos regularmente. Os resultados do estado do Maranhão e os determinantes sociais não mostraram associação direta, pois estão permeados pela pobreza. O Programa Bolsa Família contribuiu para amenizar a vulnerabilidade social da população beneficiária e a inserção na atenção básica, por meio da ESF, como forma de proteção


Introduction: Nutritional anemia is extremely relevant in the context of public health. Its prevalence in developing countries, such as Brazil, are high and, in spite of all advances in knowledge, diagnosis and treatment, its impact is still underestimated by the public power. Objective: To evaluate the feeding practice and social determinants of anemia in mothers assisted by Family Health Strategy (FHS) in the state of Maranhão. Methods: A population-based cross-sectional study that was part of the project \"Prevalence and Determinants of Anemia in Women and Children in the State of Maranhão\". Data from the socioeconomic and demographic questionnaire, the food frequency questionnaire (FFQ), biochemical data on the hemoglobin dosage of women and height-for-age children´s score were used. For the analysis of information based on women FFQ (n = 779), the association of the variables with the presence or absence of anemia and its social determinants was verified, the presence of healthy food markers (n = 779) and linear growth and anemia with social determinants (n = 966). Results: Socioeconomic conditions of families did not favor the regular consumption of iron source foods and the protection against anemia. The frequent presence of healthy food markers was highlighted by the consumption of beans (83.4%), fish (53.7) and orange (55.2%). The prevalence of short stature for age was 9.7% for the state and among the variables studied only Bolsa Família Program acted as a protection against anemia (p<0.003). Conclusion: High demand for iron would be easily achieved by the diet provided that the foods considered as source were consumed regularly. The results of the state of Maranhão and the social determinants showed no direct association, since they are permeated by poverty. Bolsa Família Program helped to alleviate the beneficiary population social vulnerability and the insertion in primary care, through the ESF, as a form of protection


Assuntos
Humanos , Feminino , Pré-Escolar , Saúde da Família/etnologia , Segurança Alimentar e Nutricional , Comportamento Alimentar , Determinantes Sociais da Saúde , Anemia/etnologia , Mães , Mulheres , Estudos Transversais , Nutrição Materna , Nutrição do Lactente
7.
BMJ Open ; 8(11): e025694, 2018 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-30391922

RESUMO

OBJECTIVES: The objectives were to characterise the haematological profile of screen-detected chronic kidney disease (CKD) participants and to correlate the complete blood count measures with the commonly advocated kidney function estimators. METHODS: The current cross-sectional study used data, collected between February 2015 and November 2016, of 1564 adults of mixed-ancestry, who participated in the Cape Town Vascular and Metabolic Health study. Kidney function was estimated using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and anaemia as haemoglobin level <13.5 g/dL (men) and <12 g/dL (women). RESULTS: Based on the MDRD and CKD-EPI equations, the crude prevalence of CKD was 6% and 3%. Irrespective of the equation used, median red blood cell (RBC) indices were consistently lower in those with CKD compared with those without CKD (all p<0.0001). Despite not showing any significant difference in total white blood cell (WBC) count between the two groups, the number of lymphocytes were lower (p=0.0001 and p<0.0001 for MDRD and CKD-EPI, respectively) and neutrophil count (both p<0.0297) and the ratio of lymphocytes to neutrophil (both p<0.0001) higher in the CKD group compared with those without CKD; with the remaining WBC indices similar in the two groups. The platelet count was similar in both groups. Of the screen-detected CKD participants, 45.5% (MDRD) and 57.8% (CKD-EPI) were anaemic, with the prevalence increasing with increasing severity of CKD, from 37.2% (stage 3) to 82.4% (stages 4-5). Furthermore, CKD-EPI-estimated kidney function, but not MDRD, was positively associated with RBC indices. CONCLUSION: Though it remains unclear whether common kidney function estimators provide accurate estimates of CKD in Africans, the correlation of their estimates with deteriorating RBC profile, suggests that advocated estimators, to some extent approximate kidney function in African populations.


