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Haematological Diseases in the Tropics
#MMPMIDC7167525
Thachil J
; Owusu-Ofori S
; Bates I
Manson's Tropical Infectious Diseases
2014[]; ? (?): 894-932.e7
PMIDC7167525
show ga
? Africa and Asia have more than 85% of the world's anaemic populations and
anaemia burden is highest among children and women of reproductive age. ? The
accurate diagnosis of anaemia has been neglected; clinical assessment of anaemia
is unreliable unless the anaemia is severe. ? In low-income countries, anaemia in
an individual is often due to multiple interdependent factors. Removing or
treating a single factor may not resolve the anaemia. ? Early diagnosis of sickle
cell disease and rapid access to a specialist centre for emergencies such as
severe pain crises, strokes and acute chest syndrome, can help to prevent
permanent long-term complications. ? Beta-thalassaemia major is fatal in the
first few years of life unless regular blood transfusions are given; unless they
are accompanied by iron chelation, these transfusions will eventually cause death
due to irreversible organ damage from iron overload. ? Malarial anaemia is a
particular problem for children and pregnant women and severe anaemia can be
caused by P. falciparum and P. vivax. Malarial anaemia can be reduced with
chemoprophylaxis and intermittent treatment, and by anti-mosquito measures such
as insecticide-treated bed nets and vector control. ? Anaemia occurs in 70% of
HIV-infected patients and is an independent risk factor for death. Prompt
treatment of factors associated with anaemia, such as infections and poor
nutrition, and commencement of antiretroviral treatment will reduce deaths. ?
Blood shortages are common in tropical countries. To increase the availability of
blood, transfusions should be prescribed in accordance with guidelines and
efforts made to encourage blood donors to donate regularly as repeat donors are
the safest type of donor.
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