High Prevalence Of Anemia Research Articles

Haemoglobin diagnostic cut-offs for anaemia in Indian women of reproductive age.

The persistent high prevalence of anaemia among Indian women of reproductive age (WRA) despite aggressive long-term iron supplementation could be related to over-diagnosis from an inappropriately high haemoglobin (Hb) diagnostic cut-off. To develop an appropriate cut-off for Indian WRA, we hypothesized that during iron-folic acid (IFA) supplementation to a mixed (anaemic/non-anaemic) WRA population, the positive slope of the Hb-plasma ferritin (PF) response in anaemic women would inflect into a plateau (zero-response) as a non-anaemic status is reached. The 2.5th percentile of the Hb distribution at this inflection point will be the diagnostic Hb cut-off for iron-responsive anaemia. A hierarchical mixed effects model, with a polynomial mean and variance model to account for intraclass correlation due to repeated measures, was used to estimate the response curve of Hb to PF, or body iron stores, in anaemic and non-anaemic WRA (without inflammation), who were receiving a 90-day IFA supplementation. The Hb response curve at low PF values showed a steep increase, which inflected into a plateau at a PF of 10.1 µg/L and attained a steady state at a PF of 20.6 µg/L. The Hb distribution at the inflection was a normal probability distribution, with a mean of 12.3 g/dL. The 2.5th percentile value of this distribution, or the putative diagnostic Hb cut-off for anaemia, was 10.8 g/dL (~11 g/dL). The derived Hb cut-off is lower than the current adult values of 12 g/dL and could partly explain the persistently high prevalence of anaemia.

Anemia Profiles in Cancer Patients: Prevalence, Contributing Factors, and Insights From a Retrospective Study at a Single Cancer Center in Saudi Arabia.

Anemia, a common complication of cancer and its treatments, significantly affects cancer patients' survival and quality of life. Nevertheless, there is limited research conducted in the southern region of Saudi Arabia regarding its effects. This study aims to assess the prevalence of anemia, as well as its associated factors, among cancer patients undergoing active chemotherapy treatment. This retrospective study analyzed adult cancer patients who underwent chemotherapy at King Khaled Hospital's oncology department in Najran, Saudi Arabia, between 2017 and 2022. We aimed to determine the prevalence and contributing factors of anemia through comprehensive demographic and clinical assessment. Univariate analysis was performed to assess factors necessitating blood transfusion. A total of 95 cancer patients received chemotherapy, with a mean age of 52.2 ± 16.5 years. The majority were females (65.3%) aged between 18 and 64 years (74.7%). Gastrointestinal (42.1%) and breast (17.9%) cancers were the most prevalent malignancies. Most patients (56.8%) were in locally advanced stages. Anemia was present at admission in 48 (50.5%) patients with a higher prevalence among colorectal and genitourinary tract cancer patients. The mean hemoglobin (Hb) drop during treatment was 9.1 ± 2.1 g/dL. Anemia severity was stratified as follows: life-threatening (7.4%), severe (33%), moderate (31%), and lower limited (29%). Blood transfusions were required in 79% of cases. Advanced age, increased chemotherapy cycles, and anemia of chronic disease (ACD) were significantly associated with increased anemia severity (p<0.05). Increasing chemotherapy cycles also correlated with an increased need for blood transfusion (p<0.001). Older patients (≥65 years) had higher anemia at admission, poor Eastern Cooperative Oncology Group (ECOG) performance status, more Hb decrease during treatment, and increased need for blood transfusions (p<0.05) compared to younger patients (<65 years). The study noted a high prevalence of anemia (50.5%) in patients receiving active cancer treatment, specifically in the context of genitourinary and gastrointestinal tract cancers. Advanced age, frequent chemotherapy cycles, and ACD were associated with increased severity of anemia. Furthermore, older patients displayed a higher frequency of anemia, poorer performance status, and an increased requirement for transfusions with an escalating number of chemotherapy cycles.

