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Anaemia and being underweight are two global public health issues that include the significant population of girls of adolescents, directly affecting one's working capacity and posing a great risk for future motherhood. In this study, a total of 798 college-going girls were observed with their height, weight and haemoglobin level over a period of five years. The mean age of the girls was 18 years, within the range of 17 years to 22 years. Anaemia poses a significant threat on a worldwide scale; in the present study, it was observed that 22% of the girls are severely anaemic, 34% are moderately anaemic, 17% are mildly anaemic, and only 26% are non-anaemia, which is significantly alarming about their health condition. On the other hand, we calculated their body mass index (BMI) with height and weight. It was found that only 36% of girls had a normal BMI, while 44% of the girls were underweight, which also raises concerns about their health issues for the near future. Although no direct relation can be drawn between the severity of anaemia and BMI, the parameters can help to express one's overall health status and can be used to improve health rights from adolescence. [ABSTRACT FROM AUTHOR]

The most vital blood cells in the body are red blood cells (RBCs), which carry oxygen and nutrients to the tissues. Poikilocytosis refers to a change in the red blood cells' normal physical shape and structure. The lack of oxygen and nutrients causes defective RBCs to suffer from health problems such as anaemia and stroke. This study proposes a hybrid CNN-SVM model for promptly and precisely classifying poikilocytosis abnormalities. The features of poikilocytosis were extracted using the proposed custom CNN (Convolutional Neural Network) model and classified using the Radial kernel basis SVM (Support Vector Machine) classifier. In comparison to the CNN model with a soft-max classifier and other benchmark work, the hybrid model produced better results. The overall accuracy of the algorithm is 98.21 %, which is higher than the traditional CNN (>5 %) and other benchmark methods. This hybrid CNN-SVM model is promising for the automatic classification of poikilocytosis abnormalities. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether autochthonous high-intensity D. repens microfilaremia leads to haematological changes in companion dogs. Dogs with hypermicrofilaremia presented to the District Veterinary Centre, Kannur were selected for the study. A total of 100 dogs were positive for hypermicrofilariaemia with D. repens based on peripheral blood smear examination and Knott's test. Of these, 3 dogs were concurrently positive for sheathed microfilaria (MF) of Brugia spp. Interestingly, an adult live worm of D. repens approximately eight cm in length was detected on a subcutaneous mass on the hind limb of a hypermicrofilaremic dog in the study. We compared the hematological parameters of 100 autochthonous hypermicrofilaremic dogs and 15 uninfected dogs. The hematological findings in the study are mild to moderate anemia, moderate to severe thrombocytopenia, leucocytosis with granulocytosis, lymphocytosis and monocytosis as compared to the uninfected group of dogs. The pathogenicity of naturally occurring hypermicrofilaremia is poorly studied, and knowledge of its epidemiology, host-parasite relationship and impact on various organs is warranted for better prevention and control, especially in hot-spot areas. [ABSTRACT FROM AUTHOR]

Objective: To assess whether monitoring the peak systolic velocity (PSV) in the middle cerebral artery (MCA) was a useful, non-invasive method for predicting anaemia in fetuses. Study Design: Cross-sectional study Place and Duration of Study: Armed Forces Institute of Radiology, Rawalpindi Pakistan, from Feb and Aug 2022. Methodology: Fifty pregnant women who did not have hydropic babies were included. The peak systolic velocity (PSV) was measured in the middle cerebral artery (MCA). A positive result was determined when the MCA-PSV value exceeded 1.5 multiples of the median (MoM). The blood samples obtained from neonates were forwarded to the hospital laboratory to estimate haemoglobin levels shortly after birth. The outcome of the method (MoM) was observed and subsequently compared with neonatal haemoglobin levels. Results: 60% of neonates were anaemic according to middle MCA-PSV while the haematology laboratory reported 74% of neonates as anaemic according to cut-off haemoglobin of less than 13.5gm/dl. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the MCA-PSV in detecting the anaemia were 93.75%, 61.1%, 81.08%, 84.62%, and 82%, respectively. Conclusion: MCA-PSV Doppler is deemed valuable as a diagnostic technique for fetal anaemia, albeit secondary to the primary approach of neonatal haemoglobin estimation upon birth.

Background/objective: The practice of complementary and alternative medicine has significantly gained acceptance worldwide, such as Al-Hijama, also known as cupping therapy. Despite the growing popularity of therapeutic cupping among athletes, little is known about the impact of cupping therapy on sports fields. The current study was designed to explore the effect of wet cupping therapy on the haematological and inflammatory parameters in Jordanian national team players. Methods: The procedure was carried out at a specialized centre for cupping in Amman on the morning of the 19th Rajab. The data were obtained from 14 healthy male participants aged between 21 and 22 years. The haematological and inflammatory parameters were assessed by comparing venous blood components before and after four weeks of wet cupping. Results: Complete blood count (CBC) analysis of venous blood samples four weeks after wet cupping showed a significant increase in the values of total white blood cells (WBCs), neutrophils, lymphocytes, red blood cells (RBCs), haematocrit, and haemoglobin as compared with venous blood samples before cupping. Blood film examination of venous blood samples post-cupping revealed normocytic normochromic RBCs; WBCs and platelets were unremarkable. Analysis of inflammatory markers post cupping showed a significant decrease in the monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) but no differences in neutrophil/lymphocyte ratio (NLR). Conclusion: The findings of this study suggest that wet cupping has an indispensable influence on haematological and immunological parameters in athletes, where it reinforces cellular immunity, generates younger blood cells, and reduces inflammation markers. It is probable, therefore, that cupping improves sports performance and achievement. The evidence from this research adds to a growing body of literature on cupping therapy in sports.

