Anaemias in children in Malaya

Abstract

A study of the causes of severe anaemia in children admitted to the General Hospital, Kuala Lumpur, was made to obtain an overall picture of the causes of severe anaemia in children of different racial groups; 2,025 newly admitted children were examined. Mean haemoglobin level was 10·6 g. per 100 ml. (in 851 Chinese 10·9, in 734 Indians 10·4, and in 440 Malays 10·3). When the Indian group was divided into Sikhs and Southern Indians, 105 Sikhs had a mean haemoglobin level of 9·7 g. and 629 Southern Indians 10·5 g. per 100 ml. The lowest mean haemoglobin levels occurred in the group 6 months to 3 years old. 258 (68 Chinese, 128 Indians and 62 Malays) had a haemoglobin level of 8 g. per 100 ml. or less and 179 (45 Chinese, 92 Indians and 42 Malays) were examined further. The findings in the children studied were: iron-deficiency anaemia in 108 (19 Chinese, 71 Indians, 18 Malays); megaloblastic bone marrow changes in 35 (2 Chinese, 25 Indians, 8 Malays), 20 of whom (1 Chinese, 15 Indians, 4 Malays) had associated iron deficiency; congenital haemolytic anaemia in 12 (8 Chinese, 2 Indians, 2 Malays); malaria in 10 (1 Chinese, 1 Indian, 8 Malays); acute leukaemia in 6 (5 Chinese, 1 Malay); chronic infections in 8, including 4 of the kidney and urinary tract. A miscellaneous group consisted of cases of auto-immune haemolytic anaemia, thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, haemolytic anaemia due to G-6-PD deficiency, aplastic anaemia and malignant tumours. Some haematological findings in the different groups are presented, but we wish to emphasize that the causes of anaemia in many children were multiple and complex.