Anemia Status Research Articles

Status of Anaemia amongst women in India: trend analysis of NFHS data

The study was taken up to assess the changing trend in prevalence and severity of anaemia in women of reproductive age over the last 15 years by analyzing National Family Health Survey (NFHS) factsheet data and to draw a comparison between the prevalence of anaemia across different states/UTs of India. NFHS 3, 4 and 5 factsheets have been referred for the same. An increase in the prevalence of anaemia from 53% to 57% in all women aged 15-49 years is seen, 50.4% to 52.2% in pregnant women and 53.2% to 57.2% in non-pregnant women between NFHS 4 and 5. West Bengal has the highest prevalence of anaemia, followed by Tripura (67.2%) and Assam with 65.9% among women of 15-49 years. NFHS 5 data shows an increase in the prevalence of anaemia in all women by 4%, 1.8% in pregnant women and a increase by 4 % in non-pregnant women. Anemia Mukt Bharat campaign launched in 2019, was expected to reduce or inert the anaemia burden, but NFHS 5 data indicates a surge in anaemia incidences significantly across women of all age groups over the last five years. Hence, there is a need for revamping and implementing the programmes in a better way.

Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort

Comparing biomarker profiles measured at similar ages, but earlier in life, among exceptionally long-lived individuals and their shorter-lived peers can improve our understanding of aging processes. This study aimed to (i) describe and compare biomarker profiles at similar ages between 64 and 99 among individuals eventually becoming centenarians and their shorter-lived peers, (ii) investigate the association between specific biomarker values and the chance of reaching age 100, and (iii) examine to what extent centenarians have homogenous biomarker profiles earlier in life. Participants in the population-based AMORIS cohort with information on blood-based biomarkers measured during 1985–1996 were followed in Swedish register data for up to 35 years. We examined biomarkers of metabolism, inflammation, liver, renal, anemia, and nutritional status using descriptive statistics, logistic regression, and cluster analysis. In total, 1224 participants (84.6% females) lived to their 100th birthday. Higher levels of total cholesterol and iron and lower levels of glucose, creatinine, uric acid, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, lactate dehydrogenase, and total iron-binding capacity were associated with reaching 100 years. Centenarians overall displayed rather homogenous biomarker profiles. Already from age 65 and onwards, centenarians displayed more favorable biomarker values in commonly available biomarkers than individuals dying before age 100. The differences in biomarker values between centenarians and non-centenarians more than one decade prior death suggest that genetic and/or possibly modifiable lifestyle factors reflected in these biomarker levels may play an important role for exceptional longevity.

School-based supplementation with iron-folic acid or multiple micronutrient tablets to address anemia among adolescents in Burkina Faso: a cluster-randomized trial

BackgroundIron-deficiency anemia is a leading cause of morbidity among adolescents (aged 10–19 y), especially in low- and middle-income settings. Few policies and programs have targeted adolescent health. ObjectivesThis study aimed to evaluate the effectiveness of school-based supplementation with iron-folic acid (IFA) or multiple micronutrient supplements (MMSs) in addressing anemia among adolescents in Burkina Faso. MethodsIn this cluster-randomized trial, 3123 secondary school students aged 10 to 18 y in Burkina Faso were either supplemented with weekly IFA, daily MMSs, or received standard nutrition education as controls. Supplementation occurred between April 2021 and April 2022 over 2 supplementation periods (10 wk, then 16 wk) separated by a gap of 20 wk without supplementation. Hemoglobin was evaluated 4 times: at baseline prior to each supplementation period and at the end of each period. Anemia was categorized by the World Health Organization hemoglobin level cutoffs as none, mild, moderate, or severe. Associations between treatment arm and anemia or continuous hemoglobin (g/dL) were assessed using multilevel mixed effects generalized linear models with schools as a random effect, controlling for baseline hemoglobin or anemia status. ResultsBaseline anemia prevalence was similar across study arms, with 32.7% in IFA, 31.2% in MMS, and 29.5% in the control arm. Over the full study period, adolescents provided IFA had hemoglobin levels higher than those in the control arm (adjusted β: 0.32; 95% CI: 0.02, 0.62). No significant associations were observed for MMS or for anemia outcomes; however, the direction and magnitude of nonsignificant associations indicate potential protective effects of IFA and MMSs on anemia. ConclusionsThe results do not provide strong evidence that weekly IFA or daily MMS alone is effective, but supplementation may play a role in addressing adolescent anemia if combined with cointerventions. Additional research is required to determine the best strategy to address anemia.This trial was registered at clinicaltrials.gov as NCT04657640.