Abstract Animal flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anaemia status among 585 Malawian infants enroled in a 6‐month egg‐feeding trial. The percentage of days of small fish, large fish and meat consumption were assessed through weekly 7‐day animal‐source food screeners. Grams of intake were assessed through 24‐h recalls conducted at 6–9, 9–12 and 12–15 months of age. Plasma ferritin, soluble transferrin receptor (sTfR) and haemoglobin concentrations were measured at 6–9 and 12–15 months of age. Iron biomarkers were adjusted for inflammation during analysis. At enrolment, each flesh food category was consumed by

Objective: To evaluate vitamin D deficiency in children with iron-deficiency anaemia, and to identify the risk factors for such deficiency. Method: The cross-sectional study was conducted at the Children’s Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from October 2021 to March 2022, and comprised children aged 1-5 years who had been diagnosed with iron-deficiency anaemia. Quantitative variables, like age, height, weight, gender, socioeconomic status and sibling status, were controlled by stratification. Data was compared to assess the risk factors of vitamin D deficiency among the subjects. Data was analysed using SPSS 22. Results: Of the 236 children with iron-deficiency anaemia, 159(67.5%) also had vitamin D deficiency; 95(59%) girls and 65(41%) boys. Overall, 104(65.4%) subjects were aged 4-5 years and 55(34.6%) were aged 1-3 years. Vitamin D deficiency had significant association with female gender, older age, height and weight

Space travel exposes astronauts to several environmental challenges, including microgravity and radiation exposure. To overcome these stressors, the body undergoes various adaptations such as cardiovascular deconditioning, fluid shifts, metabolic changes, and alterations in the state of the bone marrow. Another area of concern is the potential impact of these adaptations on erythrocyte and haemoglobin concentrations, which can lead to what is commonly referred to as space anaemia or microgravity-induced anaemia. It is known that anaemia may result in impaired physical and cognitive performance, making early detection and management crucial for the health and wellbeing of astronauts during extended space missions. However, the effects and mechanisms of space anaemia are not fully understood, and research is underway to determine the extent to which it poses a challenge to astronauts. Further research is needed to clarify the long-term effects of microgravity on the circulatory system and to investigate possible solutions to address spaceflight-induced anaemia. This article reviews the potential link between spaceflight and anaemia, based on existing evidence from simulated studies (e.g., microgravity and radiation studies) and findings from spaceflight studies (e.g., International Space Station and space shuttle missions).

Beta thalassaemia is one of the most common inherited haemoglobinopathies, characterised by reduced or absent production of the beta globin chain. In India, the carrier frequency of thalassaemia is estimated to be 3-4%. The prevention of Beta thalassaemia is the best strategy, and this can be achieved through carrier screening and prenatal diagnosis. Carriers of beta thalassaemia can be easily identified using haematological parameters such as complete blood count and High Performance Liquid Chromatography (HPLC) for haemoglobin analysis. The characteristic findings observed in thalassaemia carriers include microcytosis, hypochromia, with a Mean Corpuscular Volume (MCV) of less than 80 fL and Mean Corpuscular Haemoglobin (MCH) of less than 28 pg. They also present with elevated levels of HBA2 (α2δ2) ≥3.5%. Carrier screening for beta thalassaemia primarily relies on the observation of elevated HbA2 levels. However, in rare cases, some carriers can have normal HbA2 levels, leading to false-negative screening results. In a case involving a married couple who underwent routine preconceptional screening by complete blood count and HPLC for thalassaemia screening, the male partner had elevated HbA2 levels (5.2%), while the female partner had normal HbA2 levels (1.6%). Molecular testing revealed that the male partner was heterozygous for the Intervening Sequence (IVS) 1-5 (G>C) mutation, while the female partner was found to be heterozygous for the CD41-42 (-CTTT) mutation. It is important to consider molecular testing of the HBB gene in couples, even if one partner is a carrier and the other partner has normal or borderline HbA2 levels.

Context: Anaemia is the most common nutritional deficiency in Indian pregnant females. It ensues foetal hypoxia resulting in different compensatory mechanisms in the foetus which may result in adverse perinatal outcomes. Colour Doppler can be used to measure these hemodynamic changes of the foetus ahead of the clinical manifestations, guiding the obstetrician for the appropriate management and circumventing any dire complication. Aims: The aim of this study is to detect foetal haemodynamic changes associated with maternal anaemia and assess the parameters which predict these changes accurately. Settings and Design: Prospective cohort study. Materials and Methods: Two hundred and forty pregnant females in the third trimester, divided into four groups based on their haemoglobin levels in the non-anaemic, mild, moderate and severe anaemic groups, were included in the study. These patients were followed up for foetal outcome in terms of effective foetal weight, APGAR score and neonatal intensive care unit admission. Statistical Analysis Used: Analysis of Variance Appearance, Pulse, Grimace, Activity and Respiration (ANOVA) test was used to compare the quantitative variables. SPSS software was used. Results: The middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR) values were increasing while umbilical Doppler indices were decreasing with the increasing severity of anaemia. CPR was found to be the most sensitive predictor for foetal outcome. Conclusions: Maternal anaemia results in foetal hypoxia which can be measured in terms of foetal Doppler indices. CPR was found to be more sensitive than the umbilical or MCA in predicting foetal hypoxia and in turn the perinatal outcome of foetuses of anaemic pregnant females. The foetuses with low CPR values will require urgent intervention to improve the outcomes.