Assuntos
Contagem de Células Sanguíneas , Grupos Étnicos , Falência Renal Crônica/sangue , Adulto , Idoso , Anemia/sangue , Anemia/diagnóstico , Anemia/etnologia , Antropometria , Estudos Transversais , Índices de Eritrócitos , Feminino , Taxa de Filtração Glomerular , Hemoglobinometria , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/etnologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Valores de Referência , África do Sul
9.
Aust N Z J Public Health ; 42(5): 456-462, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30151954

RESUMO

OBJECTIVE: Data collection 'silos' can be linked for health research. Anaemia in early childhood is a long-recognised health issue in remote Aboriginal communities of the Northern Territory and Western Australia, but information is lacking for Queensland. The objective of this work was to compile existing information from health and education data collections to investigate anaemia among Aboriginal and Torres Strait Islander mothers and their children in Far North Queensland. METHODS: Data mapping identified four health data collections and one education data collection holding relevant information. Data Custodians' approval was secured for release of linked de-identified information. RESULTS: Approval processes and preparation of the dataset for release took 23 months. Birth information was obtained for 2,205 mother-child pairs where the Aboriginal and/or Torres Strait Islander child was born in Far North Queensland between 2006 and 2010. Pathology information from before/during pregnancy was obtained for 2,126 mothers (96.4%), growth and haemoglobin information for 982 children (44.5%), and childhood development indicators at school entry for 963 children (43.7%). CONCLUSION: Linking existing information 'silos' enables research into key public health issues. Implications for public health: Information linkage is particularly valuable in respect of vulnerable populations including rural and remote Aboriginal and Torres Strait Islander peoples.


Assuntos
Anemia/etnologia , Armazenamento e Recuperação da Informação , Mães , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Queensland/epidemiologia
11.
J Immigr Minor Health ; 20(6): 1317-1323, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29611017

RESUMO

This study examined the variation among ethnic populations in prevalence of anemia, vitamin D and B12 deficiencies among refugee children. A retrospective chart review of 388 government assisted refugee children ≤ 16 years of age, seen at the Refugee Health Clinic in Kitchener, Canada from January 2009 to December 2014 was conducted. Vitamin D levels were only collected until December 1st 2010 (116 children). 15.7% were anemic (25% < 5 years, 8.7% 5-11 years, and 18.3% 12-16 years old) with Somali children having the lowest hemoglobin levels compared to those from Iraq, Afghanistan and Myanmar. 53.5% were vitamin D deficient (25(OH)D < 50 nmol/L), seen most commonly in Iraqis and Afghans. 11.2% had vitamin B12 levels < 150 pmol/L. Providers' knowledge of prevalence of nutritional deficiencies related to region of origin, can guide appropriate screening and treatment options to promote longer term cognitive, physical and developmental health.


Assuntos
Deficiências Nutricionais/etnologia , Refugiados/estatística & dados numéricos , Adolescente , Anemia/etnologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Ontário/epidemiologia , Prevalência , Estudos Retrospectivos , Deficiência de Vitamina B 12/etnologia , Deficiência de Vitamina D/etnologia
13.
J Immigr Minor Health ; 20(6): 1332-1338, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29582203

RESUMO

Currently, vast numbers of migrants with largely unknown health statuses have been entering Europe. To improve care taking strategies, prevalence, severity and types of anemia in a large refugee cohort were assessed. Blood counts were performed in n = 787 inhabitants from six German refugee centers. Most included migrants were young, male adults. Anemia was present in 22.5% of subjects with an age-dependent prevalence increase (7.9% > 18 years vs. 30.8% > 50 years). More females than males were anemic (27.1% vs. 20.4%). The majority of affected migrants had mild anemia (86.2%) of either normocytic/normochromic (55.9%) or microcytic/hypochromic (20.9%) type. Observed anemia frequencies are in accordance with global anemia prevalence recently estimated by the WHO. However, the observed high rates of anemia particularly in female and older refugees emphasize the need for adapted care taking strategies in refugee medicine. Further evaluation of causes of anemia in the migrating population is needed.


Assuntos
Anemia/etnologia , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Anemia/classificação , Criança , Feminino , Alemanha/epidemiologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Fatores Sexuais , Adulto Jovem
14.
Pediatr Infect Dis J ; 37(6): 586-591, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29329166

