Anemia is a serious global public health problem that particularly affects young children and pregnant women. WHO estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anemic.

Anemia is a condition in which you don’t have enough healthy red blood cells to carry oxygen to the vital organs. In anemia, number of red blood cells or the haemoglobin concentration within them is lower than normal. Haemoglobin is needed to carry oxygen and if you have too few or abnormal red blood cells, or not enough haemoglobin, there will be a decreased capacity of the blood to carry oxygen to the body’s tissues. This results in symptoms such as fatigue, weakness, dizziness and shortness of breath, among others.

Anemia is measured according to the amount of haemoglobin — the protein within red blood cells that carries oxygen from the lungs to the body’s tissues.  It is diagnosed when a blood test shows a hemoglobin value of less than 13.5 gm/dl in a man or less than 12.0 gm/dl in a woman. Normal values for children vary with age.

 

 

 

Symptoms

Anemia can cause a wide range of symptoms including fatigue, weakness, dizziness and drowsiness. Children and pregnant women are more prone to develop anemia , with an increased risk of maternal and child mortality. The prevalence of anemia remains high globally, particularly in low-income settings, where a significant proportion of young children and women of childbearing age can be assumed to be anemic. Iron deficiency anemia has also been shown to affect cognitive and physical development in children and reduce productivity in adults. Anemia is an indicator of both poor nutrition and poor health.

The symptoms of anemia include:

• Tiredness and lack of energy

• Shortness of breath

• Noticeable heartbeats (heart palpitations)

• Pale skin

• Cold hands and feet

• Light headedness

Some forms of anemia cause specific symptoms, including:

• Aplastic anemia: This can cause a fever, frequent infections, and skin rashes.

• Folic acid deficiency anemia: This can cause irritability, dirrhea, and a smooth tongue.

• Hemolytic anemia: This can cause jaundice, dark urine, a fever, and abdominal pain.

• Sickle cell anemia: This can cause painful swelling in the feet and hands, as well as fatigue and jaundice.

 

 

 

 

Anemia types and causes

There are more than 400 types of anemia, and they’re divided into three groups:

• Anemia caused by blood loss

• Anemia caused by decreased or faulty red blood cell production

• Anemia caused by destruction of red blood cells

 

1.Anemia caused by blood loss

Iron-deficiency anemia is the most common type of anemia, and blood loss is often the cause. Bone marrow needs iron to make hemoglobin. Without adequate iron, body cannot produce enough hemoglobin for red blood cells. Low iron levels frequently occur as a result of blood loss.

Blood loss can be acute or chronic. Some causes of rapid blood loss include surgery, childbirth, and trauma. Chronic blood loss is more often responsible for anemia. It can result from a stomach ulcer, cancer, or another type of tumor.

Other causes of anemia due to blood loss include:

• Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the stomach), and cancer

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can cause ulcers and gastritis

• Menorrhagia (heavy menstrual bleeding)

• Post-trauma or post-surgery as well.

 

 

2.Anemias caused by faulty red blood cell production

With this type of anemia, your body may not create enough blood cells, or they may not work the way they should. This can happen because there’s something wrong with your red blood cells or because you don’t have enough minerals and vitamins for your red blood cells to work well.

• Vitamin- deficiency anemia: Vitamin B-12 and Folate are both essential for the production of RBCs. If a person does not consume enough of either vitamin, their RBC count may be low.

• Sickle-cell anemia: This causes RBCs to be shaped like crescents. They may break down more quickly when circulating through the blood vessels than healthy RBCs or become lodged in small blood vessels. This blockage can reduce oxygen levels and cause pain further down in the bloodstream

• Anemia associated with bone marrow disease:

A number of diseases can affect bone marrow, including leukemia. This is a type of cancer that triggers the production of excessive and abnormal white blood cells, disrupting the production of RBCs. Problems with bone marrow can cause anemia. Aplastic anemia, for example, occurs when few or no stem cells are present in the marrow. Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells. The condition leaves you fatigued and more prone to infections and uncontrolled bleeding.

 

 

 

3.Destruction of RBCs

Many factors can cause an excessive breakdown of RBCs, including:

• infections

• certain drugs, including some antibiotics

• Splenomegaly: Enlargement of spleen, which traps red blood cells causing destruction of them too early

• vascular grafts and prosthetic heart valves

• toxins produced by advanced kidney or liver disease

• an autoimmune attack, due to hemolytic disease, for example

• snake or spider venom

• Hemolytic anemia

 

 

 

 

Risk factors

The following factors increase the risk of developing anemia

• Having diet low in vitamins, minerals like vitamin B-12 or folate and iron 

• Menorrhagia, heavy menstrual bleeding

• being pregnant and giving birth

• regularly taking medications that inflame the stomach lining, such as ibuprofen

• having a family history of inherited anemia, such as sickle cell anemia or thalassemia

• having an intestinal disorder that affects the absorption of nutrients such as Vitamin B-12 called pernicious anemia

• losing blood, due to surgery or trauma

• having a chronic illness, such as AIDS, Diabetes, kidney disease, cancer, rheumatoid arthritis, heart failure, or liver disease

 

 

 

References

1. Anemia. (n.d.). Retrieved from WebMD: https://www.webmd.com/a-to-z-guides/understanding-anemia-basics#1
2. Anemia. (2020, March 16). Retrieved from World Health Organization: https://www.who.int/health-topics/anaemia#tab=tab_1
3. https://www.healthline.com/health/anemia. (2019, August 1). What You Need to Know About Anemia. Retrieved from HealthLine: https://www.healthline.com/health/anemia
4. Meredith Goodwin, M. F. (2020, March 26). What to know about anemia. Retrieved from MEDICAL NEWS TODAY: https://www.medicalnewstoday.com/articles/158800

 

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