Background: Pregnancy anaemia is a significant public health concern in South Africa (SA), particularly in rural areas, but little is known about its prevalence and risk factors in rural areas. The objective of the study was to determine the prevalence and identify risk factors of pregnancy anaemia in the public health facilities of Limpopo Province (LP), SA. Methods: A cross-sectional study was conducted among a consecutive sample of 211 pregnant women attending antenatal care at Seshego Hospital and its feeder health centre (May to June 2019). Anaemia was defined as haemoglobin (Hb)

Aims: We aim to evaluate the usefulness of postoperative blood tests by investigating the incidence of abnormal results following total joint replacement (TJR), as well as identifying preoperative risk factors for abnormal blood test results postoperatively, especially pertaining to anaemia and acute kidney injury (AKI). Methods: This is a retrospective cohort study of patients who had elective TJR between January and December 2019 at a tertiary centre. Data gathered included age at time of surgery, sex, BMI, American Society of Anesthesiologists (ASA) grade, preoperative and postoperative laboratory test results, haemoglobin (Hgb), white blood count (WBC), haematocrit (Hct), platelets (Plts), sodium (Na+), potassium (K+), creatinine (Cr), estimated glomerular filtration rate (eGFR), and Ferritin (ug/l). Abnormal blood tests, AKI, electrolyte imbalance, anaemia, transfusion, reoperation, and readmission within one year were reported. Results: The study included 2,721 patients with a mean age of 69 years, of whom 1,266 (46.6%) were male. Abnormal postoperative bloods were identified in 444 (16.3%) patients. We identified age (≥ 65 years), female sex, and ASA grade ≥ III as risk factors for developing abnormal postoperative blood tests. Preoperative haemoglobin (≤ 127 g/dl) and packed cell volume (≤ 0.395 l/l) were noted to be significant risk factors for postoperative anaemia, and potassium (≤ 3.7 mmol/l) was noted to be a significant risk factor for AKI. Conclusion: The costs outweigh the benefits of ordering routine postoperative blood tests in TJR patients. Clinicians should risk-stratify their patients and have a lower threshold for ordering blood tests in patients with abnormal preoperative haemoglobin (≤ 127 g/l), blood loss > 300 ml, chronic kidney disease, ASA grade ≥ III, and clinical concern. Cite this article: Bone Jt Open 2023;4(11):899–905.

Although being very effective in the treatment of diabetes and a few other conditions, metformin (MTF) cannot be tolerated by many patients due to gastrointestinal (GI) complaints. A number of risk factors for intolerance were identified, but many are still controversial or uninvestigated. The aim of this study was to further investigate possible risk factors for the occurrence of GI complaints in patients on MTF therapy. A cross-sectional design was used for this multicentric study on adult patients visiting 50 community pharmacies in Montenegro. The patients were surveyed by semi-structured questionnaire after a service of a pharmacist was delivered, and their drugs dispensed. Uni- and multi-variate regression methods were used for processing the data.

Abstract Background Gastrointestinal bleeding is a cause of anaemia in dogs. A reliable, non‐invasive biomarker to differentiate gastrointestinal bleeding from other causes of anaemia would be advantageous to direct clinical decisions in anaemic patients. Plasma urea:creatinine ratio is an accepted biomarker of upper gastrointestinal bleeding in human medicine. Objectives The objective of this study was to evaluate plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in a population of dogs with anaemia. Methods This was a prospective cross‐sectional study of dogs with anaemia presenting to referral centres for the investigation of anaemia. Cases were categorised as having overt gastrointestinal bleeding (melena on presentation), occult gastrointestinal bleeding (historical and diagnostic findings consistent with gastrointestinal bleeding without melena at presentation) or anaemia of other cause (confident diagnosis other than gastrointestinal bleeding reached, normal diagnostic imaging of gastrointestinal tract). Urea:creatinine ratio at presentation was calculated by dividing urea (mg/dL) by creatinine (mg/dL). Results Ninety‐five dogs were included. Plasma urea:creatinine ratio was not significantly different between dogs with overt or occult gastrointestinal bleeding or those with anaemia of other cause (median urea:creatinine ratio 25.8, 20.7 and 22.5, respectively). No significant difference in urea:creatinine ratio was found between dogs with upper and lower gastrointestinal bleeding (median urea:creatinine ratio 19.4 and 24.6, respectively). Conclusions Plasma urea:creatinine ratio was not helpful in differentiating between dogs with anaemia resulting from gastrointestinal bleeding (overt or occult) and those with other causes of anaemia.