Allogeneic Blood Transfusion and Risk of Postoperative Complications in Patients with Mild and Moderate Anemia of Any Cause? A Retrospective Cohort Study in Total Revision Hip Surgery

Introduction: Patients undergoing revision total hip surgery (RTHS) have a high prevalence of mild and moderate preoperative anemia, associated with adverse outcomes. The aim of this study was to investigate the association of perioperative allogeneic blood transfusions (ABT) and postoperative complications in preoperatively mild compared to moderate anemic patients undergoing RTHS who did not receive a diagnostic anemia workup and treatment before surgery. Methods: We included 1,765 patients between 2007 and 2019 at a university hospital. Patients were categorized according to their severity of anemia using the WHO criteria of mild, moderate, and severe anemia in the first Hb level of the case. Patients were grouped as having received no ABT, 1–2 units of ABT, or more than 2 units of ABT. Need for intraoperative ABT was assessed in accordance with institutional standards. Primary endpoint was the compound incidence of postoperative complications. Secondary outcomes included major/minor complications and length of hospital and ICU stay. Results: Of the 1,765 patients, 31.0% were anemic of any cause before surgery. Transfusion rates were 81% in anemic patients and 41.2% in nonanemic patients. The adjusted risks for compound postoperative complication were significantly higher in patients with moderate anemia (OR 4.88, 95% CI: 1.54–13.15, p = 0.003) but not for patients with mild anemia (OR 1.93, 95% CI: 0.85–3.94, p < 0.090). Perioperative ABT was associated with significantly higher risks for complications in nonanemic patients and showed an increased risk for complications in all anemic patients. In RTHS, perioperative ABT as a treatment for moderate preoperative anemia of any cause was associated with a negative compound effect on postoperative complications, compared to anemia or ABT alone. Discussion: ABT is associated with adverse outcomes of patients with moderate preoperative anemia before RTHS. For this reason, medical treatment of moderate preoperative anemia may be considered.

Influence of serum transferrin concentration on diagnostic criteria for iron deficiency in chronic heart failure.

Transferrin saturation (TSAT), a marker of iron deficiency, reflects both serum concentrations of iron (SIC) and transferrin (STC). TSAT is susceptible to changes in each of these biomarkers. Little is known about determinants of STC and its influence on TSAT and mortality in patients with heart failure. Accordingly, we studied the relationship of STC to clinical characteristics, to markers of iron deficiency and inflammation and to mortality in chronic heart failure (CHF). Prospective cohort of patients with CHF attending a clinic serving a large local population. A total of 4422 patients were included (median age 75 (68-82) years; 40% women; 32% with left ventricular ejection fraction ≤40%). STC≤2.3g/L (lowest quartile) was associated with older age, lower SIC and haemoglobin and higher high-sensitivity C-reactive protein, ferritin and N-terminal pro-brain natriuretic peptide compared with those with STC>2.3g/L. In the lowest STC quartile, 624 (52%) patients had SIC ≤13μmol/L, of whom 38% had TSAT ≥20%. For patients in the highest STC quartile, TSAT was <20% when SIC was >13μmol/L in 185 (17%) patients. STC correlated inversely with ferritin (r=-0.52) and high-sensitivity C-reactive protein (r=-0.17) and directly with albumin (r=0.29); all P<0.001. In models adjusted for age, N-terminal pro-brain natriuretic peptide and haemoglobin, both higher SIC (hazard ratio 0.87 [95% CI: 0.81-0.95]) and STC (hazard ratio 0.82 [95% CI: 0.73-0.91]) were associated with lower mortality. SIC was more strongly associated with both anaemia and mortality than either STC or TSAT. Many patients with CHF and a low STC have low SIC even when TSAT is >20% and serum ferritin >100μg/L; such patients have a high prevalence of anaemia and a poor prognosis and might have iron deficiency but are currently excluded from clinical trials of iron repletion.

Prevalence of Anemia during 1st Trimester and Physiological symptoms of Pregnancy A Single Center Study

