Thalassemia and other Hemoglobinopathies among Anemic Individuals in Metro Manila, Philippines and Their Intake of Iron Supplements

Asia Pacific Journal of Clinical Nutrition. 2018;27(3):519-526. doi: 10.6133/apjcn.092017.01

Background and Objectives: Iron deficiency is the most common cause of anemia worldwide. In Southeast Asia, studies showed that genetic hemoglobin disorders also contribute significantly to the burden of anemia. The study aimed to estimate the proportion of thalassemia and other hemoglobinopathies versus iron deficiency and other causes in a sample of anemic individuals; describe the characteristics of thalassemic subjects in terms of severity of anemia, adequacy of iron stores, and hematological profile; examine the intake of iron supplements among individuals with varying causes of anemia.
Methods and Study Design: A random sample of 101 anemic individuals living in Metro Manila was examined. Hemoglobinopathy was determined using capillary electrophoresis. Iron deficiency was determined using immunoradiometric assay for serum ferritin. A questionnaire was used to obtain information on the use of iron supplements.
Results: The most frequent underlying cause of anemia was iron deficiency (37.6%), followed by anemia due to other causes (34.7%), and hemoglobinopathy (27.8%). The most prevalent form of hemoglobinopathy was alpha-thalassemia trait (20.8%), followed by betathalassemia trait (5%), iron deficiency anemia with concomitant HbE (1%), and beta-thalassemia HbE interacting (1%). Thalassemic subjects exhibited mild anemia, had either normal or excessive iron stores, and did not ingest iron supplements.
Conclusions: The majority of anemia (62.5%) in this sample was due to other causes and hemoglobinopathy, rather than iron deficiency. Genetic hemoglobin disorders appear to be common among anemic individuals. Population screening is needed to determine the real prevalence of the disease. Further investigation is needed to identify other causes of anemia among Filipinos.

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