Haematology in the Tropics: A Review

Abstract

Tropical Haematology in current usage in medical literature and practice is understood to mean haematological manifestations of either primary or secondary haematological diseases/disorders which have been influenced or driven by infectious agents and poor nutrition and their sequelae. In this communication, the common examples of infectious agents with serious impact on human haematological manifestations discussed are malaria parasite and HIV. Malaria has contributed greatly to shaping the human genome and driven our evolutionary history. The roles of hookworm and schistoma parasites in relation to the prevalence of iron deficiency anaemia-a component of nutritional anaemia, in the tropics, are mentioned. Poor nutrition itself constitutes a common cause of nutritional anaemia, a common cause of morbidity and deaths in the tropics. Primary haematological malignancies such as the leukaemias and lymphomas [including lymphomas secondary to HIV infection], are also considered. Similarly, common inherited disorders believed to be the consequences of malaria infections in the past, i.e. the haemoglobinopathies e.g. Sickle Cell diseases/ anaemia, and the enzymopathies, eg Glucose-6-phosphate dehydrogenase deficiency [G6Pd], are also mentioned, as are inherited disorders of haemostasis eg the less common inherited disorder, the Haemophilias. The impact of Genomics, the most recent and far-reaching development in molecular biological research is bound to have profound impact on Tropical Haematology as it already has been in other knowledge areas of human medicine. These early findings in genomics clearly emphasize the need for all haematologists in the Tropics to acquire adequate knowledge, and many, the expertise in Genomics, and for some specialized Centres/Institutes in Genomics to be established in different countries in the Region as a matter of utmost urgency.