Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey

Allen, Angela; Allen, Stephen; Rodrigo, Rexan; Perera, Lasantha B.; Shao, Wei; Li, Chao; Wang, Duolao; Olivieri, Nancy F.; Weatherall, D. J.; Premawardhena, Anuja

doi:10.1371/journal.pone.0188110

Cited by 18 publications

(27 citation statements)

References 38 publications

(37 reference statements)

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“…Further analysis of the same study identi ed that b thalassaemia trait and deletional a thalassaemia contributed to anaemia in a further 3%. 11 children with Sickle cell trait had been identi ed in this study but there is no mention about their haemoglobin level (4,(28)(29)(30). Though anaemia is identi ed to be an important nding in the present study, it is unlikely that SCD has a signi cant bearing on the national anaemia gures due to its relative low prevalence.…”

Section: Genetic Ndingsmentioning

confidence: 73%

Sickle cell disease in Sri Lanka: Clinical and molecular basis and the unanswered questions about disease severeity.

Darshana

Bandara²,

Nawarathne³

et al. 2020

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Background Though case reports and limited case series of Sickle cell disease in Sri Lanka have been reported previously, no attempt has been made hitherto to undertake a comprehensive genotypic-phenotypic analysis of this “rare” group of patients. Results All accessible Sickle cell disease patients, totaling 60, including, 51 Sickle β-thalassaemia and 9 homozygous sickle patients were enrolled from seven thalassaemia treatment centres between December 2016 - March 2019. The majority of patients were of Sinhalese ethnicity (n=52, 86.67%). Geographically, two prominent clusters were identified and the distribution of Sickle haemoglobin in the island contrasted markedly with the other haemoglobinopathies. 3/ 9 homozygous sickle patients and 3/ 51 Sickle β-thalassaemia patients were receiving regular transfusion. Joint pain was the commonest clinical presentation among all sickle cell disease patients (n=39, 65.0%). Dactylitis was significantly more common in homozygous sickle patients compared with the Sickle β-thalassaemia groups (p 0.027). Two genetic backgrounds sickle mutation were identified namely, Arab Indian and Benin. Among the regulators of Foetal hemoglobin in Sickle patients of the present study rs1427407 G>T seemed to be the most prominent modifier, with a significant association with Foetal haemoglobin levels (p 0.04). Conclusions Overall, the clinical course of the Asian version of Sickle cell disease in Sri Lanka appears to be milder than that described in India.

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Section: Genetic Ndingsmentioning

confidence: 73%

Sickle cell disease in Sri Lanka: Clinical and molecular basis and the unanswered questions about disease severeity.

Darshana

Bandara²,

Nawarathne³

et al. 2020

Preprint

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“…In contrast to β-haemoglobinopathies, α-thalassaemia trait cannot be diagnosed in adults without genetic testing and therefore, is greatly under diagnosed in Sri Lanka. However, a recent island-wide survey among adolescents revealed that α-thalassaemia trait is commoner than β-thalassaemia trait in Sri Lanka [ 7 , 10 , 14 ]. Our results collaborate well with the findings of this survey.…”

Section: Discussionmentioning

confidence: 99%

Anaemia among females in child-bearing age: Relative contributions, effects and interactions of α- and β-thalassaemia

et al. 2018

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IntroductionAnaemia in women during pregnancy and child bearing age is one of the most common global health problems. Reasons are numerous, but in many cases only minimal attempts are made to elucidate the underlying causes. In this study we aim to identify aetiology of anaemia in women of child bearing age and to determine the relative contributions, effects and interactions of α- and β-thalassaemia in a region of the world where thalassaemia is endemic.MethodsA cross sectional study was conducted at the Colombo North Teaching Hospital of Sri Lanka. The patient database of deliveries between January 2015 and September 2016 at University Obstetrics Unit was screened to identify women with anaemia during pregnancy and 253 anaemic females were randomly re-called for the study. Data were collected using an interviewer-administered questionnaire and haematological investigations were done to identify aetiologies.ResultsOut of the 253 females who were anaemic during pregnancy and were re-called, 8 were excluded due to being currently pregnant. Of the remaining 245 females, 117(47.8%) remained anaemic and another 22(9.0%) had non-anaemic microcytosis. Of anaemic females, 28(24.8%) were iron deficient, 40(35.4%) had low-normal serum ferritin without fulfilling the criteria for iron deficiency,18(15.3%) had β-haemoglobinopathy trait and 20(17.0%) had α-thalassaemia trait. Of females who had non-anaemic microcytosis, 14(66.0%) had α-thalassaemia trait. In 4 females, both α- and β-thalassaemia trait coexist. These females had higher levels of haemoglobin (p = 0.06), MCV (p<0.05) and MCH (p<0.01) compared to individuals with only β-thalassaemia trait. A significantly higher proportion of premature births (p<0.01) and lower mean birth weights (p<0.05) were observed in patients with α-thalassaemia trait.ConclusionsNearly one third of anaemic females in child bearing age had thalassaemia trait of which α-thalassemia contributes to a majority. Both α- and β-thalassaemia trait can co-exist and have ameliorating effects on red cell indices in heterozygous states. α-Thalassaemia trait was significantly associated with premature births and low birth weight. It is of paramount importance to investigate the causes of anaemia in women of child bearing age and during pregnancy in addition to providing universal iron supplementation.

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“…IDA has detrimental effects on the cognitive and physical development of children, the productivity and physical performance of adults and on pregnancy outcomes [ 27 ]. Even if it does not progress to anemia, ID may impair growth, cognition, behavior, immunity, hormone balance, performance, and work capacity [ 23 ]. Although several studies have evaluated anemia status in Sri Lanka, few have investigated ID.…”

Section: Prevalence Of Mnd In Sri Lankamentioning

confidence: 99%

“…The aim of this review is to compile available data on MND to understand the nature and degree of MND in Sri Lanka. Data were retrieved from national nutrition and micronutrient surveys [ 16 , 17 ], national vitamin A survey [ 18 ], national iodine surveys [ 19 , 20 , 21 , 22 ] and related articles [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 23 ] published from 2000. The details of the studies are summarized in Table 2 .…”

Section: Introductionmentioning

confidence: 99%

Micronutrient Status in Sri Lanka: A Review

et al. 2018

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Micronutrients include vitamins, minerals and, trace elements that are required in minute quantities but play a vital role in normal human growth, development and physiological functioning. Micronutrient deficiencies, also known as hidden hunger, are a global issue, with particularly high prevalence rates in developing countries. Currently, Sri Lanka is experiencing the double burden of over- and undernutrition. This review describes the micronutrient status of Sri Lanka based on results of national surveys and related articles published from 2000. The available data suggest a higher prevalence of iron, zinc, calcium, folate, and vitamin A deficiencies. The prevalence of iodine deficiency has declined gradually following the implementation of a universal salt iodization program. Iron deficiency is the most common cause of anemia and low red blood cell indices. Females are more vulnerable to micronutrient deficiencies than males. The coexistence of multiple micronutrient deficiencies and concurrent macro- and micronutrient deficiencies is common. Studies have shown an association between micronutrient deficiencies and different demographic, socioeconomic, and dietary factors. Therefore, there is a need for comprehensive studies, nutritional policies, and nationwide intervention programs in Sri Lanka to improve the micronutrient status of the population.

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Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey

Cited by 18 publications

References 38 publications

Sickle cell disease in Sri Lanka: Clinical and molecular basis and the unanswered questions about disease severeity.

Sickle cell disease in Sri Lanka: Clinical and molecular basis and the unanswered questions about disease severeity.

Anaemia among females in child-bearing age: Relative contributions, effects and interactions of α- and β-thalassaemia

Micronutrient Status in Sri Lanka: A Review

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