Background. Anaemic syndrome of complex origin is not uncommon in urinary tract infection, particularly in dietary non-adherence, menstrual cycle disorders, or concomitant digestive diseases, recurrent respiratory infections, etc. However, there is currently insufficient epidemiological data on this comorbidity in the literature. This study aims to establish the features of pyelonephritis course in its combination with anaemic syndrome in children. Materials and methods. We analysed the medical records of 200 children aged 0 to 17 years with acute non-complicated pyelonephritis, complicated and recurrent urinary tract infections for 2012–2017. In the second stage of our work, we comprehensively examined 85 girls aged 11 to 17 who underwent inpatient treatment between 2018 and March 2023. Thirty children of the same age and gender made up the comparison group. A paediatric gastroenterologist, a paediatric gynaecologist and/or urologist examined all patients. Immunochemical method with electrochemiluminescence immunoassay was used to assess ferritin content; also, serum iron and total iron-binding capacity were measured. Results. Anaemic syndrome is common in most girls with urinary tract infections (58.8 % of сases). Among the causes, the follo­wing are distinguished: menstrual cycle disorders with abnormal uterine bleeding (50.0 %), chronic digestive disorders, in particular malabsorption syndrome of unknown origin (25.0 %), recurrent bronchopulmonary disorders (15.0 %), and unbalanced diet (10.0 %). The features of urinary tract infections and concomitant iron deficiency in children include fatigue (55.0 % in acute non-complicated pyelonephritis vs. 40.0 % in complicated urinary tract infections, р 0.05). The ferritin level was the highest in patients with complicated urinary tract infections (18.2 µg/mL). In patients with recurrent urinary tract infections, this indicator was the lo­west — 5.0 µg/mL. Conclusions. Retrospective analysis of medical records confirmed the presence of anaemia in 30.0 % of girls with inflammatory kidney diseases. During the physical examination, 58.8 % of female adolescents with urinary tract infections had signs of anaemic syndrome.

Introduction: Anaemia in pregnant women is a major public health problem and is associated with adverse outcomes both in pregnant mothers and new-borns. According to NFHS-5, 45.7% of women in urban India were affected by anaemia during their pregnancy. The objectives of this study were to estimate the proportion of pregnant women who were anaemic and its effect on maternal and birth outcomes, and additionally, to assess the various socio-economic factors contributing to anaemia during pregnancy. Methodology: Data was collected by reviewing records between December 2018 and December 2021 of 302 pregnant women who had received antenatal care at a secondary level health facility in Krishnagiri, Tamil Nadu. The data included details of socio-economic parameters, parity, haemoglobin levels, mode of delivery, pregnancy related complications during the antenatal period and during delivery, including need for blood transfusions in mothers. Birth-related outcomes like miscarriages, intra-uterine death, low birth weight (LBW), need for NICU admission and congenital defects were also analysed. Variables in the study are described as frequencies and proportions. Appropriate tests were used to check for association and a P- value of less than 0.05 was considered as statistically significant. Results: The mean age of the women was 24 ± 3.72 years and the mean Haemoglobin level during the first trimester was 10.5 ± 1.12 gm/dl. The proportion of women with anaemia in the first trimester was 174 (57.6%). Among the anaemics, 15 (8.6%) required treatment in the form of injectable iron and 29 (16.7%) required blood transfusion. Gestational diabetes mellitus (GDM) (31.6%) (P < 0.05), preeclampsia (38.9%) (P < 0.02) less among anaemic. Hyperemesis (66.7%) (P = 0.58), risk of miscarriage (57.8%) (P = 0.94), postpartum haemorrhage (PPH) (80.0%) (P = 0.15) was higher in the anaemic group. Adverse Neonatal-related outcomes such as low birth weight babies (52.0%) (P = 0.54), meconium aspiration (72.7%) (P = 0.25) and need for NICU admission (75.0%) (P = 0.25) was higher in babies born to anaemic pregnant women. Conclusions: The proportion of anaemic women was 57.6%. There was no significant difference in maternal demographic characteristics or obstetric factors between anaemic and non-anaemic pregnant women. GDM, pre-eclampsia was less prevalent among anaemic women. Hyperemesis, risk of abortion, postpartum haemorrhage and low birth weight (LBW) infants was higher in anaemic pregnancies. The need for providing education regarding iron supplementation and early detection of anaemia during pregnancy should be emphasised to avoid complications.

Background and Objective: Anaemia is a common clinical condition that affects the majority of school aged children. Reduced resistance to disease, increased susceptibility to infection, impaired physical development, and poor school performance are all consequences of anaemia in this group. The present study was designed with the objective of estimating the prevalence of anaemia among school children in Bengaluru. This included identifying the associated factors or causes and consequences of anaemia. Methods: A school based cross-sectional study was conducted among children in schools from 3rd to 8th standard in Bengaluru Urban North Division Karnataka State, India, over a period of one year. 250 children were selected using convenience sampling. Results: The overall prevalence of anaemia among school going children was found to be 21.2%. Prevalence of anaemia was significant among variables like socioeconomic status, dietary habits, increased heart rate, breathlessness, lack of energy, dizziness, irregular menstrual cycles, jaundice, blood loss during menstruation, menstrual cycle pattern, pallor signs of palpebral conjunctiva, mucous membrane, and skin, splenomegaly and hepatomegaly, consumption of chicken, fish, citrus fruit, milk, Mizāj ‘Ām (overall mizaj of body, specifically choleric) duration of menstrual flow, headache, poor wound healing, and chronic disease. Conclusion: The overall prevalence of anaemia in our study of school children in Bengaluru (21.2%) was lower than the prevalence in the data recently shown by NFHS-5. Prevalence of anaemia was highly significant among variables like low socioeconomic status, dietary deficiencies, blood loss, and chronic infections. There were also highly significant correlations with several clinical findings.

