Alpha-thalassaemia trait as a cause of unexplained microcytosis in a South African population

Loonat, Sakina Bibi; Naran, Nitien H.; Thein, Swee Lay; Alli, N

doi:10.7196/samj.2016.v106i3.10005

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…This suggests that the thalassaemia trait is uncommon in the study population. While the α-thalassaemia trait is present in some communities in South Africa, with a prevalence of 3.8% [ 59 ] and 16% in non-random samples [ 60 ], testing is mainly done if there is unexplained microcytosis [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Causes of Moderate and Severe Anaemia in a High-HIV and TB-Prevalent Adult Population in the Eastern Cape Province, South Africa

O'Mahony

Mabunda

Mntonintshi

et al. 2023

IJERPH

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Background: Anaemia affects one in four adults in South Africa, with a higher prevalence in persons with HIV and tuberculosis. The aim of this study is to characterise the causes of anaemia in primary care and a district hospital setting. Methods: A cross-sectional study design investigated a purposive sample of adult males and non-pregnant females at two community health centres and a hospital casualty and outpatients. Fingerpick blood haemoglobin was measured with HemoCueHb201+. Those with moderate and severe anaemia underwent clinical examination and laboratory tests. Results: Of 1327 patients screened, median age was 48 years, and 63.5% were female. Of 471 (35.5%) with moderate and severe anaemia on HemoCue, 55.2% had HIV, 16.6% tuberculosis, 5.9% chronic kidney disease, 2.6% cancer, and 1.3% heart failure. Laboratory testing confirmed 227 (48.2%) with moderate and 111 (23.6%) with severe anaemia, of whom 72.3% had anaemia of inflammation, 26.5% iron-deficiency anaemia, 6.1% folate deficiency, and 2.5% vitamin B12 deficiency. Overall, 57.5% had two or more causes of anaemia. Multivariate modelling showed that patients with severe anaemia were three times more likely to have tuberculosis (OR = 3.1, 95% CI = 1.5–6.5; p-value = 0.002). Microcytosis was present in 40.5% with iron deficiency, macrocytosis in 22.2% with folate deficiency, and 33.3% with vitamin B12 deficiency. The sensitivities of the reticulocyte haemoglobin content and % hypochromic red blood cells in diagnosing iron deficiency were 34.7% and 29.7%, respectively. Conclusions: HIV, iron deficiency, and tuberculosis were the most prevalent causes of moderate and severe anaemia. The majority had multiple causes. Iron, folate, and vitamin B12 deficiencies should be identified by biochemical testing rather than by red cell volume.

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Section: Discussionmentioning

confidence: 99%

Causes of Moderate and Severe Anaemia in a High-HIV and TB-Prevalent Adult Population in the Eastern Cape Province, South Africa

O'Mahony

Mabunda

Mntonintshi

et al. 2023

IJERPH

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“…[12][13][14][15] A more recent study, investigating the role of α-thalassaemia in unexplained microcytosis in the South African (SA) population, demonstrated the prevalence of α-thalassaemia trait to be 19.1% among black and Indian patients. [16] The -α 3.7 deletion is the most common deletion identified in SA. Other deletions reflect the ancestral origins of individuals.…”

Section: Alpha-thalassaemiamentioning

confidence: 99%

Thalassaemia (part 1)

Alli

Patel

2021

S Afr Med J

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“…To the Editor: I read the article by Loonat et al [1] with interest. In the early 1980s a study was undertaken at Red Cross War Memorial Children's Hospital, Cape Town, South Africa (SA), to assess the frequency with which a low red cell mean corpuscular volume (MCV) was associated with the presence of thalassaemia or an abnormal haemoglobin.…”

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confidence: 98%

“…I am not clear whether other haemoglobin variants, in particular Hb E, were screened for in the study by Loonat et al [1] Hb E was first described in Thailand and is common in South-East Asia. Many South-East Asians who were brought to the Cape in the early years of settlement were from Indonesian islands, and presumably this accounts for the presence of Hb E in the mixed-race population of the Western Cape.…”

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confidence: 99%