Conjunctival vasculature in the assessment of anemia

Kent, Alexander R.; Elsing, Sarah H.; Hebert, Renee

doi:10.1016/s0161-6420(99)00048-2

Cited by 22 publications

(11 citation statements)

References 6 publications

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“…These data contrast with those reported by Roy et al (1985) in the USA, which indicated that CVA was not correlated with Hb levels in SS patients, and by Hayes et al (1981) and Fox et al (1990) from Jamaica, in which Hb >9.0 g/dl was considered to be a risk factor for RVA, depending on gender and phenotype. Conversely, Aisen et al (1983) and Kent et al (2000) reported similar patterns of retinal and conjunctival vessel alterations, as found in SCD patients, in patients with anaemia of chronic disease, iron-deficiency anaemia, acute gastrointestinal tract haemorrhage, acute haemolytic anaemia and megaloblastic anaemia, and attributed the alterations to hypoxia.…”

Section: Discussionmentioning

confidence: 66%

Risk factors for conjunctival and retinal vessel alterations in sickle cell disease

Lima

Rocha

Silva

et al. 2006

Acta Ophthalmologica Scandinavica

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Purpose: The aim of this study was to clarify whether the clinical, laboratory and genetic aspects of sickle cell disease (SCD) influence the occurrence of vessel alterations in the conjunctiva and retina. Methods: A total of 102 SCD patients underwent biomicroscopical and retinal examination, in addition to evaluations of haemoglobin (Hb) and haematocrit (Ht) levels, fetal haemoglobin (HbF) estimations, serum creatinine and albuminuria levels, glomerular filtration rate (GFR) values, phenotypes, b-globin gene haplotypes and a-thalassaemia. The relationship between ocular vessel alterations and clinical, laboratory and genetic features were evaluated using chisquared or Fisher tests and logistic regression analysis. In 13 patients on enalapril treatment, a second ophthalmological evaluation was performed after a 12-month period to evaluate the longitudinal effect of the drug on ocular vessels. Results: Conjunctival vessel alteration (CVA) was not influenced by age, gender, HbF estimation, serum creatinine and albuminuria levels, GFR values, b-globin gene haplotypes or a-thalassaemia. However, increased frequencies of CVA were found in patients with Hb £ 9.0 g/dl, Ht £ 26.7% and sickle cell anaemia (SS) phenotype. Retinal vessel alteration (RVA) was identified only in patients aged 17 years or older. Enalapril did not demonstrate ocular vessel amelioration after 12-months of daily use. Conclusion:The results indicate that lower Hb and Ht levels and SS phenotype are risk factors for CVA, and age over 17 years may be risk factors for RVA in SCD patients.

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Section: Discussionmentioning

confidence: 66%

Risk factors for conjunctival and retinal vessel alterations in sickle cell disease

Lima

Rocha

Silva

et al. 2006

Acta Ophthalmologica Scandinavica

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“…Additionally, a rapid diagnostic test (RDT) for malaria was performed (ICT ML01 malaria Pf kit; ICT Diagnostics, Cape Town, South Africa). Children with clinical malaria (defined as positive RDT plus recent history of fever), asthma (assessed by study physician using a stethoscope), anemia (assessed by study physician after pulling down of eyelid and noting pale color [32]), or dyspnea (assessed by study physician using a stethoscope), according to the physician's appraisal, were excluded from the subsequent fitness test as motivating them to reach their maximal physical capacity was considered as potentially harmful.…”

Section: Methodsmentioning

confidence: 99%

Effect of Schistosomiasis and Soil-Transmitted Helminth Infections on Physical Fitness of School Children in Côte d'Ivoire