Abstract Background Anaemia persistently remains a grave public health challenge in most sub-Saharan African countries. Understanding the perspectives of young adults concerning the multi-factorial nature of anaemia may be an important step towards meeting the 2025 global nutrition target of halving anaemia since these individuals might be in the process of reproductive decisions. Aim To explore the relationship between students’ knowledge about individuals at risk of developing anaemia, and anaemia consequences, and anaemia prevention strategies in a tertiary student cohort. Methods This sequential exploratory study adopted a mixed-methods approach to triangulate the data collection. A semi-structured questionnaire was used to gather baseline data regarding students’ perspective on anaemia. Themes that emerged from the initial questionnaire data analyses guided a focus group discussion (FGD) to further explore students’ perspectives on anaemia. FGD data was thematically analysed to unearth reasons behind questionnaire item selection. Structural equation modeling (SEM) was used to explore the relationship between constructs in the anaemia knowledge questionnaire. Results Overall, 543 students participated in the initial questionnaire data acquisition compared to 16 in the FGD. Our latent variable structural model showed that knowing the causes of anaemia did not significantly (p > 0.05) associate with either knowledge about anaemia consequences (b = 0.113) or knowledge about anaemia prevention strategies (b = 0.042). However, knowledge about individuals at-risk of anaemia was significantly positively associated with both anaemia prevention strategies (b = 0.306, p

Abstract Background Single low-dose primaquine (SLDPQ) effectively blocks the transmission of Plasmodium falciparum malaria, but anxiety remains regarding its haemolytic potential in patients with glucose-6-phopshate dehydrogenase (G6PD) deficiency. We, therefore, examined the independent effects of several factors on haemoglobin (Hb) dynamics in falciparum-infected children with a particular interest in SLDPQ and G6PD status. Methods This randomised, double-blind, placebo-controlled, safety trial was conducted in Congolese and Ugandan children aged 6 months–11 years with acute uncomplicated P. falciparum and day (D) 0 Hbs ≥ 6 g/dL who were treated with age-dosed SLDPQ/placebo and weight-dosed artemether lumefantrine (AL) or dihydroartemisinin piperaquine (DHAPP). Genotyping defined G6PD (G6PD c.202T allele), haemoglobin S (HbS), and α-thalassaemia status. Multivariable linear and logistic regression assessed factor independence for continuous Hb parameters and Hb recovery (D42 Hb > D0 Hb), respectively. Results One thousand one hundred thirty-seven children, whose median age was 5 years, were randomised to receive: AL + SLDPQ (n = 286), AL + placebo (286), DHAPP + SLDPQ (283), and DHAPP + placebo (282). By G6PD status, 284 were G6PD deficient (239 hemizygous males, 45 homozygous females), 119 were heterozygous females, 418 and 299 were normal males and females, respectively, and 17 were of unknown status. The mean D0 Hb was 10.6 (SD 1.6) g/dL and was lower in younger children with longer illnesses, lower mid-upper arm circumferences, splenomegaly, and α-thalassaemia trait, who were either G6PDd or heterozygous females. The initial fractional fall in Hb was greater in younger children with higher D0 Hbs and D0 parasitaemias and longer illnesses but less in sickle cell trait. Older G6PDd children with lower starting Hbs and greater factional falls were more likely to achieve Hb recovery, whilst lower D42 Hb concentrations were associated with younger G6PD normal children with lower fractional falls, sickle cell disease, α-thalassaemia silent carrier and trait, and late treatment failures. Ten blood transfusions were given in the first week (5 SLDPQ, 5 placebo). Conclusions In these falciparum-infected African children, posttreatment Hb changes were unaffected by SLDPQ, and G6PDd patients had favourable posttreatment Hb changes and a higher probability of Hb recovery. These reassuring findings support SLDPQ deployment without G6PD screening in Africa. Trial registration The trial is registered at ISRCTN 11594437.

Abstract Background Anaemia has become a major public health concern among women in Sub-Saharan Africa (SSA). However, little is known about the spatial disparities in anaemia prevalence and their associated factors among pregnant women in the region. This study analysed the spatial disparities in anaemia and their associated factors among pregnant women in rural and urban settings in SSA. Methods This is a secondary analysis of the most recent demographic and health surveys of 26 countries in SSA. Spatial autocorrelation and hotspot assessment were conducted, while a multivariate logistic regression model was used to identify demographic factors associated with anaemia. Results Anaemia was reported among ~50% of pregnant women in urban and rural areas of SSA. The hotspot analysis identified the West African sub-region as having a higher concentration of anaemia cases in rural settings. In urban areas, the odds of anaemia were significantly higher among pregnant women in their second trimester (Adjusted OR = 2.39, CI = 1.99, 2.76). On the other hand, pregnant women in their third trimester (Adjusted OR = 1.98, CI = 1.77, 2.22) and those who had taken intestinal parasite drugs (Adjusted OR = 1.12 CI = 1.02, 1.23) had a higher likelihood of having anaemia in rural areas. Pregnant women aged 35–39 years (Adjusted OR = 0.52, CI = 0.33, 0.81) and those aged 40–44 years (Adjusted OR = 0.69, CI = 0.50, 0.95) had a lesser likelihood of having anaemia compared to women aged 15–19 years in urban and rural areas respectively. Compared to Congo DR, Benin (OR = 2.22, CI = 1.51, 3.28) and Mali (OR = 3.71, CI = 2.73, 5.05) had higher odds of anaemia in urban and rural areas respectively. Conclusions Spatial disparities in anaemia persist among pregnant women in rural and urban settings in SSA. Prevailing spatial variations in anaemia may be addressed by specialised interventions considering the contextual residential settings and socio-economic factors highlighted in this study.