Abstract:&#x0D; Background: Anemia in pregnancy accounts for one fifth maternal deaths worldwide and is associated with high maternal morbidity, mortality and adverse pregnancy outcomes. Pregnancy is associated with a variety of physiological symptoms, which can be distressing and need to be managed.&#x0D; Objectives: To determine the frequency of anemia and frequency of physiological symptoms of pregnancy in the first trimester with a view to developing tools to increase awareness to prevent, and timely escalation of the care.&#x0D; Methodology:&#x0D; A cross-sectional analytic study was conducted on data for women attending a rural health center for their first antenatal visit from January to November 2021. A formal interview of eligible participants was conducted by on duty doctor to determine pregnancy related symptoms and demographic data. Hemoglobin, and urine analysis reports were obtained from the hospital’s laboratory. Data was entered in Microsoft excel Sheet and analyzed using SPSS 21 and reported as frequencies and percentages.&#x0D; Results: &#x0D; The mean age of participants was 27.2 ± 4.6 years and mean Hb levels were 9.82 ±0.66 g/dl. The overall frequency of anemia was 96.5%. Majority were mildly anemic (71.5%), 5.9% were moderately anemic, 0.3% were severely anemic. Nausea and vomiting were the most common symptoms reported in 190 (23.7%) females. Heart burn was reported in 117 (14.6%), urinary tract infection (UTI) in 97 (12.1%), constipation in 39 (4.9%), backache in 33 (4.1%) and 28 (3.5%) women reported pelvic pain in the first trimester.&#x0D; Conclusion: &#x0D; There was high prevalence of anemia among pregnant women in the first trimester which calls for awareness and education of the community. Most common symptoms found in our population were nausea and vomiting, followed by heart burn and urinary tract infection.

Contribution of hemoglobin concentration to cardiorespiratory fitness in black African American patients with recently decompensated heart failure and reduced ejection fraction.

Previous studies have shown that patients with heart failure with reduced ejection fraction (HFrEF) and anemia have reduced peak oxygen consumption (VO<inf>2</inf>). Black or African American (B-AA) patients have a higher prevalence of anemia and are underrepresented in clinical studies of HFrEF. The aim of this study was to determine the contribution of hemoglobin to peak VO<inf>2</inf> in B-AA patients recently hospitalized for acute decompensated HFrEF. We analyzed cardiopulmonary exercise testing (CPX) data measured within two weeks of discharge for acute decompensated HF in B-AA patients with HFrEF (left ventricular ejection fraction [LVEF] ≤40%) without severe anemia (Hb<8 g/dL). Blood samples were collected prior to CPX. Data are reported as median [interquartile range] and compared between groups with the Mann-Whitney, Chi-Square, and Spearman's rank tests. We included 81 patients; 27 (33%) women, 57 [27-79] years of age, Body Mass Index of 33 [15-55] kg/m2 and LVEF of 30 [23-36] %. Hemoglobin ranged between 9.1 to 18.1 g/dL (median= 13.3 [11.9-14.5] g/dL); 26 (32%) were considered to have anemia based on a Hb concentration of males <13 g/dL and females <12 g/dL. Peak VO<inf>2</inf> was lower in patients with anemia (11.8 [10.0-14.2] vs. 14.1 [10.6-17.0] mL·kg-1·min-1; P=0.010) with a significant correlation between peak VO<inf>2</inf> and hemoglobin concentration (R=+0.455; P<0.001). Anemia is prevalent among B-AA patients with recently decompensated HFrEF and appears to be a significant contributor to reductions in peak VO<inf>2</inf>.

Global Prevalence of Anemia Among Type 2 Diabetic Adult Patients: A Systematic Review and Meta-Analysis.

Anemia is a common and often overlooked hematological change observed in patients with diabetes mellitus. However, there is no global survey or health registry that estimates the pooled prevalence of anemia in patients with type 2 diabetes. Therefore, this study aimed to determine the global pooled prevalence of anemia among adult patients with type 2 diabetes. This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The study protocol was registered on PROSPERO with the reference number (CRD42022327135), and the link provided (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327135) display the published methodology. Previously published articles were searched in PubMed/Medline, Cochrane Library, WHO Global Index Medicus, African Journals Online, ScienceDirect, Google Scholar, and Google from October 26 to November 09, 2022. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. Random-effects model was used to estimate the pooled prevalence of anemia. The degree of heterogeneity among the included studies was assessed using I2 statistics. Publication bias was detected using funnel plot symmetry analysis supplemented by Egger's and Begg's tests. Twenty-four studies with a total number of 19,118 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among type 2 diabetic adult patients was 27.0% (95% CI: 24.0, 31.0, I2 = 96.45%; P< 0.001). Geographical and time-based subgroup analysis showed that higher prevalence of anemia was observed in Africa region 28.0% (95% CI: 17.0, 39.0) and from 2015 to 2022, 28.0% (95% CI: 24.0, 33.0), respectively. Anemia is a moderate public health problem among adult patients with type 2 diabetes. Nearly one in four patients with type 2 diabetes develops anemia. Therefore, considering the negative impact of anemia, it is important to include anemia screening in the routine assessment of diabetes-related complications.