Assessment of anaemia and hyperglycaemic status in progression of diabetic retinopathy along with macular changes: A case control study

: Diabetes-related visual impairment is preventable through control measures. As diabetic retinopathy and maculopathy lack effective treatment, prevention is key. This study examines glucose, HbA1c, and hemoglobin to assess their impact on disease development and severity.Study includes 100 case (diabetic retinopathy) and 100 control (diabetes without retinopathy)subjects. Further, case group was subdivided into subgroups according to its severity and depending on the presence of maculopathy. Thereafter, values of different renal parameters were compared between these sub groups.The mean FBS and PPBS values significantly correlate with diabetic retinopathy (DR) severity (P<0.001 for FBS, P=0.012 for PPBS). Uncontrolled diabetes compounds DR risk. All very severe NPDR and PDR patients had HbA1c >7.0. No significant relationship between HbA1c and DR severity (P=0.302) was found. Elevated HbA1c in cases (P<0.001) underscores hyperglycemia's role. CSME, F/PP blood sugar, and HbA1c show no significant correlation. DR group has higher anemia likelihood (P=0.001), increasing with severity (P=0.017). Hemoglobin's relation to CSME is statistically insignificant.Elevated FBS, PPBS, and HbA1C levels in diabetic retinopathy (DR) cases link hyperglycemia to DR development. Severity correlates with these parameters. HbA1C rises notably in severe NPDR and PDR. Anemia risk increases, but CSME shows no significant correlation. Monitoring biochemistry is vital due to limited DR treatment options.

Seasonality, food security, diet quality and nutritional status in urban poor adolescents in Malaysia

Seasonality was shown to have an effect on food availability and accessibility, increasing the risk of food insecurity and causing poor diet quality and malnutrition. Therefore, this study aimed to determine seasonal effects on household food security status, diet quality, and nutritional status of urban poor adolescents in Malaysia. A cohort study was conducted among 164 adolescents aged 10–17 from 12 People Housing Programme in Kuala Lumpur, Malaysia during the Northeast (November 2021 till March 2022) and Southwest (June 2022 till September 2022) monsoon. Household food security status was measured using the 18-item USDA Household Food Security Survey Module. Dietary intake was determined using a two-days 24-h dietary recall and translated into Standardized Malaysian Healthy Eating Index (S-MHEI). Anthropometric and haemoglobin level measurements were performed to determine nutritional status. Seasonality was found to have a significant effect on overall diet quality (p = 0.021), food groups such as fish (p < 0.001), meat/poultry/eggs (p = 0.003), and legumes/nuts (p < 0.001), and fat nutrient (p = 0.037) as well as anaemia status (p = 0.020) after controlling the confounders. Although food security did not vary with seasons, seasonality affected the consumption of certain food groups as well as anaemia status for urban poor adolescents. Seasonally sensitive nutrition initiatives should be developed to ensure diet adherence to recommendations, ultimately enhancing the diet quality of urban poor adolescents.

Association between preoperative anemia and postoperative short-term outcomes in patients undergoing colorectal cancer surgery - a propensity score matched retrospective cohort study

BackgroundBased on previous studies which failed to analyze important confounding variables, the association between preoperative anemia and outcomes of patients who underwent colorectal cancer (CRC) surgery has not been clearly demonstrated. This study aimed to investigate the relationship between preoperative anemia and short-term outcomes in patients with CRC.MethodsData from a retrospective collective database of patients who underwent CRC surgery at our hospital between September 1, 2019 and September 30, 2021 were retrieved and analyzed, and the short-term postoperative outcomes of anemic (hemoglobin < 120 g dL− 1 for female, hemoglobin < 130 g dL− 1 for male) and non-anemic patients were analyzed, using a 1:1 propensity score matching (PSM) analysis.ResultsAfter excluding some cases, the remaining 1894 patients had complete data available for analysis. The incidence of preoperative anemia was 39.8% (754/1894). Before PSM, preoperative anemia patients had a higher risk of major morbidity than non-anemia patients (27.2% vs. 23.1%, odds ratio [OR] 1.245, 95% confidence interval [CI] 1.008–1.538, P = 0.042). After PSM was performed in the cohort, 609 patients remained in the anemic and non-anemic groups. The incidence of major morbidity (25.8% vs. 24.0%, OR 1.102, 95% CI 0.849–1.429, P = 0.446) between anemic and non-anemic patients was comparable. No significant difference was found between the anemic and non-anemic groups in postoperative length of stay (8.0 [6.0–12.0] vs. 8.0 [7.0–11.0], P = 0.311). The sensitivity analysis results were in accordance with the primary outcome. Furthermore, we did not ascertain any discernible correlation between the extent of anemia and significant major morbidity.ConclusionsCompared with preoperative non-anemia, anemia status does not seem to be associated with major morbidity in patients with CRC surgery. It is noteworthy that, anemia is insufficient as a solitary risk factor and may be a better marker of poor health resulting from multiple factors.Trial registrationRegistration Authority: Chinese Clinical Trial Registry; Registration number and date: ChiCTR2100049696, 08/08/2021; Principal investigator: Ting Yan; Link to trial registry: http://www.chictr.org.cn/showproj.aspx?proj=131698; .

