Anaemia characterised by normal-sized red blood cells
Cause
- Acute blood loss
- Haemolysis (destruction of red cells), e.g., auto-immune disorder, hypersplenism, haemoglobin abnormalities
(sickle cell disease, thalassemia), drugs (sulphonamides, dapsone, primaquine) - Decreased reticulocytosis (formation of new blood cells), e.g. chronic kidney disease
Clinical features
- General features of anaemia
Investigations
- Evidence of haemolysis
- Full blood count smear: spherocytes
- HIV serology
Management
Generally
- Identify and treat cause of anaemia
Medicine treatment
- DO NOT treat with iron, folic acid or vitamin B12 unless there is clear documented deficiency
- Treat all patients with folic acid 5 mg daily in haemolytic anaemia
- Refer to hospital for further management
Prevention/Health Education for Anaemia
Educate the public about:
- The life long effects of anaemia on health, and cognitive development
- Dietary measures: encourage exclusive breastfeeding for the first 6 months. Encourage the use of iron-containing weaning locally available foods (red meat, beans, peas, dark leafy vegetables)
- Hygiene: avoid walking barefeet to avoid hook worm infestation, use of pit latrines for faecal disposal, and
practice good hand washing habits - Medical: encourage periodic screening for children and pregnant mothers, and presumptive iron therapy for either groups in cases of anaemia.
- Routine iron supplementation for all pregnant mothers
- Early treatment of malaria, helminthic infections, etc