Feto-Maternal Outcome of Moderate Anaemia in Term Pregnancy at DMCH

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics &amp; Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion &amp; 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 &amp; had folic acid ..

Pattern of Suicidal Deaths in Cases Coming to a Tertiary Center in Bangladesh

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics &amp; Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion &amp; 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 &amp; had folic acid def

#6242 CLINICAL CHARACTERISTICS OF HEMODIALYSIS PATIENTS FROM AFRICAN COUNTRIES OF PORTUGUESE OFFICIAL LANGUAGE: A PORTUGUESE COHORT

Abstract Background and Aims Chronic kidney disease (CKD) is a leading cause of morbidity and mortality worldwide, with African descendants being at increased risk of occurrence and progression to end-stage renal disease (ESRD). However, the burden of CKD and ESRD in African continent is still largely conjectural and access to treatment of CKD is restricted in those countries. Africa contributes to &amp;lt;10% of the total renal replacement therapy (RRT) patients worldwide, mainly due to the high costs associated. The purpose of this analysis was to describe the clinical characteristics and outcomes of patients from African Countries of Portuguese Official Language (ACPOL) who integrated the HD program of a tertiary hospital in Portugal. Method Retrospective analysis of 126 African patients who integrated the HD program of a tertiary hospital in Portugal, between January 2015 and December 2019. Last follow-up was ascertained in January 2021. Results Mean age was 49.9 ± 14.1 years, and 53.6% were male (n = 71). Hypertension was a comorbidity in 96.0% (n = 121). Twenty-one patients came from Angola (16.7%), 53 from Cape Verde (42.1%), 23 from Guinea-Bissau (18.3%), 20 from Saint Thomas and Prince (15.9%), and 9 from Mozambique (7.1%). Motive for referral to Portugal was RRT requirement in 93.7% of the cases (n = 118) and vascular access (VA) dysfunction in 6.3% (n = 8); these 8 patients with VA dysfunction were already on hemodialysis program before their evacuation to Portugal and they were mainly from Cape Verde (n = 4), Angola (n = 3), and one patient from Guinea-Bissau. At arrival, patients who initiated HD in our unit had mean serum creatinine 9.4 ± 4.4 mg/dL, urea 182.5 ± 109.1 mg/dL, Hb 9.6 ± 1.7 g/dL, serum albumin 3.6 ± 0.6 g/dL, PTH 491.7 ± 392.6 pg/mL. Patients referred due to VA dysfunction had mean Hb 10.1 ± 1.8 g/dL, serum albumin 3.7 ± 1.0 g/dL, PTH 918.9 ± 541.6 pg/mL. There were no statistically significant differences in both groups concerning country of origin, although hypoalbuminemia was more frequent in patients from Saint Thomas and Prince (50%) and Angola (42.9%). All patients started HD with a central venous catheter (CVC). During follow-up, CVC remained the vascular access in 51.6% (n = 65), arteriovenous fistula in 42.9% (n = 54), and arteriovenous graft in 5.6% patients (n = 7). Nine patients had exhaustion of VA for HD. Mean follow-up time was 70.5 ± 41.3 months, 1.6% of the patients transitioned to peritoneal dialysis (n = 2) and 15.1% were submitted to renal transplantation (n = 18). The mortality rate during follow-up was 14.3% (n = 18). Conclusion There are few studies about African patients undergoing HD and this is the first study presenting the clinical characteristics and outcomes of hemodialysis patients from ACPOL. These are young patients, almost all with hypertension, with a high prevalence of anemia, malnutrition, and secondary hyperparathyroidism. All patients started HD with CVC and several presented multiple access dysfunction. These data reinforce the urgent need of improvement and investment in African countries’ healthcare, especially on what concerns the ESRD, as it contributes to serious consequences in these patients’ survival and quality of life. With the cooperation protocol, Portugal provides these patients with RRT, treatment of the CKD complications, VA care, possibility of peritoneal dialysis and renal transplantation, ultimately improving their chance of survival and quality of life.