RESUMO

BACKGROUND: Brucellosis is a common zoonosis in the Bedouin population of southern Israel. Limited data exist for the rate and risk factors of hematologic complication of brucellosis in children. We assessed anemia, leukopenia, thrombocytopenia and pancytopenia in childhood brucellosis in southern Israel. METHODS: Our medical center is the sole hospital in southern Israel. All medical files of brucellosis, 2005-2014, identified through positive blood cultures or International Classification of Diseases 9th revision coding with positive serology, were reviewed retrospectively. RESULTS: Overall, 511 brucellosis episodes were identified; 42% (N = 214) with ≥1 cytopenia, including 13% (N = 68) anemia, 28% (N = 144) leukopenia, 14% (N = 74) thrombocytopenia and 2% (N = 9) pancytopenia. Overall, 99.8% of episodes were in Bedouin children and 70% in males. In 79% of episodes, blood culture was positive for Brucella melitensis. Acute infections comprised 84% of all episodes. In univariate analysis, older age (10.49 ± 4.81 vs. 9.25 ± 4.89 years), fever (92% vs. 78%), positive blood culture (84% vs. 75%) and IgM ≥1:640 levels (50% vs. 39%) were associated with cytopenia. In contrast, arthralgia was associated with noncytopenic episodes. In multivariate analyses, older age (odds ratio = 1.063) and fever (odds ratio = 3.127) were associated with cytopenia. CONCLUSIONS: Brucellosis is commonly presented with cytopenia, especially in bacteremic episodes with fever. However, pancytopenia is uncommon and its finding should alert the physician to look for other possible etiologies.


Assuntos
Bacteriemia/complicações , Brucelose/sangue , Brucelose/complicações , Zoonoses/etnologia , Adolescente , Anemia/etnologia , Anemia/etiologia , Animais , Árabes/estatística & dados numéricos , Bacteriemia/etnologia , Brucella melitensis , Brucelose/etnologia , Criança , Pré-Escolar , Monitoramento Epidemiológico , Feminino , Febre/etnologia , Humanos , Lactente , Israel/epidemiologia , Leucopenia/etnologia , Leucopenia/etiologia , Masculino , Pancitopenia/etnologia , Pancitopenia/etiologia , Estudos Retrospectivos , Trombocitopenia/etnologia , Trombocitopenia/etiologia , Zoonoses/microbiologia
15.
J Prim Health Care ; 10(3): 267-278, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-31039941

RESUMO

INTRODUCTION Primary health care organisations need to continuously reform to more effectively address current health challenges, particularly for vulnerable populations. There is growing evidence that optimal health service structures are essential for producing positive outcomes. AIM To determine if there is an association between process of care indicators (PoCIs) for important young indigenous child health and social issues and: (i) primary health-care service and child characteristics; and (ii) organisational health service structures. METHODS This was a cross-sectional study of 1554 clinical child health audits and associated system assessments from 74 primary care services from 2012 to 2014. Composite PoCIs were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted, clustering for health services. Odds ratios and 95% confidence intervals were derived. RESULTS Overall, 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. Children aged 12-23 months were significantly more likely to receive all PoCIs compared to children aged 24-59 months. For every one point increase in assessment scores for team structure and function (aOR 1.14, 95% CI 1.01-1.27) and care planning (aOR 1.14, 95% CI 1.01-1.29) items, there was a 14% greater odds of a child having an anaemia PoCI. Social and emotional wellbeing and child neurodevelopment PoCIs were not associated with system assessment scores. DISCUSSION Ensuring young indigenous children aged 24-59 months are receiving quality care for important social and health indicators is a priority. Processes of care and organisational systems in primary care services are important for the optimal management of anaemia in indigenous children.


Assuntos
Anemia/etnologia , Serviços de Saúde do Indígena/organização & administração , Transtornos do Neurodesenvolvimento/etnologia , Grupo com Ancestrais Oceânicos , Atenção Primária à Saúde/organização & administração , Fatores Etários , Criança , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Lactente , Relações Interpessoais , Masculino , Saúde Mental/etnologia , Qualidade da Assistência à Saúde/organização & administração , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos
16.
Environ Int ; 109: 20-28, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28923461

RESUMO

Pollution by heavy metals and more recently by rare earth elements (REE) and other minor elements (ME) has increased due in part to their high use in technological and electronic devices. This contamination can become very relevant in those sites where e-waste is improperly processed, as it is the case in many countries of the African continent. Exposure to some toxic elements has been associated to certain hematological disorders, specifically anemia. In this study, the concentrations of 48 elements (including REE and other ME) were determined by ICP-MS in whole blood samples of sub-Saharan immigrants with anemia (n=63) and without anemia (n=78). We found that the levels of Fe, Cr, Cu, Mn, Mo, and Se were significantly higher in the control group than in the anemia group, suggesting that anemia was mainly due to nutritional deficiencies. However, since other authors have suggested that in addition to nutritional deficiency, exposure to some elements may influence hemoglobin levels, we wanted to explore the role of a broad panel of toxic and "emerging" elements in hemoglobin deficiency. We found that the levels of Ag, As, Ba, Bi, Ce, Eu, Er, Ga, La, Nb, Nd, Pb, Pr, Sm, Sn, Ta, Th, Tl, U and V were higher in anemic participants than in controls. For most of these elements an inverse correlation with hemoglobin concentration was found. Some of them also correlated inversely with blood iron levels, pointing to the possibility that a higher rate of intestinal uptake of these could exist in relation to a nutritional deficiency of iron. However, the higher levels of Pb, and the group of REE and other ME in anemic participants were independent of iron levels, pointing to the possibility that these elements could play a role in the development of anemia.


