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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
High prevalence of microcytic anaemia in Omani children: a prospective study
A Padmanabhan1, S Thomas, H Sheth
1Department of Child Health, Ibra Central Hospital, Ibra, PO Box 03, PC 413, Sultanate of Oman. padmnabn@omantel.net.om
Insights
In Oman, alpha-thalassaemia trait is a common cause of microcytic anemia in children, complicating iron deficiency diagnosis. This study highlights the need to consider hemoglobinopathies when diagnosing anemia in this region.
Area of Science:
- Pediatrics
- Hematology
- Genetics
Background:
- Iron deficiency is a primary cause of microcytic anemia.
- Haemoglobinopathies, particularly alpha-thalassaemia, are prevalent in Arab populations, complicating anemia diagnosis.
- Accurate diagnosis of anemia requires differentiating between iron deficiency and inherited hemoglobin disorders.
Purpose of the Study:
- To determine the prevalence and causes of anemia in Omani children.
- To investigate the role of alpha-thalassaemia trait in microcytic anemia within this population.
- To assess diagnostic challenges in differentiating anemia causes in regions with high hemoglobinopathy prevalence.
Main Methods:
- Prospective study of 256 children aged 3-12 years in Oman.
- Assessment of anemia prevalence using World Health Organization (WHO) criteria.
- Evaluation of red blood cell indices, serum ferritin levels, and glucose-6-phosphate dehydrogenase deficiency.
Main Results:
- Anemia prevalence was 45.1% in 3-5 year olds and 37.9% in 10-12 year olds.
- All anemic children exhibited low mean corpuscular hemoglobin, with 75% showing microcytosis.
- Normal serum ferritin and lack of glucose-6-phosphate dehydrogenase deficiency suggested non-iron deficiency causes for microcytosis.
Conclusions:
- The high prevalence of microcytosis and microcytic anemia in Omani children is likely due to the alpha-thalassaemia trait.
- Alpha-thalassaemia trait significantly confounds the diagnosis of iron deficiency anemia in Oman.
- This finding is crucial for countries with high alpha-thalassaemia gene prevalence to ensure accurate anemia diagnosis.
Abstract:
Iron deficiency is a common cause of microcytic anaemia. However, a high prevalence of haemoglobinopathies in the Arab population makes differential diagnosis difficult. This prospective study of anaemia in children attending a regional hospital in the Sultanate of Oman looked at the prevalence and causes of anaemia in 256 children, 153 in the age group 3-5 years (group A) and 103 in the age group 10-12 years (group B). Of the children studied, 45.1% in group A and 37.9% in group B were anaemic according to WHO criteria. All the anaemic children had low mean corpuscular haemoglobin and 75% showed microcytosis. Serum ferritin levels were normal and glucose-6-phosphate dehydrogenase deficiency did not contribute to the anaemia. The microcytosis and microcytic anaemia in the study population could be attributed to the alpha-thalassaemia trait which is highly prevalent in Oman. The information is of value in any country where there is a significant prevalence of alpha-thalassaemia genes because these can confound the diagnosis of iron deficiency.
