Dr Ravinder K Gupta, Dr Akhilpreet Kaur
Anemia is a serious global public health problem that particularly affects young children and pregnant women. According to World Health Organization (WHO), it affects over 1.6 billion people worldwide. The estimates that 42 percent of children less than 5 years of age and 40 percent of pregnant women worldwide are anemic. It is a significant public health concern in developing countries, where malnutrition and limited access to healthcare contribute to its high occurrence. Many individuals may not even realize they have these conditions, as they often present themselves as symptoms of fatigue, lethargy, and mental fog.
The body makes three types of blood cells. White blood cells fight infection, platelets help blood clot and red blood cells carry oxygen throughout the body. Red blood cells have an iron-rich protein that gives blood its red color, called hemoglobin. Hemoglobin is a protein found in red cells that carries oxygen from the lungs to all other organs in the body. And it lets red blood cells carry carbon dioxide from other parts of the body to the lungs to be breathed out. Spongy matter inside many of the large bones, called bone marrow, makes red blood cells and hemoglobin. To make them, the body needs iron, vitamin B-12, folate and other nutrients from foods. Anemia is a condition in which one lacks enough healthy red blood cells to carry adequate oxygen to body’s tissues. Having anemia, also referred to as low hemoglobin, can make feel tired and weak.
While most of us are aware of our cholesterol and blood pressure levels, very few individuals know their blood count. Neglecting this knowledge can have a direct impact on our everyday quality of life and increase our vulnerability to risks such as bleeding, injuries, or the need for hospitalization.
Blood, along with its vessels, constitutes the largest organ system in the body, necessitating the maintenance of its balance and health. In pregnancy, iron deficiency anemia can lead to perinatal loss, prematurity and low birth weight (LBW) babies
Anemia occurs when the hemoglobin level in red blood cells is lower than normal. It is categorized as mild(10-10.9mg/dl), moderate(7-9.9mg/dl) and severe(<7mg/dl). There are many forms of anemia. Each has its own cause. Anemia can be short term or long term. It can range from mild to severe. Anemia can be a warning sign of serious illness.
The various causes that can lead to anemia are …Nutritional Deficiencies: Iron deficiency, Vitamin B12 deficiency, Folic Acid deficiency. Blood Loss: Heavy menstrual bleeding, Gastrointestinal Ulcers, hemorrhoids, colon polyps, or colorectal cancer, surgery or trauma. Chronic Diseases: Chronic kidney disease, Cancer, Autoimmune diseases like Lupus, rheumatoid arthritis, and inflammatory conditions. Bone Marrow Disorders: Aplastic anemia, Leukemia and other blood cancers. Hemolysis : Hemolytic anemia , Sickle Cell anemia , Thalassemia and Infections and Parasitic Diseases: Malaria , Hookworm Infection , HIV/AIDS etc etc.
The most common type of anemia is Iron deficiency anemia which results from too little iron in the body. Bone marrow needs iron to make hemoglobin. Without enough iron, the body can’t make enough hemoglobin for red blood cells. Pregnant ladies can get this type of anemia if they don’t take iron supplements. Blood loss also can cause it. Blood loss might be from heavy menstrual bleeding, an ulcer, cancer or regular use of some pain relievers, especially aspirin.
Iron deficiency anemia results in impaired cognitive and motor development in children and decreased work capacity in adults. Besides iron, the body needs folate and vitamin B-12 to make enough healthy red blood cells. A diet that doesn’t have enough of these and other key nutrients can result in the body not making enough red blood cells.
Anemia symptoms depend on the cause and how bad the anemia is. Anemia can be so mild that it causes no symptoms at first. But symptoms usually then occur and get worse as the anemia gets worse.
If another disease causes the anemia, the disease can mask the anemia symptoms. Then a test for another condition might find the anemia. Certain types of anemia have symptoms that point to the cause.