et al. 2011

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BackgroundSchistosomiasis and soil-transmitted helminthiasis are important public health problems in sub-Saharan Africa causing malnutrition, anemia, and retardation of physical and cognitive development. However, the effect of these diseases on physical fitness remains to be determined.MethodologyWe investigated the relationship between schistosomiasis, soil-transmitted helminthiasis and physical performance of children, controlling for potential confounding of Plasmodium spp. infections and environmental parameters (i.e., ambient air temperature and humidity). A cross-sectional survey was carried out among 156 school children aged 7–15 years from Côte d'Ivoire. Each child had two stool and two urine samples examined for helminth eggs by microscopy. Additionally, children underwent a clinical examination, were tested for Plasmodium spp. infection with a rapid diagnostic test, and performed a maximal multistage 20 m shuttle run test to assess their maximal oxygen uptake (VO2 max) as a proxy for physical fitness.Principal FindingsThe prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides infections was 85.3%, 71.2%, 53.8%, 13.5% and 1.3%, respectively. Children with single, dual, triple, quadruple and quintuple species infections showed VO2 max of 52.7, 53.1, 52.2, 52.6 and 55.6 ml kg−1 min−1, respectively. The VO2 max of children with no parasite infections was 53.5 ml kg−1 min−1. No statistically significant difference was detected between any groups. Multivariable analysis revealed that VO2 max was influenced by sex (reference: female, coef. = 4.02, p<0.001) and age (years, coef. = −1.23, p<0.001), but not by helminth infection and intensity, Plasmodium spp. infection, and environmental parameters.Conclusion/SignificanceSchool-aged children in Côte d'Ivoire showed good physical fitness, irrespective of their helminth infection status. Future studies on children's physical fitness in settings where helminthiasis and malaria co-exist should include pre- and post-intervention evaluations and the measurement of hemoglobin and hematocrit levels and nutritional parameters as potential co-factors to determine whether interventions further improve upon fitness.

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“…Additionally, a rapid diagnostic test (RDT) for malaria was performed (ICT ML01 malaria Pf kit, ICT Diagnostics; Cape Town, South Africa). Children with clinical malaria (defined as positive RDT plus recent history of fever), asthma (assessed by stethoscopy), anaemia (assessed by observing conjunctival vasculature [22]) or dyspnoea (assessed by stethoscopy), according to the physician's appraisal, were excluded from the subsequent fitness test, as participation was considered potentially harmful to them.…”

Section: Methodsmentioning

confidence: 99%

Questionnaire-based approach to assess schoolchildren's physical fitness and its potential role in exploring the putative impact of helminth and Plasmodium spp. infections in Côte d'Ivoire

et al. 2011

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BackgroundDisability weights (DWs) are important for estimating burden of disease in terms of disability-adjusted life years. The previous practice of eliciting DWs by expert opinion has been challenged. More recent approaches employed quality of life (QoL) questionnaires to establish patient-based DWs, but results are ambiguous.MethodsIn early 2010, we administered a questionnaire pertaining to physical fitness to 200 schoolchildren in Côte d'Ivoire. Helminth and Plasmodium spp. infections were determined and schoolchildren's physical fitness objectively measured in a maximal multistage 20 m shuttle run test. Associations between objectively measured and self-reported physical fitness and between self-reported physical fitness and infection status were determined. Spearman rank correlation coefficient, uni- and multivariable linear regression models adjusting for children's age and sex, ambient air temperature and humidity, Fisher's test, χ² and t-test statistics were used for statistical analysis.ResultsThe prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides in 167 children with complete parasitological results was 84.4%, 74.9%, 54.5%, 14.4% and 1.2%, respectively. High infection intensities and multiple species parasite infections were common. In the 137 children with complete data also from the shuttle run test, we found statistically significant correlations between objectively measured and self-reported physical fitness. However, no statistically significant correlation between the children's parasitic infection status and self-reported physical fitness was identified. An attrition analysis revealed considerably lower self-reported physical fitness scores of parasitized children who were excluded from shuttle run testing due to medical concerns in comparison to parasitized children who were able to successfully complete the shuttle run test.ConclusionsOur QoL questionnaire proofed valid to assess children's physical fitness in the current study area. Reasons why no differences in self-reported physical fitness in children with different parasitic infections were found are manifold, but do not preclude the use of QoL questionnaires in the elicitation of DWs. Indeed, the questionnaire was particularly useful in assessing physical fitness of those children, who were - supposedly due to parasitic infections - unable to complete the shuttle run test. Hence, we encourage others to use QoL questionnaires to determine not only physical fitness, but also more subtle morbidities.

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Conjunctival vasculature in the assessment of anemia

Cited by 22 publications

References 6 publications

Risk factors for conjunctival and retinal vessel alterations in sickle cell disease

Risk factors for conjunctival and retinal vessel alterations in sickle cell disease

Effect of Schistosomiasis and Soil-Transmitted Helminth Infections on Physical Fitness of School Children in Côte d'Ivoire

Questionnaire-based approach to assess schoolchildren's physical fitness and its potential role in exploring the putative impact of helminth and Plasmodium spp. infections in Côte d'Ivoire

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