Assuntos
Anemia/sangue , Resíduo Eletrônico , Emigrantes e Imigrantes , Poluição Ambiental/efeitos adversos , Substâncias Perigosas/sangue , Metais Pesados/sangue , Metais Terras Raras/sangue , Adolescente , Adulto , África ao Sul do Saara/etnologia , Anemia/etnologia , Anemia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Adulto Jovem
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(9): 1269-1273, 2017 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-28910945

RESUMO

Objective: To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy. Methods: The pregnant women (≤12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study, and for them anemia had been excluded by physical examination. Baseline survey and follow up till childbirth were conducted for them. A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group, 760 pregnant women without anemia randomly selected and matched by age, habitual residence during pregnancy as control group. And t test, χ(2) test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy. Results: Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08, 95%CI: 1.22-3.59), low educational level (OR=2.09, 95%CI: 1.22-3.59), pre-pregnancy perm/hair dye (OR=2.23, 95%CI: 1.63-3.05), early pregnancy vomiting (OR=2.51, 95%CI: 1.56-4.03) were the risk factors for anemia during pregnancy. Intake of vitamin and trace element supplements (OR=0.69, 95%CI: 0.50-0.94), frequent meat, fish, shrimp, egg intakes (OR=0.68, 95%CI: 0.49-0.92), frequent soy milk, milk intakes (OR=0.51, 95%CI: 0.27-0.95) were the protective factors for anemia during pregnancy. Conclusion: A number of factors, such as family annual income level, education level, poisonous and harmful material contact, pregnancy reaction, nutrition, are related to the incidence of anemia during pregnancy, it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.


Assuntos
Anemia/epidemiologia , Gestantes , Adulto , Anemia/etnologia , Estudos de Casos e Controles , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Gravidez , Cuidado Pré-Natal , Fatores de Risco
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(5): 588-591, 2017 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-28651392

RESUMO

Objective: To analyze the level of hemoglobin level and the prevalence of anemia in students aged 7-14 years in China. Methods: According to the 2010 Chinese National Surveys on Students'Constitution and Health, 71 130 students who were aged 7, 9, 12 and 14 years and had received hemoglobin test were sampled as the subjects, WHO anemia diagnostic criteria was used to explore the hemoglobin level and the prevalence of anemia. Results: The mean concentrations of hemoglobin were (129.25±11.37) g/L, (131.04±11.08) g/L, (135.02±12.12) g/L and (138.47±13.97) g/L and the prevalence of anemia was 9.0%, 6.5%, 8.6% and 7.7% respectively in 7, 9, 12 and 14 years old students. The prevalence of anemia was 9.7% in girls, significant higher than that in boys (6.2%), and 8.8% in rural students, significantly higher than that in urban students (7.1%). The hemoglobin levels were (133.19±12.56) g/L, (133.28±12.76) g/L, (134.24±12.73) g/L and (133.79±12.16) g/L and the prevalence of anemia were 8.8%, 8.3%, 6.7% and 5.9% respectively in thin, normal, overweight and fat students, there were significant differences among four groups. Conclusion: The prevalence of anemia in students aged 7-14 years in China was still high, and there was significant differences among different gender, area, age and nutritional status groups.


Assuntos
Anemia/epidemiologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Hemoglobinas/metabolismo , Anemia/etnologia , China/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Masculino , Estado Nutricional , Sobrepeso/epidemiologia , Prevalência , População Rural , Caracteres Sexuais , Estudantes , População Urbana
19.
Eur J Haematol ; 98(6): 553-562, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28160324