Possible symptoms of anemia include: Tiredness, weakness, shortness of breath., pale or yellowish skin, which might be more obvious on white skin than on black or brown skin irregular heartbeat, dizziness or lightheadedness, chest pain, cold hands and feet and headaches.
The Anemia Mukt Bharat (AMB) scheme was launched by the Government of India in 2018 under the Poshan Abhiyaan (National Nutrition Mission). It aims to reduce the prevalence of anemia across all age groups, especially among children, adolescents, pregnant women, and lactating mothers. The primary goal of the Anemia Mukt Bharat initiative is to reduce anemia prevalence by 3% per year among targeted populations. The program follows a six-pronged strategy to achieve this goal: Prophylactic Iron and Folic Acid Supplementation – Distribution of Iron and Folic Acid (IFA) tablets to vulnerable groups like children, adolescents, and women. Deworming – Biannual deworming campaigns to prevent intestinal parasitic infections that hinder nutrient absorption. MoHFW is implementing National Deworming Day (NDD) programme under which biannual mass deworming for children and adolescents in age group 1-19 years is carried on designated dates – 10th February and 10thAugust every year. Intensified behaviour changes communication campaign – Awareness campaigns on anemia prevention, diet, and hygiene. Testing and treatment of anemia – Screening for anemia in pregnant women and children, with appropriate treatment interventions. Addressing Non-nutritional causes of anemia – Measures to tackle malaria, fluorosis, and hemoglobinopathies that contribute to anemia. Strengthening Monitoring and Evaluation Mechanisms – Tracking program implementation through digital platforms and periodic surveys.
Recognizing the urgency to address this global issue, World Anemia Awareness Day is observed annually on 13th February to spread awareness, encourage prevention, and promote treatment strategies for anemia.
The preventive steps include
* eating a balanced diet which should include key nutrients essential for red blood cell production ie Iron-Rich Foods .. Plant Sources: Spinach, lentils, chickpeas, beans, tofu, nuts, and iron-fortified cereals. Many fruits are high in iron, including strawberries, raisins, prunes, and dried apricots, raisins and dates. Animal Sources: Red meat, liver, chicken, fish, and eggs. Vitamin C-Rich Foods which enhances iron absorption Citrus fruits (oranges, lemons, grapefruit) Tomatoes, bell peppers, and strawberries. Vitamin B12 and Folate Sources include Dairy products, eggs, fish, and fortified cereals, Dark green leafy vegetables, legumes, and fortified grains.
* Pregnant women and adolescents should take Iron and Folic Acid (IFA) supplements as recommended by healthcare providers.
* Parasitic infections (such as hookworms) can cause iron loss and anemia. Children and adults in high-risk areas should take deworming medication every 6 months.
* Prevent Excessive Blood Loss. Women should manage heavy menstrual bleeding through medical consultation. Avoid self-medication with painkillers that may increase the risk of stomach ulcers and bleeding.
* Improve Hygiene and Sanitation. Wash hands regularly to prevent infections that may contribute to anemia. Ensure clean drinking water and proper waste disposal to reduce parasitic infections
* Regular Health Check-Ups..Routine blood tests can help detect anemia early. Pregnant women, children, and the elderly should undergo regular hemoglobin level monitoring.
* Lifestyle Changes for Long-Term Management: Regular exercise, Adequate hydration, Stress management.
Indian Academy of Pediatrics (IAP) is creating awareness about anemia this year by conducting activities in schools, screening pregnant and lactating women, distribution of iron fortified foods to school children and hemoglobin screen.
World Anemia Awareness Day serves as a crucial reminder of the importance of addressing anemia as a public health priority. By increasing awareness, promoting better nutrition, and improving healthcare access, we can work together to reduce the burden of anemia and improve the well-being of millions worldwide.
Theme for This Year- “Raise your hands for Blood health”
Slogan – “Know Your Number, break the silence on anemia”
(The authors are from Department of Pediatrics, Acharya Shri Chander College of Medical Sciences (ASCOMS), Jammu )
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