Abstract
Anaemia remains a common global health issue with approximately a quarter of the worlds’ population affected despite universal initiatives to address the disorder. Iron deficiency anaemia and anaemia of chronic disease remain the two top ranking causes of anaemia globally and when these conditions co-exist, diagnosis is often challenging. In South Africa, high-risk groups include children, pregnant women and human immunodeficiency virus infected individuals. The morbidity and mortality associated with anaemia mandates the correct identification of the underlying cause, thus ensuring early, appropriate management. This review proposes morphological assessment with the appropriate baseline biochemical testing as the initial approach to unexplained anaemia in a primary health care setting in South Africa, in order to expedite diagnosis and ensure appropriate management.
Highlights
Anaemia can be defined as a reduction in the haemoglobin concentration of circulating red blood cells.[1]
Anaemia occurs either due to decreased bone marrow production of red blood cells or peripheral loss/destruction of circulating red blood cells. The former can be due to nutritional deficiencies, anaemia of chronic disease (ACD) or inherited bone marrow disorders whereas the latter can be due to blood loss, haemolysis or splenic sequestration
Conditions www.tandfonline.com/oemd 28 The page number in the footer is not for bibliographic referencing most commonly associated with ACD include infections such as human immunodeficiency virus (HIV) and tuberculosis, cancer, rheumatoid arthritis and other auto-immune conditions as well as chronic renal impairment
Summary
Anaemia can be defined as a reduction in the haemoglobin concentration of circulating red blood cells.[1]. The World Health Organization (WHO) grades the severity of anaemia within these groups as follows:
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