Tibeso Gemechu,1 Wako Dedecha,1 Miesa Gelchu,2 Oliyad Husen,1 Habtemu Jarso3 1Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia; 2Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia; 3Department of Public Health, School of Health Science, Madda Walabu University Shashemene Campus, Shashemene, EthiopiaCorrespondence: Tibeso Gemechu, Email tibesoshuke@gmail.comBackground: Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome.Objective: This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia.Methods: A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors.Results: The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74– 3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36– 3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32– 3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02– 2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000).Conclusion: Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.Keywords: prevalence, asymptomatic malaria, plasmodium infection, pregnant women, anaemia, Ethiopia

Abstract Background The prevalence (≈ 30%) of anaemia among women of reproductive age in Sub-Saharan Africa (SSA) is a significant concern. Additionally, less than half of households in the region have access to basic sanitation facilities, raising questions about the potential role of poor sanitation in increasing anaemia prevalence. To address this, we examined the relationship between access to basic sanitation facilities and the prevalence of anaemia among women of reproductive age in SSA. Methods The study analysed cross-sectional household-level Demographic and Health Survey data from selected SSA countries. A total of 100,861 pregnant and non-pregnant women aged 15 to 49 from 27 countries were analysed. Access to basic sanitation and haemoglobin (Hb) levels were classified using WHO and UNICEF standards. To examine the link between access to basic sanitation facilities and the prevalence of anaemia, a multilevel regression analysis was conducted, which adjusted for country fixed-effects to ensure that the findings were not biassed by variations in country-level factors. Results Nearly 37% (95% CI: 36.4, 37.9) of households had access to basic sanitation facilities, and 41% (95% CI: 40.8, 42.1) of women had Hb levels that indicated anaemia. Women with access to basic sanitation had a lower risk of anaemia than those without access (AOR = 0.95; 95% CI: 0.93, 0.98, p

Background: Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are predictors of anaemia severity.

Background: Pre-conception care (PCC) is a set of interventions that aim to identify and modify biomedical, behavioural and social risks to women’s health and pregnancy outcomes. Materials and Methods: It was an observational descriptive cross-sectional study conducted in the obstetrics and gynaecology (OBGY) outpatient department (OPD) of a tertiary care teaching institute in a rural set-up. Two hundred women in the first trimester of pregnancy were interviewed using a pre-designed and pretested questionnaire following informed verbal consent. The study was conducted between May and September 2019. The study excluded women in the 2nd or 3rd trimester of pregnancy, inpatient department (IPD) patients and those unwilling to participate. Results: The study revealed that 25.5% of the women had conceived between 14 and 19 years of age. Fifty-four percent of the pregnancies were unplanned. Merely 14.5% had consulted and 15% had their laboratory investigations performed before pregnancy. Only 11% had received pre-conception folic acid supplementation. Pregnancies with birth spacing

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease of autoimmune origin that affects multiple systems, with the haematologic system being commonly involved. However, the co-existence of haemoglobinopathies and connective tissue disorders has rarely been investigated, and the available data on this matter are primarily anecdotal. Aim: To determine the prevalence of Haemoglobin E (HbE) haemoglobinopathy in adult SLE patients and to assess the association of HbE haemoglobinopathy and SLE with disease activity. Materials and Methods: A hospital-based cross-sectional study was conducted at the Department of General Medicine, Regional Institute of Medical Sciences (RIMS) Hospital, Imphal, Manipur, India, from April 2021 to July 2022. The study included SLE patients diagnosed during the study period who attended the rheumatology Outpatient Department (OPD). The independent variables were age, gender, occupation, religion, and family history, while HbE haemoglobinopathy, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Red Blood Cell (RBC) count, and Systemic Lupus Activity Measure Revised Index (SLAM-R index) score were the dependent variables. Data were analysed using Statistical Package for Social Sciences (SPSS) version 21.0, with proportions analysed using the Chi-square test and Fisher’s-exact test, and means compared using Analysis of Variance (ANOVA) and independent t-test. A p-value of

Abstract Background While anaemia following liver transplant is common, anaemia in the context of BK viraemia is not a commonly recognised phenomenon. Case presentation We present the case of 59-year old gentleman with severe anaemia in the context of BK viraemia and nephropathy following ABO incompatible liver transplant. Severity of anaemia appeared to correlate with high titres of BK virus in the serum. Bone marrow biopsy revealed hypocellular marrow with normal cytogenetics. Anaemia improved with treatment with cidofovir, intravenous immunoglobulin, reduction in immunosuppression and erythropoietin stimulating agent. Conclusion To our knowledge, this is the first case of anaemia post liver transplant contributed to by BK viraemia.

Abstract Objectives To establish packed cell volume (PCV) ranges for non‐pregnant, pregnant and post‐partum bitches from day 10 of proestrus, investigating any relationship with parity and litter size. Methods This prospective cohort study used 37 healthy breeding bitches to examine PCV counts from routine blood samples collected every 4 weeks, from day 10 of proestrus, as part of routine PCV monitoring. Results For pregnant (n = 19) and non‐pregnant (n = 18) bitches, PCV decreased until week 8 (corresponding to 8.5 ± 1.1 days before whelping for pregnant bitches) and recovered by 16–20 weeks after the initial sample; bitches that whelped average and large litters showed greater declines. PCV began to recover sooner for bitches that had previously whelped one or two litters compared to bitches that had previously whelped three or more litters. There was a significant three‐way interaction between time after the onset of proestrus, litter size and the number of previous litters which demonstrated that the large decrease in PCV for bitches that had previously whelped three or more litters only occurred in bitches that were expecting an average or large sized litter. Clinical Significance Chronological variation in PCV for pregnant and non‐pregnant bitches was established during the reproductive cycle. There was no evidence to suggest that routine PCV measurement for normal, healthy bitches would be beneficial. However, knowledge from this study may be useful when deciding whether to prospectively monitor a bitch where there is a history of previous pregnancy‐related anaemia, when performing a caesarean section due to the anticipated blood loss during surgery, or when examining blood profiles for post‐litter bitches.

