Iron deficiency anaemia in Jamaican children, aged 1-5 years, with sickle cell disease.
OBJECTIVE
The aim of this study was to determine, using a combination of measures, the prevalence of iron deficiency anaemia (IDA) in children under five years-of-age who have sickle cell disease (SCD) and attend the Sickle Cell Clinic (SCU) of the Tropical Medicine Research Institute.


METHODS
Children with homozygous sickle cell anaemia (Hb SS) or doubly heterozygous for Hb S and Hb C (Hb SC) disease who had not received a blood transfusion within three months prior to the iron measurements, were enrolled. The diagnosis of IDA was made if transferrin saturation was less than 16% with serum iron less than 10.7 micromol/l and a low mean corpuscular volume (MCV) for age.


RESULTS
Twelve children (8.5%), seven with Hb SS and five with Hb SC had IDA. Adjusting for genotype, children with IDA had significantly higher red blood cell (RBC) counts (4.3 x10(9)/l vs 3.0 x 10(9)/l, p < 0.001) and total iron binding capacity (TIBC) (65.6 micromol/l vs 55.2 micromol/l, p < 0.004) but significantly lower reticulocyte (retic) counts (7.8 % vs 12.2%, p = 0.001) than children without IDA.


CONCLUSIONS
Iron deficiency anaemia is a clinical problem which affects children with SCD in Jamaica. The higher RBC counts in the IDA group may be due to decreased haemolysis and increased red cell survival whilst the lower reticulocyte counts may be due to impaired erythropoiesis. These observations need to be extended by clinical studies to establish improved diagnostic measures for IDA in SCD. Additionally, clinical trials are needed to determine whether treatment of IDA in children with SCD reduces morbidity and is associated with clinical benefits such as improvements in neurocognitive function.
King
L
L
Sickle Cell Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica.
Reid
M
M
Forrester
T E
TE
D017677:Age Distribution; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D000755:Anemia, Sickle Cell / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D015994:Incidence; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate