High prevalence of anaemia among African migrants in Germany persists after exclusion of iron deficiency and erythrocyte polymorphisms

Abstract

Abstractobjectives Haematological parameters differ between individuals of African and European ancestry. However, respective data of first-generation African migrants are virtually absent. We assessed these in Ghanaian migrants living in Berlin, compared them with reference data from Germany and Ghana, and estimated the role of iron deficiency (ID) and erythrocyte polymorphisms in anaemia.methods A total of 576 Ghanaians (median age, 45 years) were analysed. Blood counts were performed, haemoglobinopathies and glucose-6-phosphate dehydrogenase (G6PD) deficiency were genotyped, and concentrations of ferritin and C-reactive protein were measured to define ID.results Most individuals had resided in Germany for more than a decade (median, 18 years). By WHO definition, anaemia was present in 30.9% of females and 9.4% of males. Median haemoglobin (Hb) levels were lower than among Germans (women, À0.8 g/dl, men, À0.7 g/dl). However, applying reference values from Ghana, only 1.9% of the migrants were considered anaemic. Alphathalassaemia, Hb variants and G6PD deficiency were observed in 33.9%, 28.3% and 23.6%, respectively. ID was highly prevalent in women (32.0%; men, 3.9%). The population fraction of anaemia cases attributable to ID was 29.0% (alpha-thalassaemia, 13.6%; G6PD deficiency, 13.5%). Nevertheless, excluding ID, alpha-thalassaemia, G6PD deficiency and sickle cell disease, anaemia prevalence remained high (women, 18.4%; men, 6.5%), and was also high when applying uncensored thresholds proposed for African Americans (females, 19.3%; males, 7.8%).conclusions Iron deficiency and erythrocyte polymorphisms are common among first-generation Ghanaian migrants but explain only part of the increased prevalence of anaemia. Common Hb thresholds for the definition of anaemia may not be appropriate for this group.

Validation of the rapid test Carestart(tm) G6PD among malaria vivax-infected subjects in the Brazilian Amazon

“…Although a previous study on the Cambodian population found that G6PDd was associated with lower hemoglobin levels (33) , we could discern no clear relationship between G6PDd and hemoglobin levels in the present study. However, in another study, Satyagraha et al (34) found that G6PDd was associated with higher hemoglobin levels, whereas, in contrast, other studies have found no correlation between G6PDd and hemoglobin levels (35) (36) .…”

Preoperative Anaemia and Associated Postoperative Outcomes in Noncardiac Surgery Patients in Central Region of Ghana

“…This is in line with the high prevalence of iron deficiency among black Africans including Ghanaians. A prevalence of 32.0% was reported among Ghanaian women living in Germany [ 19 ], 41–63% iron deficiency among Ivoirians women [ 20 ], and 39% IDA among Nigerians women aged 16–45 years [ 21 ]. Thalassaemia is equally prevalent in Ghanaians, alpha-thalassaemia is about 34% [ 19 ] and beta-thalassaemia is about 5% [ 22 ], but could not be differentiated due to restriction on confirmatory investigations at the selected centres.…”

Adherence to clinical guidelines for use of blood components at a tertiary hospital in Ghana

“…One fifth of patients had no cause for anaemia documented in their notes either before transfusion or during their admission. Over 40% of transfused patients had microcytic anaemia which in Ghana would most commonly be due to iron deficiency anaemia or a haemoglobinopathy . Only a limited number of investigations to determine the cause of anaemia are available at VRH and patients may not be able to afford investigations.…”