Relationship between Eating Patterns and Sleep Patterns on the Anemia Status of Class XI Female Students at SMAN 7 Samarinda

Based on data from the Samarinda Health Office for 2021 in Harapan Baru Village, the percentage of risk of anemia for young women is (58%). Adolescence is a transition period, therefore eating and sleeping patterns must be appropriate to needs. The aim of this research is to determine the relationship between eating patterns and sleep patterns on anemia status in female students. The research design used a cross sectional approach with a sample size of 45 people. Bivariate data analysis used the Spearman rank test. The results of the study stated that there was a relationship between diet and sleep patterns and anemia status. The ρ value for the diet variable is 0.003 (&lt;0.05), so Ha is accepted with the г value being 0.14. The strength of the correlation is weak in the direction of positive (significant) correlation. The ρ value for the sleep pattern variable is 0.007 (&lt;0.05), so Ha is accepted with the г value being -0.47. The strength of the correlation is quite strong with a negative correlation direction (not significant). There is a relationship between diet and sleep patterns on anemia status with different strength and direction of correlation.

Predictors of Change in the Anemia Status Among Pulmonary Tuberculosis Patients Following Anti-tuberculosis Treatment in Puducherry, India.

Background Pulmonary tuberculosis (PTB) is commonly associated with reversible peripheral blood abnormalities. The evolution of tuberculosis (TB)-associated anemia with anti-tuberculosis treatment (ATT) has not been well elucidated. This study aimed to compare the hematological profiles at the start and end of the ATT among new sputum smear-positive (NSP) PTB patients in Puducherry, India. Methods A prospective cohort study was conducted in the 10 urban primary health centers of Puducherry from 2017 to 2020. All the NSP PTB participants aged ≥18 years registered under the National Tuberculosis Elimination Program (NTEP) were contacted within two weeks of the start of the ATT. All eligible participants were enrolled, and they were followed up till the end of ATT (180 days). Hematological profiles and anthropometric measurements were compared at the start and end of the ATT. Binomial logistic regression analysis was used to assess the predictors of changes in the anemia status at the start and end of the ATT. Results Out of 176 NSP PTB participants, 145 were followed up after treatment. Initially, 63% (111/176) patients had anemia, which decreased to 44% (64/145) by the end of treatment. The risk factors for a negative change in hemoglobin levels were female gender, below poverty level, underweight, and reduced iron intake. The adjusted risk ratios (ARRs) were 1.53 (1.24-1.88), 1.18 (1.01-1.38), 1.29 (1.02-1.64), and 1.26 (1.05-1.51),respectively. Conclusion ATT may lead to the resolution of TB-associated anemia. Moreover, female gender, possession of a red ration card, being underweight, and reduced iron intake were identified as risk factors for negative changes in hemoglobin levels during treatment.

Using the community-based breeding program (CBBP) model as a collaborative platform to develop the African Goat Improvement Network-Image collection protocol (AGIN-ICP) with mobile technology for data collection and management of livestock phenotypes.

