Haemato-biochemical basis of anaemia in Agogo, Ashanti Region, Ghana

Abstract

This cross sectional study was conducted to evaluate the underlying causes of anaemia among 200 adult patients (18-60 years) without any established chronic disease from September 2011 to February 2012 at the outpatients department of the Agogo Presbyterian Hospital. Participant selection was based on the WHO definition of anaemia in adults [Hb<12.0g/dl (female) and Hb<13.0g/dl (male)]. Venous blood samples were drawn for full blood count (FBC), total iron, ferritin, folate, vitamin B₁₂ and malaria parasite tests. One hundred and forty-eight (74%) of the study participants presented with mild anaemia, 40(20%) had moderate anaemia and 12(6%) had severe anaemia. Study participants with mild anaemia presented with higher mean red blood cell count (4.14±0.51 M/μL) when compared to those with moderate (3.71±0.67 M/μL) and severe (2.30±0.73 M/μL) anaemia. About one quarter (51/200) of the study participants had folate deficiency (serum folate <5.0 ng/ml) and 60/200 had vitamin B₁₂  deficiency (serum vitamin B₁₂<200ng/L). Iron deficiency (serum iron <8.9 µmol/L), the most prevalent cause of anaemia, occurred in 69/200 of the study participants and had a statistically significant association with the severity of the anaemia (p=0.0028). Malaria infection increased the risk of mild to moderate anaemia (OR=5.2; 95%CI=2.0-13.5) five times and mild to severe anaemia (OR=6.9; 95%CI=1.8-26.9) seven times. Deficiencies in iron, vitamin B₁₂  and folic acid are significantly associated with the burden of anaemia in Agogo, Ashanti. It is imperative that the cause of anaemia be fully investigated to enable medical interventions to be fashioned around the underlying aetiology thus optimizing the use of limited health resources associated with the burden of anaemia in Agogo-Ashanti.

Journal of Medical and Biomedical Sciences (2016) 5(3), 1-12

Keywords: Anaemia, Microcytosis, Hypochromasia, Immunoassay, Agogo, Ghana, Malaria