RESUMO

OBJECTIVE: α-Thalassemia, one of the most common genetic diseases, is caused by deletions or point mutations affecting one to four α-globin genes. Molecular diagnosis is important to prevent the most severe forms of the disease. However, the diagnosis of α-thalassemia is complex due to a high variability of the genetic defects involved, with over 250 described mutations. We summarize herein the findings of genetic analyses of DNA samples referred to our laboratory for the molecular diagnosis of α-thalassemia, along with a detailed clinical description. METHODS: We utilized a diagnostic algorithm including Gap-PCR, to detect known deletions, followed by sequencing of the α-globin gene, to identify known and novel point mutations, and multiplex ligation-dependent probe amplification (MLPA) for the diagnosis of rare or novel deletions. RESULTS: α-Thalassemia was diagnosed in 662 of 975 samples referred to our laboratory. Most commonly found were deletions (75.3%, including two novel deletions previously described by us); point mutations comprised 25.4% of the cases, including five novel mutations. Our population included mostly Jews (of Ashkenazi and Sephardic origin) and Muslim Arabs, who presented with a higher rate of point mutations and hemoglobin H disease. Overall, we detected 53 different genotype combinations causing a spectrum of clinical phenotypes, from asymptomatic to severe anemia. CONCLUSION: Our work constitutes the largest group of patients with α-thalassemia originating in the Mediterranean whose clinical characteristics and molecular basis have been determined. We suggest a diagnostic algorithm that leads to an accurate molecular diagnosis in multiethnic populations.


Assuntos
Anemia/diagnóstico , Hemoglobina H/genética , Mutação Puntual , Deleção de Sequência , alfa-Globinas/genética , Talassemia alfa/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/etnologia , Anemia/genética , Anemia/patologia , Árabes , Sequência de Bases , Criança , Pré-Escolar , Feminino , Expressão Gênica , Genótipo , Humanos , Lactente , Israel , Judeus , Masculino , Pessoa de Meia-Idade , Modelos Moleculares , Reação em Cadeia da Polimerase Multiplex/métodos , Fenótipo , Análise de Sequência de DNA , Índice de Gravidade de Doença , alfa-Globinas/química , Talassemia alfa/etnologia , Talassemia alfa/genética , Talassemia alfa/patologia
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(2): 154-157, 2017 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-28231657

RESUMO

Objective: To investigate the hemoglobin (Hb) levels during pregnancy and Hb changes from early pregnancy and association with birth weight on infants. Methods: Mothers of Zhuang Nationality who participated in the pregnancy care program and delivered at the Pingguo County Hospital from May 2013 to May 2015 were included in this study. Retrospective analysis was applied to collect data of health care and pregnancy outcomes. Multiple regression analysis and unconditional logistic regression model were used for data analysis. Results: The mean birth weight appeared as (313 5.92±435.84) grams. The Hb levels at early pregnancy showed significantly positive association with birth weight. Results from our study demonstrated that when Hb levels increased + 1 g/dl at early pregnancy, birth weight would increase 17.61(95% CI: 0.60-34.67) grams, in the adjusted model. The Hb levels at late pregnancy were significantly inversely associated with birth weight. Our findings suggested that when Hb levels increased + 1 g/dl at late pregnancy, birth weight would reduce 19.61(95% CI: -37.53 --1.70) grams in the adjusted model. Changes in Hb from early pregnancy stages were significantly inversely associated with birth weight after adjusting for confounders and Hb levels in the early pregnancy stages. The results also indicated that when Hb levels increased a + 1 g/dl from early to late pregnancy, the birth weight would decrease 32.63 g(95% CI: -48.93--16.32). Compared to the non-anemia group, the anemia group showed significantly increase of small-for-gestational-age (SGA)(OR=1.58, 95%CI: 1.08-2.32) in early pregnancy. Compared to women under the most reduction status, women with the least reduction had a significantly increase of SGA (OR= 1.87, 95% CI:1.24-2.81) among their infants. With the magnitude of reduction on Hb concentration during pregnancy, the risk of delivering babies with SGA showed a gradual trends of increase. Conclusion: Hb levels at early pregnancy were positively associated with birth weight, but the changes of Hb were inversely associated with birth weight at late pregnancy, in women of Zhuang Nationality. Anemia in early pregnancy and the low amplitude of decreased Hb concentration during pregnancy were both risk factors for newborns under less gestational ages.


Assuntos
Anemia/complicações , Peso ao Nascer , Hemoglobinas/metabolismo , Complicações Hematológicas na Gravidez/etnologia , Trimestres da Gravidez/sangue , Nascimento Prematuro/sangue , Adulto , Anemia/diagnóstico , Anemia/etnologia , China/epidemiologia , Parto Obstétrico , Grupos Étnicos , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Complicações Hematológicas na Gravidez/sangue , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/etnologia , Cuidado Pré-Natal , Estudos Retrospectivos , Fatores de Risco
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