Introduction: The African Goat Improvement Network Image Collection Protocol (AGIN-ICP) is an accessible, easy to use, low-cost procedure to collect phenotypic data via digital images. The AGIN-ICP collects images to extract several phenotype measures including health status indicators (anemia status, age, and weight), body measurements, shapes, and coat color and pattern, from digital images taken with standard digital cameras or mobile devices. This strategy is to quickly survey, record, assess, analyze, and store these data for use in a wide variety of production and sampling conditions. Methods: The work was accomplished as part of the multinational African Goat Improvement Network (AGIN) collaborative and is presented here as a case study in the AGIN collaboration model and working directly with community-based breeding programs (CBBP). It was iteratively developed and tested over 3years, in 12 countries with over 12,000 images taken. Results and discussion: The AGIN-ICP development is described, and field implementation and the quality of the resulting images for use in image analysis and phenotypic data extraction are iteratively assessed. Digital body measures were validated using the PreciseEdge Image Segmentation Algorithm (PE-ISA) and software showing strong manual to digital body measure Pearson correlation coefficients of height, length, and girth measures (0.931, 0.943, 0.893) respectively. It is critical to note that while none of the very detailed tasks in the AGIN-ICP described here is difficult, every single one of them is even easier to accidentally omit, and the impact of such a mistake could render a sample image, a sampling day's images, or even an entire sampling trip's images difficult or unusable for extracting digital phenotypes. Coupled with tissue sampling and genomic testing, it may be useful in the effort to identify and conserve important animal genetic resources and in CBBP genetic improvement programs by providing reliably measured phenotypes with modest cost. Potential users include farmers, animal husbandry officials, veterinarians, regional government or other public health officials, researchers, and others. Based on these results, a final AGIN-ICP is presented, optimizing the costs, ease, and speed of field implementation of the collection method without compromising the quality of the image data collection.

Pelaksanaan Skrining Anemia Pada Catin Wanita Di Puskesmas Tapin Utara Tahun 2021

Hb examination on female catin is useful to determine the status of anemia so that it can be prevented and intervened before pregnancy. According to the 2021 report of the Tapin District Health Office, the incidence of anemia in Catin was 160 people (14.1%) from 1135 catin examined. Puskesmas Tapin Utara is one of the puskesmas in Tapin regency that has provided reproductive health services to catin with the second most catin targets in Tapin district. The purpose of the study was to determine the implementation of anemia screening in women at the North Tapin health center. Quantitative descriptive observational research method on catin characteristics of anemic women through the reproductive health register instrument of the North Tapin Health Center in 2021. The results of the study of 130 women screened at the North Tapin health center in 2021 were 23 adolescents (17.7%), 107 adults (82.3). Very Thin category 12 people (9.2%), Thin category 23 people (17.7%), Normal 71 people (54.6%), Obese 10 people (7.7%), and Obesity 14 people (10.8%). Anemia 23 people (17.7%) and those who are not anemic 107 people (82.3%).

The complex relationship between iron status and anemia in pregnant and postpartum women in India: Analysis of two Indian study cohorts of uncomplicated pregnancies.

Low hemoglobin is widely used as an indicator of iron deficiency anemia in India and other low-and-middle income counties, but anemia need not accurately reflect iron deficiency. We examined the relationship between hemoglobin and biomarkers of iron status in antenatal and postnatal period. Secondary analysis of uncomplicated singleton pregnancies in two Indian study cohorts: 1132 antenatal women in third trimester and 837 postnatal women 12-72 h after childbirth. Associations of hemoglobin with ferritin in both data sets, and with sTfR, TSAT, and hepcidin in the postnatal cohort were examined using multivariable linear regression. Multinomial logistic regression was used to examine the association between severity of anemia and iron status. Regression models were adjusted for potential confounders. Over 55% of the women were anemic; 34% of antenatal and 40% of postnatal women had low ferritin, but 4% antenatal and 6% postnatal women had high ferritin. No evidence of association between hemoglobin and ferritin was observed (antenatal: adjusted coefficient [aCoef] -0.0004, 95% confidence interval [CI] -0.001, 0.001; postnatal: aCoef -0.0001, 95% CI -0.001, 0.001). We found a significant linear association of hemoglobin with sTfR (aCoef -0.04, 95% CI -0.07, -0.01), TSAT (aCoef -0.005, 95% CI -0.008, -0.002), and hepcidin (aCoef 0.02, 95% CI 0.02, 0.03) in postnatal women. Likelihood of low ferritin was more common in anemic than non-anemic women, but high ferritin was also more common in women with severe anemia in both cohorts. Causes of anemia in pregnant and postpartum women in India are multifactorial; low hemoglobin alone is not be a useful marker of iron deficiency.

