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in children seen at RCWMCH Martie Wege Rudzani Muloiwa, Patricia - - PowerPoint PPT Presentation
in children seen at RCWMCH Martie Wege Rudzani Muloiwa, Patricia - - PowerPoint PPT Presentation
Prevalence and mangement of anaemia in children seen at RCWMCH Martie Wege Rudzani Muloiwa, Patricia Hartley Introduction: Anaemia is a well known public health problem in children Actual prevalence for anaemia in children from
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Research Aim:
To describe the prevalence of anaemia in children 6-36months of age presenting to MEU, SSW and MOPD at RCWMCH, as well as the management of children with suspected Iron deficiency anaemia.
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What is anaemia?
For this study purpose: Hb ≤ 10.5 for all children 6months to 3 years
Case definition for Microcytosis: MCV of 70 fl PLUS 1fl for each year
6-12m: 70fl 1-2yr: 71fl 2-3yr: 72fl
Classification of anaemia:
Mild anaemia: Hb 10 – 10.5g/dl
Moderate anaemia: Hb 8.0 – 9.9g/dl
Severe anaemia: Hb <8g/dl
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Selection and sampling of patients:
75 954 • All FBC’s done for 2011&2012 at RCWMCH 36 898 • After dropping all duplicates and FBC’s done during 2011 12 218 • Only keep patients that had their first FBC done at MEU/SSW/MOPD. 2 661 • Exclude all children <6months or >36 months of age 540
- 50% of anaemic patients were sampled
502
- Folders located for a detailed review
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Prevalence of anaemia in age categories:
10 20 30 40 50 60 70 80 90 100 All 6-12months 1-2 years 2-3 years Anaemia No Anaemia
This was in keeping with a 10% decline in the prevalence
- f anaemia with
increase in age category.
RR10,9 (CI 0,84- 0.95)
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Anaemia in different wards
0% 10% 20% 30% 40% 50% 60% 70% Anaemia No anaemia 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% MEU (872/2042) MOPD (216/619)
(χ2p = 0.001)
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Folder review:
Severity of Anaemia at RCWMCH:
36% 53% 11%
Mild Moderate Severe
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Correlation between Pallor and laboratory confirmed anaemia
383 76% 28 6% 91 18%
No Unknown Yes
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Folder review: Morphology of anaemia
328 65% 172 34% 2 1% Microcytic Normocytic Macrocytic
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Treatment of microcytic anaemia
75 23% 73 22% 180 55% Iron ≤ 1/12 Iron > 1/12 No iron
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Causes for anaemia:
Anaemia not investigated Anaemia of prematurity Chronic disease Epistaxis Iron deficiency Iron deficiency, B12 deficiency Malignancy Pulmonary Haemosider
- sis
Sickle cell anaemia Sickle cell anaemia, Iron deficiency Specific cause not found Thalassaemi a, Iron deficiency Causes 365 3 50 1 73 2 1 1 1 1 1 3
- 50
50 100 150 200 250 300 350 400
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Causes for anaemia:
Anaemia not investigated Anaemia of prematurity Chronic disease Epistaxis Iron deficiency Iron deficiency, B12 deficiency Malignancy Pulmonary Haemosider
- sis
Sickle cell anaemia Sickle cell anaemia, Iron deficiency Specific cause not found Thalassaemi a, Iron deficiency Causes 365 3 50 1 73 2 1 1 1 1 1 3
- 50
50 100 150 200 250 300 350 400
10% 15% 73%
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Conclusion:
Prevalence of anaemia at RCWMCH 40.8%
Anaemia in unwell children at RCWMCH are almost double the predictable prevalence for children in SA
Anaemia is significantly more prevalent in younger children
The more acutely ill children presenting to RXH are more likely to be anaemic
More than 75% of children with suspected iron deficiency received NO iron or ≤ 1/12 of iron
A FBC is a frequently performed test on children presenting to the MEU/MOPD at RCWMCH and the information is under-utilized by physicians.
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