Clinical, Hematological Parameters and Social Determinants of Nutritional Anaemia in Paediatric Patients: A Prospective Observational Study

Abstract

Introduction: Nutritional anaemia is a global health concern, particularly in developing countries, affecting millions of children. It is primarily caused by deficiencies in iron, vitamin B12, and folate, leading to reduced red blood cell numbers. In India, 58.4% of children aged 6 to 59 months are anaemic, with factors like poor dietary intake, frequent infections, and socio-economic factors contributing to the high prevalence. Clinical manifestations include pallor, fatigue, and poor growth.

Aims and Objectives: The study aims to estimate nutritional anaemia prevalence in children aged 6-14, study clinical and hematological parameters, identify social determinants, and determine treatment outcomes.

Material and Methods: A prospective observational study was conducted on 100 children aged 6 months to 14 years at Dhanalakshmi Srinivasan Medical College and Hospital in Perambalur District, Tamilnadu. The children were assessed for nutritional anaemia following IMNCI guidelines. The study documented the findings on a structured questionnaire. If symptoms were present, blood investigations were conducted, including CBC, peripheral smear, reticulocyte count, CRP, iron profile, and stool occult blood. Children with microcytic hypochromic anaemia were given oral iron syrup for three months, followed by hemoglobin and reticulocyte count. If peripheral smear showed macrocytic anaemia, serum vitamin B12 and folic acid as says were conducted. If folic acid deficiency was found, oral supplementation was given.

Results: The median age of the children was 30 (IQR – 60) months and majority 53% were male. Around 35% had mild anaemia, 59% moderate, and 6% severe. Peripheralsmear examination revealed 55% normocytic normochromic, 33% normocytic hypochromic, and 92% microcytic hypochromic anaemia. The mean baseline hemoglobin levels were 9.48±1.26 g/dL, with an increase after oral folic acid supplementation. The mean hemoglobin levels were significantly higher between the first and third months of follow-up visits. The mean reticulocyte count was higher during follow-up visits, with a difference of less than 0.05. The study highlights the importance of addressing anaemia in children.

Conclusion: The study evaluated pediatric nutritional anaemia in children aged 12-60 months. Moderate anaemia was the most common, with symptoms like lethargy and dizziness. Examination revealed pallor, glossitis, cheilitis, and hepatosplenomegaly. Peripheral smear showed microcytic hypochromic anaemia. The study emphasizes the importance of early detection and treatment for improved clinical outcomes and overall health.