ANAEMIA, EXPECTANT MOTHERS AND DIETARY HABITS: ISSUES AND CONCERNS

The problem of anaemia among expectant mothers, instead of declining has increased over the years at the all India level and also in almost all the states of the country though differentially. These revelations come from the comparative analysis of the NFHS- 4 and NFHS- 5 data on anaemia released in the year 2000 and 2022 respectively. A review of the studies attributes the problem to inadequate nutritious food available to the expectant mothers during the period of pregnancy when the need of the body for iron and calcium increases for the proper growth of the foetus. In the absence of which the women are unable to bear the pressures of bleeding in the pre and post delivery period, leading to low weight baby birth and premature births, and at times resulting in high maternal mortality. This paper examines the status of anaemia among expectant mothers and its relationship with dietary habits.

151. INFLUENCE OF PERIOPERATIVE ANEMIA ON MORBIDITY AND MORTALITY OUTCOMES AFTER RADICAL ESOPHAGECTOMY

Abstract Objectives Methods Retrospective and analytical study of patients who underwent radical esophagectomy for esophageal cancer performed in our institution from 2015 to 2021. Several parameters related to anemia were measured: hemoglobin, ferritin, transferrin saturation and iron blood levels, as well as the need for perioperative blood transfusion. We analyzed, on the one hand, the incidence of complications in the immediate postoperative period. On the other hand, we assessed the results of overall survival and disease-free survival in relation to tumor disease. Results A total of 137 patients treated for esophageal neoplasia were included. The interventions performed were McKeown/Ivor-Lewis esophagectomy. Up to 106 (77,4%) patients received neoadjuvant therapy. Patients who required transfusion in the perioperative period (35 patients; 26%) had a significantly lower mean survival (33 vs. 53 months). In addition, they presented higher rates of postoperative complications as well as a lower 5-year overall survival (Log Rank; p = 0.004). Patients with preoperative hemoglobin levels below 12 g/dL had a significantly higher recurrence rate (21% vs. 7%; p &amp;lt; 0.05). The anemic status was improved after the implementation of a multimodal prehabilitation protocol (12.1 g/dL versus 13 g/dL). Conclusions Radical esophagectomy is associated with high morbidity and mortality. Minimally invasive surgery has improved intra and postoperative outcomes. Despite this, the risk of intraoperative bleeding is not negligible. Therefore, it is essential for the patient to be in an optimal clinical and analytical status. Multimodal prehabilitation could improve this status and the postoperative recovery. Studies with a larger number of patients and a longer follow-up will be necessary to evaluate the impact of this strategy.

Analisis faktor risiko kejadian bayi berat badan lahir rendah (BBLR) selama pandemi Covid-19

The incidence of low birth weight (LBW) is still the focus of an important problem to pay attention to, especially during the Covid-19 pandemic. LBW is one of the causes of death in neonates and requires them to undergo treatment in the intensive care unit at the hospital. There are several factors that are strongly suspected of being a risk for LBW events. The aim of this research is to identify some of the risks that contribute to the incidence of LBW during the Covid-19 pandemic. A non-experimental study with a case control design was conducted in this study. Total sampling was used to get the sample, with a total of 90 case groups and 90 control groups. The case group was LBW while the control group was non LBW. The data collection technique uses secondary data by looking at medical records. The medical records used were medical records between April 2020 and August 2022. The statistical test used was the Chi-square test to get the Odds Ratio (OR) value. The results of this study indicate that multiparous mothers are 2.71 times more likely to give birth to LBW infant than primiparous mothers (OR. 2.71; 95% CI: 1.139-3.767; p=0.017). Mothers who are anemic will tend to give birth to LBW infant 2.026 times compared to mothers who are not anemic (OR.2.026; 95% CI: 1.102-3.723; p=0.023). Mothers who have a history of Covid-19 infection will tend to be 4.038 more likely to give birth to LBW infant than mothers who are negative for Covid-19 (OR.4.038; 95% CI: 1.087-15.002; p=0.037). The conclusion is parity status, anemia status, and history of COVID-19 infection are risk factors for LBW events during the Covid-19 pandemic.

