Prevalence and mangement of anaemia in children seen at RCWMCH Martie Wege Rudzani Muloiwa, Patricia Hartley Introduction: Anaemia is a well known public health problem in children Actual prevalence for anaemia in children from Cape Town remain unclear. Full Blood Count (FBC) is a frequently performed test on children as part of evaluation for other disease processes Anaemia in hospitalized children is usually an incidental finding. Research Aim: To describe the prevalence of anaemia in children 6-36months of age presenting to MEU, SSW and MOPD at RCWMCH, as well as the management of children with suspected Iron deficiency anaemia. What is anaemia? Classification of anaemia: For this study purpose: Hb ≤ 10.5 for all children 6months to 3 years Case definition for Microcytosis: MCV of 70 fl PLUS 1fl for each year Mild anaemia: Hb 10 – 10.5g/dl Moderate anaemia: Hb 8.0 – 9.9g/dl 6-12m: 70fl 1-2yr: 71fl 2-3yr: 72fl Severe anaemia: Hb <8g/dl Selection and sampling of patients: 75 954 36 898 12 218 2 661 540 502 • All FBC’s done for 2011&2012 at RCWMCH • After dropping all duplicates and FBC’s done during 2011 • Only keep patients that had their first FBC done at MEU/SSW/MOPD. • Exclude all children <6months or >36 months of age • 50% of anaemic patients were sampled • Folders located for a detailed review Prevalence of anaemia in age categories: 100 90 80 This was in keeping with a 10% decline in the prevalence of anaemia with increase in age category. RR10,9 (CI 0,840.95) 70 60 50 40 30 20 10 0 All 6-12months Anaemia 1-2 years No Anaemia 2-3 years Anaemia in different wards Anaemia No anaemia (χ2p = 0.001) 70% 100% 60% 90% 50% 80% 40% 70% 60% 30% 50% 20% 40% 10% 30% 0% 20% 10% 0% MEU (872/2042) MOPD (216/619) Folder review: Severity of Anaemia at RCWMCH: 11% 36% 53% Mild Moderate Severe Correlation between Pallor and laboratory confirmed anaemia 91 18% 28 6% No Unknown 383 76% Yes Folder review: Morphology of anaemia Microcytic Normocytic Macrocytic 2 1% 172 34% 328 65% Treatment of microcytic anaemia Iron ≤ 1/12 Iron > 1/12 No iron 75 23% 180 55% 73 22% Causes for anaemia: 400 350 300 250 200 150 100 50 0 -50 Anaemia Anaemia of not prematurity investigated Causes 365 3 Chronic disease Epistaxis Iron deficiency 50 1 73 Iron Pulmonary Sickle cell deficiency, Malignancy Haemosider B12 anaemia osis deficiency 2 1 1 1 Sickle cell anaemia, Iron deficiency 1 Specific Thalassaemi cause not a, Iron found deficiency 1 3 Causes for anaemia: 400 350 300 250 200 150 100 50 0 -50 Anaemia Anaemia of not prematurity investigated Causes 365 73% 3 Chronic disease Epistaxis Iron deficiency 50 10% 1 73 15% Iron Pulmonary Sickle cell deficiency, Malignancy Haemosider B12 anaemia osis deficiency 2 1 1 1 Sickle cell anaemia, Iron deficiency 1 Specific Thalassaemi cause not a, Iron found deficiency 1 3 Conclusion: Prevalence of anaemia at RCWMCH 40.8% Anaemia in unwell children at RCWMCH are almost double the predictable prevalence for children in SA Anaemia is significantly more prevalent in younger children The more acutely ill children presenting to RXH are more likely to be anaemic More than 75% of children with suspected iron deficiency received NO iron or ≤ 1/12 of iron A FBC is a frequently performed test on children presenting to the MEU/MOPD at RCWMCH and the information is under-utilized by physicians. Aknowledgement… NHLS haematology Laboratory at RCWMCH Dr Muloiwa and Prof Hartley
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