#6131 ANEMIA IN PERITONEAL DIALYSIS

Abstract Background and Aims Anemia is one of the most frequent complications of chronic kidney disease (CKD), affects quality of life and increases morbidity and mortality. Prevalence of anemia in patients on peritoneal dialysis (PD) is 83% according to the RIKAS study. Diagnosis of anemia in CKD is set at a hemoglobin (Hb) below 13 g/dL in men and less than 12 g/dL in women. These values serve to define the diagnosis, but not to indicate treatment. Treatment is based on the use of erythropoiesis stimulating agents (ESA) and iron therapy. Absolute iron deficiency (ferritin less than 100 ng/ml and transferrin saturation index (TSAT) less than 20%) and functional iron deficiency (TSAT less than 20% with normal ferritin), require correction with oral or intravenous iron before the use of ESA. Treatment with ESA is indicated when Hb is below 10g/dL despite adequate iron stores. The goal is to achieve Hb values between 10-12g/dL. The aims are evaluating the situation of patients in our PD program with respect to anemia, its prevalence, treatment and its results. Method This is an observational, descriptive, cross-sectional and single-center study. Inclusion criteria were patients older than 18 years with at least 3 months of permanence in our PD program. We collected: age, sex, cause of CKD, type of PD, time on PD, origin (pre-dialysis, hemodialysis, kidney transplant), residual diuresis, diabetes mellitus (DM), high blood pressure (HBP), ischemic heart disease, bleeding, urea, creatinine, albumin, calcium, phosphorus, Hb, hematocrit, iron, ferritin, TSAT, C-reactive protein (CRP), transfusions and treatments (ESA and/or iron therapy). Descriptive statistical analysis (mean, standard deviations, maximums and minimums) and comparative analysis between variables was performed using Chi-square test and ANOVA for qualitative and quantitative variables, respectively. Results N = 58 patients, 64% men and 36% women. The mean age was 61.3+/- 15.54 years. 31% of patients were CKD secondary to glomerulonephritis (predominant etiology). 5% had no cardiovascular risk factors (CVRF), 48% between one and two and 47% more than three. 74% on continuous ambulatory peritoneal dialysis (CAPD). Mean time on dialysis 28.74 +/- 25.05 months. Mean residual diuresis in 24 hours 1199.22 +/- 703.14 cc. Prevalence of anemia 74%. Mean Hb of 10.97 +/-1.29 g/dL with 78% of patients with values between 10-12 g/dl. Mean ferritin of 356.79 +/-226.84 mg/dL with 79% of patients between 100-500 mg/dl. 83% received treatment with ESA, 33% with intravenous iron. No patient received oral iron. 4 patients needed of blood transfusion and 3 of them due to bleeding (2 gastrointestinal bleeding and 1 urinary bleeding). We observed a statistically significant association between higher residual diuresis volume and adequate anemia control (P = .042) and between lower creatinine values and target Hb values (P = .0005). No statistically significant association was observed between adequate anemia control and type of dialysis (p= 0.106), time on dialysis (P = .28), sex (P = .224) and DM (p= 0.139). Conclusion The high prevalence of anemia continues to be a major problem in PD in our program, but similar to other series. Under treatment (ESA and iron therapy) is achieved an adequate control in most patients, although in approximately 20% of patients do not reach the established target. Higher residual diuresis and lower creatinine values (probably due to increased residual renal function) are associated with better anemia control.

Evaluating the Diagnostic Performance of Hemoglobin in the Diagnosis of Iron Deficiency Anemia in High-Altitude Populations: A Scoping Review.

