title: Prevalence of Anemia and Hemoglobin Disorders Among School Children in Myanmar.
abstract: The prevalence of anemia is high in the population of Myanmar and hypochromic microcytic anemia (HMA) is predominant. The objective of our study was to determine the prevalence of anemia and causes of HMA among school children. A cross-sectional study was conducted on 239 children from Thanlyin and Insein Townships, Yangon Region, Myanmar. Complete blood count (CBC) and blood film morphology was examined on venous blood samples. Hypochromic microcytic anemia cases were subsequently analyzed for serum ferritin and cellulose acetate hemoglobin (Hb) electrophoresis. The prevalence of anemia was 46.4%; 27.6% had mild, while 18.8% had moderate anemia, and no case of severe anemia was detected. The mean Hb concentration was 11.7 ± 0.9 g/dL. The younger age group (8-11 years) had a significantly higher prevalence of anemia than the older age group (12-15 years) (p = 0.029). Blood film morphology revealed a 50.6% red blood cell (RBC) disorder; HMA was the most common type (70.2%). Out of 85 children with HMA, three children (3.5%) had iron deficiency and all had comorbidity with Hb AE (βA/βE) (Hb E trait). Hemoglobin electrophoresis illustrated that Hb AA (βA/βA) (31, 36.5%) and Hb AE (βA/βE) trait (31, 36.5%) were the most common types followed by β-thalassemia (β-thal) trait (19, 22.3%) and Hb EE (βE/βE) (homozygous Hb E; HBB: c.79G>A) (three, 3.5%). Hematocrit [or packed cell volume (PCV)], mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC), showed a significant difference between Hb AE, Hb EE and β-thal trait (p = 0.029, 0.023, 0.015 and 0.01, respectively). Our findings will provide valuable information for the management of anemia in the Myanmar school-age population.
authors.affiliation: a Department of Clinical Microscopy, Faculty of Medical Technology , Mahidol University , Bangkok , Thailand.|b Department of Medical Laboratory Technology , University of Medical Technology , Yangon , Myanmar.
authors.forename: Saw Thu
authors.initials: ST
authors.lastname: Wah
authors.affiliation: b Department of Medical Laboratory Technology , University of Medical Technology , Yangon , Myanmar.
authors.forename: Yoon Shwe
authors.initials: YS
authors.lastname: Yi
authors.affiliation: b Department of Medical Laboratory Technology , University of Medical Technology , Yangon , Myanmar.
authors.forename: Aye Aye
authors.initials: AA
authors.lastname: Khin
authors.affiliation: a Department of Clinical Microscopy, Faculty of Medical Technology , Mahidol University , Bangkok , Thailand.|c Center for Research and Innovation, Faculty of Medical Technology , Mahidol University , Bangkok , Thailand.
authors.forename: Chotiros
authors.initials: C
authors.lastname: Plabplueng
authors.affiliation: a Department of Clinical Microscopy, Faculty of Medical Technology , Mahidol University , Bangkok , Thailand.|c Center for Research and Innovation, Faculty of Medical Technology , Mahidol University , Bangkok , Thailand.
authors.forename: Pornlada
authors.initials: P
authors.lastname: Nuchnoi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006453:Hemoglobinopathies / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D002052:Myanmar / Q000453:epidemiology; D015995:Prevalence; D062486:Public Health Surveillance; D012574:Schools; D012720:Severity of Illness Index; D013334:Students; D057188:Workflow
chemical_list: D015415:Biomarkers
keywords: Anemia; Myanmar; hemoglobinopathies; iron deficiency; thalassemia