Abstract Objective Lifestyle choices including physical inactivity, smoking, abuse of alcohol and drugs, unhealthy diet are common among traders and market women and these behavioural activities predispose individuals to ill-health conditions including cardiovascular diseases and chronic anaemia. We evaluated lifestyle choices such as alcohol intake, smoking and resorting to self-medication among traders in the Tamale Central market in Ghana. We then associated these lifestyle choices with anaemia. Results A total of 400 participants were recruited for this study. Haemoglobin (Hb) levels of participants were measured using Mission® Plus Hb meter and anaemia was diagnosed by Hb

Abstract Background Malaria and schistosomiasis persist as major public health challenge in sub-Saharan Africa. These infections have independently and also in polyparasitic infection been implicated in anaemia and nutritional deficiencies. This study aimed at assessing asymptomatic malaria, intestinal Schistosoma infections and the risk of anaemia among school children in the Tono irrigation area in the Kassena Nankana East Municipal (KNEM) in the Upper East Region of Northern Ghana. Methods A cross sectional survey of 326 school children was conducted in the KNEM. Kato Katz technique was used to detect Schistosoma eggs in stool. Finger-prick capillary blood sample was used for the estimation of haemoglobin (Hb) concentration and blood smear for malaria parasite detection by microscopy. Results The average age and Hb concentration were 10.9 years (standard deviation, SD: ± 2.29) and 11.2 g/dl (SD: ± 1.39) respectively with 58.9% (n = 192) being females. The overall prevalence of infection with any of the parasites (single or coinfection) was 49.4% (n = 161, 95% confidence interval, CI [44.0–54.8]). The prevalence of malaria parasite species or Schistosoma mansoni was 32.0% (n = 104) and 25.2% (n = 82), respectively with 7.7% (n = 25) coinfection. The prevalence of anaemia in the cohort was 40.5% (95%CI [35.3–45.9]), of which 44.4% harboured at least one of the parasites. The prevalence of anaemia in malaria parasite spp or S. mansoni mono-infections was 41.8% and 38.6%, respectively and 64.0% in coinfections. There was no statistically significant difference in the odds of being anaemic in mono-infection with malaria (OR = 1.22, 95% CI 0.71–2.11, p = 0.47) or S. mansoni (OR = 1.07, 95% CI 0.58–1.99, p = 0.83) compared to those with no infection. However, the odds of being anaemic and coinfected with malaria parasite species and S. mansoni was 3.03 times higher compared to those with no infection (OR = 3.03, 95% CI 1.26–7.28, p = 0.013). Conclusion The data show a high burden of malaria, S. mansoni infection and anaemia among school children in the irrigation communities. The risk of anaemia was exacerbated by coinfections with malaria parasite(s) and S. mansoni. Targeted integrated interventions are recommended in this focal area of KNEM.

Abstract Background Anaemia is a common condition in alpacas and attributable to a variety of causes. Severe anaemia with a packed cell volume (PCV) less than 10% is frequently diagnosed, usually due to blood loss resulting from haemonchosis. Many South American camelids (SACs) also suffer from gastric ulcers, which are often associated with anaemia in other species. However, in alpacas and llamas, gastric ulcers usually do not lead to anaemia due to blood loss according to the current literature. There are no detailed clinical and laboratory data on this condition in the scientific literature so far. Case presentation We report on the case of a nine-year-old male alpaca that was presented to the clinic with suspected forestomach acidosis. The animal showed clinical signs of colic, hypothermia, tachypnea, tachycardia, pale mucous membranes, and died shortly after admission to the clinic. Laboratory diagnosis revealed a markedly decreased haematocrit (0.13 l/l), leucopaenia with band neutrophils, azotaemia, hypocalcaemia, hyperphosphataemia and vitamin D deficiency. Post-mortem examination revealed multiple ulcers in the first and third compartment with perforation of one ulcer in the first compartment, resulting in intraluminal blood loss and purulent peritonitis. Conclusions To the authors’ knowledge, this is the first detailed description of clinical and laboratory data of severe anaemia due to a perforated gastric ulcer in a SAC. Although the current literature suggests that severe blood loss due to gastric ulcers does not occur in SACs, this condition should be considered as a possible differential diagnosis in anaemic animals. Clinical indicators can be colic and pale mucous membranes.