We evaluated the available literature on the diagnostic performance of hemoglobin (Hb) in the diagnosis of iron deficiency anemia (IDA) in high-altitude populations. We searched PubMed, Web of Science, Scopus, Embase, Medline by Ovid, the Cochrane Library, and LILCAS until 3 May 2022. We included studies that evaluated the diagnostic performance (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curves, and accuracy) of Hb (with and without an altitude correction factor) compared to any iron deficiency (ID) marker (e.g., ferritin, soluble transferrin receptor (sTFR), transferrin saturation, or total body iron (TBI)) in populations residing at altitudes (≥1000 m above sea level). We identified a total of 14 studies (with 4522 participants). We found disagreement in diagnostic performance test values between the studies, both in those comparing hemoglobin with and in those comparing hemoglobin without a correction factor for altitude. Sensitivity ranged from 7% to 100%, whereas specificity ranged from 30% to 100%. Three studies reported higher accuracy of uncorrected versus altitude-corrected hemoglobin. Similarly, two studies found that not correcting hemoglobin for altitude improved the receiver operating characteristic (ROC) curves for the diagnosis of iron deficiency anemia. Available studies on high-altitude populations suggest that the diagnostic accuracy of Hb is higher when altitude correction is not used. In addition, the high prevalence of anemia in altitude regions could be due to diagnostic misclassification.

Comprehensive Approach for Improving Adherence to Prenatal Iron and Folic Acid Supplements Based on Intervention Studies in Bangladesh, Burkina Faso, Ethiopia, and India.

The World Health Organization recommends daily iron and folic acid (IFA) supplementation during pregnancy, but consumption remains low, and high prevalence of anemia among pregnant women (PW) persists. This study aims to (1) examine factors at the health system, community, and individual levels, which influence adherence to IFA supplements; and (2) describe a comprehensive approach for designing interventions to improve adherence based on lessons learned from 4 country experiences. We conducted literature search, formative research, and baseline surveys in Bangladesh, Burkina Faso, Ethiopia, and India and applied health systems strengthening and social and behavior change principles to design interventions. The interventions addressed underlying barriers at the individual, community, and health system levels. Interventions were further adapted for integration into existing large-scale antenatal care programs through continuous monitoring. Key factors related to low adherence were lack of operational protocols to implement policies, supply chain bottlenecks, low capacity to counsel women, negative social norms, and individual cognitive barriers. We reinforced antenatal care services and linked them with community workers and families to address knowledge, beliefs, self-efficacy, and perceived social norms. Evaluations showed that adherence improved in all countries. Based on implementation lessons, we developed a program pathway and details of interventions for mobilizing health systems and community platforms for improving adherence. A proven process for designing interventions to address IFA supplement adherence will contribute to achieving global nutrition targets for anemia reduction in PW. This evidence-based comprehensive approach may be applied in other countries with high anemia prevalence and low IFA adherence.

Determinants of hyperphosphatemia and its relation with hemoglobin levels among hemodialysis patients in two hospitals from Syria: a prospective cross-sectional study.

A prospective cross-sectional study was conducted among 146 HD patients from two HD centers in Syria, between June 2021 and March 2022. All patients at least 18 years old on maintenance HD were enrolled. The threshold of phosphorus (phos) level was divided by the upper normal range among HD patients (5.5mg/dl). We used parametric and nonparametric statistics, the Pearson and Spearman correlations with simple and multiple linear regressions between study variables. 36.9% of patients had a serum phos level of 5.5 or less (norm phos group), and 63.1% of patients had a serum phos level higher than 5.5 (high phos group). Also, 60.9% of patients had hemoglobin (Hb) less than 10g/dl, and 40.4% of patients had Hb at least 10g/dl. Age, type of HD access, phos binders (P-binders), parathyroid hormone (PTH), and calcium (Ca) showed significant effects on phos levels. Most patients were using arteriovenous fistula (AVF) (89.7%) as a HD access, and the meantime on HD was higher in the norm phos group compared to the high phos group. In a multivariate and univariate logistic regression analysis, hyperphosphatemia increased with increasing urea (Ur) and creatinine (Cr) levels, while the odds declined with increasing time on HD. Hb did not show a significant relation with phos by using several statistical methods. A high prevalence of hyperphosphatemia and anemia was encountered among this sample of HD patients from Syria. There was no correlation between phos and Hb levels in contrast to previous conflicting studies, which mandates future studies to evaluate this correlation and further efforts to determine the range of phos that could have a benefit on anemia with respect to other comorbidities.

