ironjustice
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 Posted: Mon Mar 03, 2008 1:48 pm Post subject: Iron Deficiency and Bacteremia |
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"Few case patients had iron deficiency"
"Iron deficiency was associated with a decreased risk of bacteremia."
Multiple Causes of Severe Anemia Identified in African Children
NEW YORK (Reuters Health) Feb 28 - Severe anemia is associated with
considerable morbidity and mortality in African children and the
results of a new study in Malawi indicate that multiple causes are to
blame.
Interestingly, folate and iron deficiencies, which are widely believed
to be the most common causes of severe anemia in African children,
were actually not prominent etiologies.
Dr. Job C. J. Calis, from the Academic Medical Center in Amsterdam,
and colleagues examined the causes of anemia by conducting a case-
control study of 381 severely anemic preschool children and 757
children without anemia. The subjects were drawn from both urban and
rural settings in Malawi.
The new findings appear in The New England Journal of Medicine for
February 28.
The strongest risk factor for severe anemia, which raised the risk by
5.3-fold, was bacteremia. Other risk factors included malaria,
hookworm, HIV infection, G6PD-202/-376 genetic disorder, vitamin A
deficiency, and vitamin B12 deficiency with adjusted odds ratios of
2.3, 4.8, 2.0, 2.4, 2.8, and 2.2, respectively.
Further analysis showed that malaria was a risk factor only in urban
settings, not in rural settings. The majority of hookworm infections
(76%) involved children younger than 2 years of age.
Folate deficiency, sickle cell disease, and laboratory evidence of an
abnormal inflammatory response were not commonly seen. Similarly,
relative few case patients had iron deficiency, and its presence was
actually associated with a decreased risk of the major risk factor,
bacteremia.
"Our findings indicate that even in the presence of malaria parasites,
additional or alternative diagnoses (responsible for severe anemia)
should be considered," the authors state. The results, "if confirmed
in different settings, will contribute to the assessment of new
therapeutic and preventive strategies for Africa."
N Engl J Med 2008;358:888-899.
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