Study of severe anemia in hospitalized children in Ahmedabad (Gujarat), India

Harsh J. Muliya; Maulika V. Shah; Hetal N. Jeeyani; Divy H. Dudhia; Arjun J. Jalandhra

doi:10.18203/2349-3291.ijcp20230079

Authors

Harsh J. Muliya Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
Maulika V. Shah Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
Hetal Jeeyani Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
Divy Dudhia Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
Arjun Jalandhra Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230079

Keywords:

Anemia, Iron deficiency, Hemolytic, Megaloblastic

Abstract

Background: Anemia is a major nutritional problem worldwide especially in developing countries. This research was conducted to find the incidence of severe anemia, to identify the common clinical features and etiology of it and to assess the requirement of packed red cell transfusion.

Methods: All patients having severe anemia (hemoglobin <7 gm/dl in 6-59 months and <8 gm/dl in 5-14 years as per WHO definition) between 6-14 years were included in this study. Detailed medical history, anthropometric measurements and clinical examination were done. Complete blood count, peripheral smear, reticulocyte count and stool microscopy were done in all patients. Then anemia classified morphologically into microcytic, normocytic, macrocytic and dimorphic. Further investigations were done according to the peripheral smear to identify the etiology of severe anemia.

Results: During the study period, 84 patients of severe anemia were hospitalized with incidence of 2.57%. It was more common in male in 6 months to 5 years and in female in 10-14 years age. 67% patients had microcytic, 28% had dimorphic and 2.5% each had normocytic and macrocytic anemia. The most common anemia was iron deficiency (82%) followed by anemia of chronic disease (17%), hemolytic anemia (12%), megaloblastic anemia (7%) and blood loss anemia (1%). Packed red cell transfusion was required in 16 (19%) patients with severe anemia.

Conclusions: Good clinical examination with peripheral smear is helpful in classifying the anemia morphologically. Following this, the use of investigations as per the standard flow charts, helps in identification of etiology.

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References

Norma B. Lerner, Nelson textbook of pediatrics, 20th edition, Elsevier, 2016;447:2309.

IIPS, National family Health Survey (NFHS-4), 2015-16, India. 2017;322-3.

IIPS, National Family Health Survey (NFHS-5), State Fact Sheet, Gujarat. 2019-20.

Janjale A, Pande S, Sonawane R, Ahire N, Sonawane S. A study of severe anemia in children in a tertiary care institute. MVP J Med Sci. 2018; 5(1):33-8.

Saroja CN, Alapaty S, Jeyan M. Efficacy of red cell distribution width (RDW) as a screening test for diagnosing children with iron deficiency anemia, Sch J App Med Sci. 2014;2(6H):3412-5.

Kapoor D, Agarwal KN, Sharma S. Detecting iron deficiency anemia among children (9-36 months age) by implementing a screening program in an urban slum. Indian Pediatr. 2002;39:671-6.

Dutta M, Bhise M, Prashad L, Chaurasia H, Debanath P. Prevalence and risk factors of anemia among children 6-59 months in India: A multilevel analysis. Clin Epidemiol Global Heal. 2020;8:868-78.

Yeluri SK. Prevalence of anemia and its etiology: a study in a semi urban area: Int J Pediatrics Res. 2016;3(4):266-71.

Gebreweld A. Prevalence of anemia and associated factors among children under five years of age attending Guguftu health center, South Wollo, Northeast Ethiopia, PLoS one. 2020;14(7):e0218961.

Siva PM, Sobha A, Manjula VD. Prevalence of anemia and its associated risk factors among adolescent girls of central kerala, J Clin Diagn Res. 2016;10(11):LC19-23.

Kumar A. Goyal A, Verma N, Mahesh A. Study of anemia among adolescent school girls and young adults, Int J Adv Med. 2018:5(4):877-81.

Thomas D, Chandra J, Sharma S, Jain A, Pemde HK. Determinants of nutritional anemia in adolescents. Indian Pediatrics. 2015;52:867-9.

Saba F, Poornima S, Balaji PA, Varne SR, Jayshree K. Anemia among hospitalized children at a multispeciality hospital, Banglore (Karnataka), India. J Fam Med Primary Care. 2014;3:48-53.

Wahab MA, Patwari Y. Study of pattern of anemia in children in and around Mahabub Nagar, IP. J Diagnostic Pathol Oncol. 2018;3(2):75-80.

Iron deficiency anemia assessment, prevention and control, World health organization. 2001. Available at: www.who.int>publications. Accessed on 25 Nov, 2022.

Patel AH, Kharod PP. Study of anemia in hospitalized infants with special reference to its risk factors. Int J Pediatr Res. 2019;6(10);527-33.

Gopalkrishnan S, Eashwar VM, Muthulakshmi M, Geetha A. Intestinal parasitic infestations and anemia among urban female school children in Kancheepuram district, Tamil Nadu, J Family Med Prim Care. 2018;7:1395-400.