High Prevalence of Anaemia Among Women of One of the Smallest Primitive Tribes in the World

High Prevalence of Anaemia Among Women of One of the Smallest Primitive Tribes in the World

PENYULUHAN DAN PEMERIKSAAN KADAR HEMOGLOBIN SEBAGAI SALAH SATU UPAYA DETEKSI DINI ANEMIA PADA IBU HAMIL

The high prevalence of anemia has negative consequences such as the firstdisturbance and inhibition of growth, both body cells and brain cells, while thesecond deficiency of Hb in the blood results in a lack of oxygen beingcarried/transferred to body cells and to the brain. The incidence of anemia inpregnant women in Indonesia is still high, namely 37.1, the prevalence ofanemia in pregnant women in Indonesia is 37.1%. cases of anemia in pregnant women have increased every year, namely in 2015 at the Sengkol HealthCenter as many as 200 cases, and in 2016 as many as 251 cases. Hemoglobinlevels as an early detection of anemia in pregnant women.His communityservice partner is the Chair of STIKes Yarsi Mataram and the Head of theMidwifery Study Program for the Bachelor program. This service to thecommunity uses the method of counseling and checking the hemoglobin ofpregnantwomen using the "easy touch" Hb meter. The results obtained fromthis service were the examination of 30 pregnant women in two polindes areasof the Sengkol Public Health Center, namely Tanak Awu Village and KetareVillage. From all participants, the average Hb level was 10.5 g/dL, the averageage of pregnant women was 20 years. The participants felt that this activity wasvery beneficial for them for the health of themselves and their fetus. Participantsalso hope that this community service activity can be carried out regularly

The Effectiveness of Music Therapy on Reducing Anxiety Levels in Maternity Mothers

Anemia is one of the indirect causes of death of pregnant women. The prevalence of anemia of pregnant women in developing countries is between 35-75%. One of the causes of the high prevalence of anemia in pregnant women is the need for iron and must consume iron. However, this method is often disliked because it causes nausea and vomiting caused by the smell of iron. Therefore, a healthy and safe breakthrough is needed through non-pharmacological therapy, one of which is by consuming beets. The aimed of this research to analyze the effectiveness of beet consumption in overcoming anemia in 2nd trimester pregnancy in Lebak village in 2023. Research design was quasy experimental one group pre-post test. Researchers will give beet juice with beet juice as much as 100 grams consumed in the form of fruit juice / juice up to a volume of 250 ml / day for 14 days. The study was conducted in April 2023 on 30 second trimester pregnant women. Measurements were carried out using the sahli method. The statistical analysis used is an independent t test. Giving beet juice can increase hemoglobin levels of pregnant women so that there is a change in the diagnosis of pregnant women from moderate anemia to mild anemia. The results of the analysis showed this relationship was significant (p value 0.005 &lt; 0.05).

The Relationship Between Nutritional Anemia and Acne: A Case-Control Study.

Background In the past decade, there has been growing interest in identifying the relationship between nutritional status and acne. Many dietary factors have been studied, including milk, fast food, and chocolate. However, nutritional anemia,which is a common problem inyoung individuals, has not been well investigated. Objectives The objective of this study was to determine the relationships between acne and nutritional anemia among people in the Qassim Regionof Saudi Arabia. Methods This study used a case-control design. It targeted people aged from 15 to 25 years old in the Qassim Region of Saudi Arabia. This study was conducted using a database of Electronic Health Records (EHR) data from the Qassim University outpatient department (OPD). Data analysis was conducted by using SPSS (IBM Inc., Armonk, New York). Results A total of 114 of the study populationwere involved in this study. The acne group represented was identical to the control group. The mean age of study participants was 23.1 ± 4.19 years old, and the majority of them were females (86%). Moreover, the patient group had relatively lower levels of mean corpuscular volume (MCV), vitamin B12, ferritin, mean corpuscular hemoglobin (MCH), and hemoglobin than the control group without any significant correlation, whereas the patient group had higher levels of mean corpuscular hemoglobinconcentration (MCHC) and red cell distribution width (RDW) without significant difference. Our results showed that the prevalence of anemia among respondents was 17.5%, and a higher prevalence of anemia was observed in the control group without significant differences. Furthermore, the patient group had a significantly higher prevalence of vitamin B12 deficiency (38.6%) than the control group (p=0.041). Conclusion Our results concluded that patients with acne vulgaris in the Qassim Region of Saudi Arabia had asignificantly higher rate of vitamin B12 deficiency. Additional studies are needed to confirm this association.