Correlation between serum hepcidin level and stages of chronic kidney disease: A cross sectional study

Introduction: Chronic Kidney Disease (CKD) has been associated with significant mortality and morbidity. Despite significant numbers of cases, biomarkers related to iron status and development of anaemia in these patients has not been looked upon extensively. Few biomarkers have been studied, one of which is serum hepcidin levels. We aimed to estimate the serum hepcidin levels in patients with CKD and its correlation with its successive stages. Materials and Methods: The study design was cross-sectional observational study. 51 patients of CKD KDIGO stage II to V were included and patients of obstructive uropathy or malignancy or transplant recipient were excluded from the study. The aim of the study was to evaluate the association between serum hepcidin levels and Stages of CKD in terms of eGFR. Results: The mean serum hepcidin levels which were found in Stage II, III, IV and V of CKD patients was 65.48, 116.03, 136.61 and 160.37 ng/ml respectively. There was a strong negative correlation between eGFR and serum hepcidin level, and this correlation was statistically significant (r = -1.0, p = &lt;0.001). The Krushkal-Wallis Test also provided p value of &lt;0.001 when stages of CKD and serum hepcidin levels were correlated. Conclusion: There was significant positive correlation of serum hepcidin with the stages of CKD (P &lt; 0.001) and the levels of serum hepcidin were found to be significantly higher as the stage increased. Thus, serum hepcidin may be used as a marker of iron metabolism, prognosis and progress of disease in the CKD patients.

Patient Blood Management in Microsurgical Procedures for Reconstructive Surgery.

Introduction: The main purpose of reconstructive surgery (RS) is to restore the integrity of soft tissues damaged by trauma, surgery, congenital deformity, burns, or infection. Microsurgical techniques consist of harvesting tissues that are separated from the vascular sources of the donor site and anastomosed to the vessels of the recipient site. In these procedures, there are some preoperative modifiable factors that have the potential to influence the outcome of the flap transfer and its anastomosis. The management of anemia, which is always present in the postoperative period and plays a decisive role in the implantation of the flap, covers significant importance, and is associated with clinical and laboratory settings of chronic inflammation. Methods: Chronic inflammatory anemia (ACD) is a constant condition in patients who have undergone RS and correlates with the perfusion of the free flap. The aim of this treatment protocol is to reduce the transfusion rate by maintaining both a good organ perfusion and correction of the patient's anemic state. From January 2017 to September 2019, we studied 16 patients (16 males, mean age 38 years) who underwent microsurgical procedures for RS. Their hemoglobin (Hb) levels, corpuscular indexes, transferrin saturation (TSAT) ferritin concentrations and creatinine clearance were measured the first day after surgery (T0), after the first week (T1), and after five weeks (T2). At T0, all the patients showed low hemoglobin levels (average 7.4 g/dL, STD 0.71 range 6.2-7.4 g dL-1), with an MCV of 72, MCH of 28, MCHC of 33, RDW of 16, serum iron of 35, ferritin of 28, Ret% of 1.36, TRF of 277, creatinine clearance of 119 and high ferritin levels (range 320-560 ng mL-1) with TSAT less than 20%. All the patients were assessed for their clinical status, medical history and comorbidities before the beginning of the therapy. Results: A collaboration between the two departments (Department of Transfusion Medicine and Department of Reconstructive Surgery) resulted in the application of a therapeutic protocol with erythropoietic stimulating agents (ESAs) (Binocrit 6000 UI/week) and intravenous iron every other day, starting the second day after surgery. Thirteen patients received ESAs and FCM (ferric carboxymaltose, 500-1000 mg per session), three patients received ESAs and iron gluconate (one vial every other day). No patients received blood transfusions. No side effects were observed, and most importantly, no limb or flap rejection occurred. Conclusions: Preliminary data from our protocol show an optimal therapeutic response, notwithstanding the very limited scientific literature and data available in this specific surgical field. The enrollment of further patients will allow us to validate this therapeutic protocol with statistically sound data.

Dietary Diversity and Its Contribution to the Magnitude of Anaemia among Pregnant Women: Evidence from Rural Areas of Western China.