Resumen: Antecedentes y objetivo: Los estudios sobre la prevalencia de anemia en enfermedad renal crónica (ERC) en adultos no en diálisis (ERC-ND) y en programa de diálisis (ERC-D) en España no son recientes, o se centran en ciertos subgrupos. El objetivo fue conocer la epidemiología y los patrones actuales de tratamiento de la anemia asociada a la ERC en España. Materiales y métodos: Estudio multicéntrico, no intervencionista, retrospectivo con pacientes ERC-ND estadios 3a-5 y ERC-D, atendidos en España entre 2015 y 2017 (estudio RIKAS). Resultados: La prevalencia de anemia en ERC-ND y ERC-D en 2015 fue del 33,8 y del 91,5%, respectivamente, con resultados similares durante 2016-2017. La prevalencia de inflamación sistémica en pacientes anémicos (18,1 y 51,8% para ERC-ND y ERC-D, respectivamente) fue superior, especialmente en aquellos tratados con agentes estimuladores de eritropoyesis (AEE), respecto a la población general con ERC-ND. Tras 12 meses de seguimiento, los valores medios de ferritina y del índice de saturación de transferrina (IST) en pacientes anémicos con ERC-ND fueron de 187,1 ng/ml y del 22,2%, respectivamente, mientras que en ERC-D fueron de 254,6 ng/ml y del 20,2%. En pacientes tratados con AEE, los valores medios fueron de 190,6 ng/ml y del 22,0% en ERC-ND, y de 255,0 ng/ml y del 20,2% en ERC-D. Conclusiones: La prevalencia de anemia y de inflamación aumentan con la severidad de la enfermedad, siendo mayores en ERC-D. Los parámetros férricos en pacientes anémicos tratados o no con AEE son insuficientes según las guías, por lo que existe un margen de mejora para el tratamiento de la anemia asociada a la ERC. Abstract: Background and objective: Studies on the prevalence of anaemia in chronic kidney disease (CKD) in adults not on dialysis (CKD-ND) and in dialysis programmes (CKD-D) in Spain are not recent or focus on certain subgroups. The aim of this study was to know the epidemiology and current treatment patterns of anaemia associated with CKD in Spain. Materials and methods: Multicentre, non-interventional, retrospective study with CKD-ND stage 3a-5 and CKD-D patients treated in Spain between 2015 and 2017 (RIKAS study). Results: The prevalence of anaemia in CKD-ND and CKD-D in 2015 was 33.8% and 91.5%, respectively, with similar results during 2016-2017. The prevalence of systemic inflammation in anaemic patients (18.1% and 51.8% for CKD-ND and CKD-D, respectively) was higher, especially in those treated with erythropoiesis-stimulating agents (ESA), compared to the general population with CKD-ND. After 12 months of follow-up, mean ferritin and transferrin saturation index (TSI) values in anaemic patients with CKD-ND were 187.1 ng/ml and 22.2%, respectively, while in CKD-D were 254.6 ng/ml and 20.2%. In ESA-treated patients, mean values were 190.6 ng/ml and 22.0% in ND-CKD, and 255.0 ng/ml and 20.2% in D-CKD. Conclusions: The prevalence of anaemia and inflammation increased with disease severity, being higher in D-CKD. Iron parameters in anaemic patients treated or not with ESA are insufficient according to the guidelines, so there is room for improvement in the treatment of anaemia associated with CKD.

Objective: The present study assessed the iron and Vitamin A status of children aged 0 to 36 months in Thulamela municipality, Vhembe District. Methods: A cross-sectional study was conducted among 250 children aged 0 to 36 months attending well-baby clinic services with their mothers. Convenience sampling was used to select study participants, and simple random sampling was used to choose clinics. Data were gathered via a questionnaire administered by the researcher and field workers from August to September 2019. Standard techniques were used to measure body weight and height. In addition, serum retinol, haemoglobin, iron, ferritin, transferrin saturation, and transferrin levels were also assessed. Information on dietary diversity was gathered through a 24 h dietary recall. Results: The prevalence of underweight, wasting, and stunting was 3.6%, 2%, and 9.2%, respectively. Using serum retinol p-value = 0.007). Conclusion: Iron, anaemia, and vitamin A deficiencies, accompanied by a high prevalence of stunting, were common among children in Thulamela Municipality. Thus, improving nutritional status in this area is a critical need.

Background and Objectives: Anaemia is one of the most common forms of malnutrition globally, with most anaemia cases related to micronutrient deficiency. Diets with higher dietary diversity scores (DDS) are usually nutritionally diverse and could positively impact micronutrient status, including haemoglobin (Hb) concentration improvement. The study aimed to determine DDS and its association with the Hb concentration of Boarding and Day adolescent Senior High School students in Ghana. Materials and Methods: A semi-structured and three 24 h dietary recalls were used to obtain the participants’ demographic and diet intake data, respectively. Hb concentration was assessed using a validated portable haemoglobinometer. DDS was evaluated using the Minimum Dietary Diversity for Women (MDD-W) approach. Results: A significant difference in the DDS between Boarding and Day students existed. Only 22% of the Boarding students had adequate dietary diversity, whereas 64% of the Day students had adequate dietary diversity. A significantly smaller proportion of the Boarding students consumed nuts and seeds, dairy, flesh foods, eggs, vitamin A-rich vegetables and fruits, other vegetables, and other fruits compared to Day students (p < 0.05, all). No significant difference (p = 0.925) in mean (±SD) Hb concentrations between Boarding (11.9 ± 1.1 g/dL) and Day (11.9 ± 1.1 g/dL) students was found. Additionally, no significant correlation between mean DDS and Hb concentration (p = 0.997) was recorded. Using Hb < 12 g/dL as the determination of anaemia, 55.1% Boarding and 57.8% Day students had anaemia. Conclusions: Low dietary diversity in Boarding students highlighted inadequate nutrition provided by school meals. Strategies to increase meal diversity should be prioritised by stakeholders in Ghana’s educational sector.