Haemogram and Iron Profile in Children Suffering from Severe Acute Malnutrition at a Tertiary Care Centre, Bhopal: A Cross-sectional Study

Abstract

Introduction: There is a high global prevalence of malnutrition in India, with anaemia and infection being the major co-morbidities in these patients. Iron deficiency is one of the most common causes of anaemia worldwide, which has its complications. However, data regarding haematological and iron profiles among Severe Acute Malnutrition (SAM) children in India is very limited. Aim: To study the iron profile and haemogram in children with SAM and its comparison with various associated complications. Materials and Methods: This observational cross-sectional study was conducted in the Department of Paediatrics, Gandhi Medical College, Bhopal, Madhya Pradesh, India, from March 2021 to September 2022. Children aged between six months to five years, fulfilling the World Health Organisation (WHO) criteria of SAM in this study were included and clinical and haematological data were collected, including growth parameters, haemogram, peripheral smear, Red Blood Cell (RBC) indices, reticulocyte counts, and iron profile. Categorical variables were analysed using the Chi-square test or Fisher’s-exact test. Continuous variables were assessed using the Analysis of Variance (ANOVA) or t-test. Results: Total of 175 children (80 girls and 95 boys) with SAM were enrolled in the study and data was analysed. 87% of the study population had anaemia. Most SAM children with complications had severe anaemia (51.9%) with a higher prevalence of microcytic anaemia followed by macrocytic anaemia compared to SAM without complications with normocytic anaemia. On comparing the haemogram, it was revealed that Hemoglobin (Hb), Packed Cells Volume (PCV), Red Blood Cells (RBC), Mean Corpuscular Haemoglobin (MCH), and Mean Corpuscular Haemoglobin Concentration (MCHC) were significantly low in SAM patients with complications. While the iron status of SAM patients with complications revealed low serum iron levels and transferrin saturation while ferritin and Total Iron-Binding Capacity (TIBC) were increased. Conclusion: Anaemia was observed to be highly prevalent in SAM children with complications. The most common type of anaemia was microcytic hypochromic, followed by macrocytic type. Serum iron levels were significantly lower in SAM patients with complications (p-value <0.001).

Keywords

• iron deficiency anaemia
• macrocytic anaemia
• protein energy malnutrition
• serum ferritin