Previously Undiagnosed Anemia and Iron Deficiency Anemia among Preschool Children at Taif City

Introduction: In the Arab Gulf countries, anemia, including iron deficiency anemia )IDA(, considered one of the main public health problems. Although, the World Health Organization reported that IDA as the most common type of anemia, which made up half of all anemic cases all over the world, there were limited research performed among preschool children about anemia in Saudi Arabia. Thus, the aim of this study was to investigate the prevalence of previously undiagnosed anemia and IDA among children between 2 to 6 years old. In this study, several risk factors that might contribute to the high prevalence of anemia were assessed. Methods: The study was carried out in Taif city during the period from January 2023 to April 2023. Blood samples were collected from 200 preschool children and analyzed for hematological parameters as well as related biochemistry tests to investigate the prevalence of previously undiagnosed anemia and IDA. Results: The majority of the study participants were Saudi 99% and aged 4 to 6 years 72.5%. Most of children participants, 92.5% had normal haemoglobin (Hb) concentration and normal levels of red blood cells (RBCs) and normal hematocrit indicating their non-anemia health status. In this study, previously undiagnosed anemia were reported within 6% of children indicated by low Hb concentration, low RBC count and abnormal low hematocrit level. Out of these undiagnosed anemic children, there were 25% diagnosed with IDA. Conclusions: Since, anemia and IDA are still a public health problem among preschool children in Saudi Arabia this study suggested that the hematological blood examination should be done to students as a requirement before school which may reveal the presence of previously undiagnosed anemia and might associated with low mantle and functional performance among children. Moreover, further studies are recommended at all regions of the Kingdome to investigate the underlying related risk factors, which will provide more insight ....

The question of differential diagnosis of anemia in diabetes mellitus

BACKGROUND: High prevalence of anemia in diabetes mellitus (DM) determines the relevance of studying its pathogenetic aspects, the role of anemia in DM complications development and the issue of differential diagnosis between iron deficiency anemia (IDA) and anemia of chronic disease (ACD)).AIM: To establish the diagnostic value of classical parameters for diagnosing anemia in DM and propose an optimized algorithm for the differential diagnosis of ACD and IDA in DM type 1 and 2 using new markers.MATERIALS AND METHODS: The observational, single-centre, comparative, controlled, single-stage study. Patients underwent assessment of glycated hemoglobin, creatinine, microalbuminuria; indicators of iron metabolism — hematocrit, the number of erythrocytes, reticulocytes, hemoglobin, serum iron, transferrin, ferritin, the level of soluble transferrin receptors (sTfR), sTfR/logFerpitin index, and inflammation markers — erythrocyte sedimentation rate (ESR), leukocyte count, high sensitive CRP and TNF-α. ROC-analysis was used to assess the differential diagnosis markers informative content.RESULTS: We examined 135 patients: 51 with DM 1 and 84 with DM 2. The patients were stratified into groups based on anemia type: 1) ACD 2) IDA 3) latent iron deficiency 4) without ferrokinetics disorders. According to the ROC-analysis in DM patients, the following parameters had high information content in ACD. ESR — sensitivity 92%, specificity 85%, diagnostic threshold 26.5 mm/h (area under the curve (AUC) 0.943; p&lt;0.0001); leukocyte count — sensitivity 69%, specificity 64%, diagnostic threshold 7.50x109/l (AUC 0.727; p=0.007), microalbuminuria — sensitivity 71%, specificity 72%, diagnostic threshold 29.5 mg/l (AUC 0.744; p=0.003). In DM sTfR and the sTfR /logFerritin index had high information content in IDA at diagnostic thresholds different from those for general population. The sensitivity of sTfR 71%, the specificity 71%, diagnostic threshold 1.42 ng/mL (2.9 ng/mL for general population) (AUC 0.765; p=0.024). The sensitivity of sTfR/logFerritin index 100%, the specificity 97%, diagnostic threshold 1.48 (2.0 for general population) (AUC 0.983; p=0.024).CONCLUSION: In differential diagnosis of IDA and ACD in DM, ESR, leukocyte count, microalbuminuria, sTfR and sTfR/logFerritin index have a high diagnostic value. This allows proposing them as additional markers for differential diagnosis of anemia in DM.