Prenatal anaemia causes serious consequences for both mother and foetus, and dietary factors are suggested to be associated with anaemia. However, research in pregnant women living in rural areas is limited. We aim to assess the contribution of dietary diversity to the magnitude of prenatal anaemia in rural China and identify the interactions between dietary diversity and several sociodemographic and maternal characteristics in relation to anaemia. A multi-stage random cluster sampling method was used to select pregnant women in rural western China. The Woman's Dietary Diversity Score was created to measure dietary diversity, which was recoded into terciles. Multinomial logistic regression models were used to assess the associations between dietary diversity score terciles and the magnitude of prenatal anaemia. Multiplicative interactions were tested by adding the product term of dietary diversity and several sociodemographic and maternal characteristics into the regression models. Out of 969 participants, 54.3% were measured as anaemic, with 28.6% mildly anaemic and 25.7% moderately to severely anaemic. There was an absence of agreement between self-reported and measured anaemia status (κ = 0.28, 95% CI [0.22-0.34]). Participants in the highest dietary diversity score tercile had lower odds of being moderately to severely anaemic after adjusting for potential confounders (RRR = 0.65, 95% CI [0.44, 0.98]). In participants with moderate to severe anaemia, significant interactions were found between dietary diversity score terciles, age, and parity (p for interaction < 0.05). The prevalence of prenatal anaemia in rural China remains high, and pregnant women living in these areas are insufficiently aware of their anaemia status. Improving dietary diversity is needed to manage prenatal anaemia in rural areas.

Gastrointestinal Angiodysplasia in Patients with Severe Aortic Stenosis: The Endoscopic Features of Heyde’s Syndrome

Introduction: Aortic stenosis (AS) is sometimes associated with gastrointestinal bleeding, and this phenomenon is known as Heyde’s syndrome. Such bleeding is most often considered to originate from gastrointestinal angiodysplasias, but the frequency and endoscopic features of such bleeding remain unclear. This study aimed to determine the frequency and endoscopic features of gastrointestinal angiodysplasia in patients with severe AS. Patients and Methods: In this multicenter, retrospective study, we evaluated consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with severe AS from May 2016 to December 2019. We extracted the data on the clinicopathological features according to the status of anemia, the proportion of patients who underwent gastrointestinal endoscopic examinations and demonstrated gastrointestinal angiodysplasia, and identified the endoscopic features associated with such patients. Results: In 325 patients, the rates of moderate/severe anemia (hemoglobin < 11 g/dL) were 52%. Regarding medicine, there were no significant differences between the patients with and without moderate/severe anemia. Patients were examined by esophagogastroduodenoscopy (21%), colonoscopy (12%), and balloon-assisted enteroscopy or small bowel capsule endoscopy (1.5%). Patients with moderate/severe anemia had significantly more angiodysplasia (38.3% vs. 7.7%; p < 0.0001) and active bleeding (23.4% vs. 0%; p < 0.01). Angiodysplasia was detected in 21 patients (stomach, n = 9; small intestine, n = 5, and colon, n = 10). Conclusions: The results suggest, for the first time, that patients with severe AS who underwent TAVI and moderate/severe anemia frequently had gastrointestinal angiodysplasia and active bleeding throughout the entire gastrointestinal tract.

Anaemia and iron deficiency associate with polymorphism TMPRSS6 rs855791 in Brazilian children attending day care centres.

Fe-deficiency anaemia is a major public health concern in children under 5 years of age. TMPRSS6 gene, encoding matriptase-2 protein, is implicated in Fe homoeostasis and has been associated with anaemia and Fe status in various populations. The aim of this cross-sectional study was to investigate the associations between the single nucleotide polymorphism (SNP) TMPRSS6 rs855791 and biomarkers of anaemia and Fe deficiency in Brazilian children attending day care centres. A total of 163 children aged 6-42 months were evaluated. Socio-economic, demographic, biochemical, haematological, immunological and genotype data were collected. Multiple logistic and linear regressions with hierarchical selection were used to assess the effects of independent variables on categorised outcomes and blood marker concentrations. Minor allele (T) frequency of rs855791 was 0·399. Each copy of the T allele was associated with a 4·49-fold increased risk of developing anaemia (P = 0·005) and a 4·23-fold increased risk of Fe deficiency assessed by serum soluble transferrin receptor (sTfR) (P < 0·001). The dose of the T allele was associated with an increase of 0·18 mg/l in sTfR concentrations and reductions of 1·41 fl and 0·52 pg in mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH), respectively. In conclusion, the T allele of SNP TMPRSS6 rs855791 was significantly associated with anaemia and Fe deficiency assessed by sTfR in Brazilian children attending day care centres. The effect was dose dependent, with each copy of the T allele being associated with lower MCV and MCH and higher concentrations of sTfR.

Key drivers of reversal of trend in childhood anaemia in India: evidence from Indian demographic and health surveys, 2016–21

AimRecent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021.MethodsData of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia.ResultsDuring the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6–59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers’ educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia.ConclusionThese findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India.