A study on prevalence and causative factors of megaloblastic anaemia in Hadoti region.

Abstract

Background: Anaemia is the most common problems encountered by clinicians in Hadoti Region. The affected population includes male, female as well as children. Over the last two decades, it has been found that incidence of megaloblastic anaemia is increasing. Folic Acid and Vitamin B12 deficiency are the most common cause of megaloblastic anemia. Of these two micronutrients, Vitamin B12 deficiency is more common now, due to vegetarian life style of people. At present, Anemia control or prophylaxis program give only Iron and Folic acid. This study has been chosen to focus on this issue. The cases for increasing incidences of Folate / Vit. B12 deficiency needs to be elucidated.Objectives: To focus on the incidence of megaloblastic anaemia in Hadoti Region. & Probable Causative factors will be analysed Methods: All patients presenting to our hospital over a period of 2 months with a haemoglobin <10 g/dl and peripheral smear findings consistent with megaloblastic anaemia will be included in the study. Diet, drug intake, previous blood transfusion, presenting symptoms and other relevant history will be taken into consideration. Complete blood counts, peripheral film examination, reticulocyte count and cobalamin and folate assays will be recorded. Patients with chronic disease like renal disease, cancer, tuberculosis, liver disease etc will be excluded from the study. All data will be collected and evaluated statistically. Result:In the present study, total 500 patients who were admitted in medicine, paediatric and gynaecology ward were evaluated. All these patients met the inclusion criteria. Depending on the MCV value, serum assay and peripheral smear finding, they were categorised into 3 groups-Macrocytic, normocytic and microcytic anaemia. The normal MCV value but with megaloblastic blood film or low serum markers were considered into macrocytic anaemia. Total 100 patients were diagnosed as macrocytic anaemia. The sex distribution were-70(male), 30(female). Fifty five per cent of patients with cobalamin deficiency and 08% of patients with folate deficiency were found. All the patients were vegetarian and from middle class and low socio economic group. Conclusion:Cobalamin deficiency was responsible for megaloblastic anaemia in the majority of our patients. The supplementation program for Anemia control and prophylaxis should vary according to the regional requirements. Vitamin B12 should be included in the nutritional programme along with iron and folic acid. Awareness camp and Education program about megaloblastic anemia can be implemented for the prevention.

Hematological and biochemical profile of person with macrocytic anemia in a tertiary health care centre of Nepal

“…13 A study by Wyckoff KF et al reported subjects with decreased serum vitamin B12 is likely to be without macrocytosis during the period of post fortification and folic acid fortification led to macrocytosis correction related to vitamin B12 insufficiency. 18 Likewise, D'Onofrio et al observed patients with microcytic anemia due to iron deficiency (58 patients) and heterozygous B-thalassemia (40 patients), and macrocytosis (28 patients) all had larger reticulocytes than mature RBCs by 24% to 35%. 22 A study by Balci YI et al claimed that reticulocytes could be the useful marker for differentiating iron deficiency anemia and vitamin B12 deficiency anemia.…”

Diagnostic Utility of Serum Lactate Dehydrogenase Levels (Ldl) in Differentiating Megaloblastic Anemia From Myelodysplastic Syndromes in Pakistan

“…One of the most common types of anemia is megaloblastic anemia and its incidence has increased over the last 2 decades worldwide. 1 It poses a considerable health problem in developing countries like India and Pakistan and its highest incidence has been reported from India and Africa ranging from 50-71% which is seen more in the younger age group. 2 The main causes of megaloblastic anemia includes vitamin B12 deficiency and folic acid deficiency.…”