Dr Gaurav Dixit
Reduction or lack of sufficient haemoglobin (Hb) levels (oxygen-carrying molecules in blood) is quite common blood disorder in India. Anaemia is widespread in India — 58.6 per cent of children, 53.2 per cent of non-pregnant women and 50.4 per cent of pregnant women were found to be anaemic in 2016, as per the India’s national family health survey (NFHS). India carries the highest burden of the disease despite having an anaemia control programme for 50 years.
Normal haemoglobin for women is 12 gram per decilitre (g/dlL) and men 13 g/dL.
As symptoms are usually slow to show and/or progress, most patients remain unaware of this problem for a long time, till it becomes difficult for them to carry out their daily routine. Most common reason for anaemia is inadequate production red blood cells (RBCs), bleeding, or increased destruction of RBCs. Inadequate production of RBCs due to nutritional deficiency, especially dietary iron, is the most common cause of anaemia in India.
There is total lack of awareness among public that long-term anaemia, if it remains untreated, can damage heart, brain and other organs. Hence, it is imperative that if you notice any of these symptoms, meet a specialist and start treatment. Anaemia can be diagnosed by a simple blood test called complete blood profile (CBC), available in all labs and hospitals.
A decrease in haemoglobin levels should never be ignored because it may indicate some other serious underlying disease like kidney disorders, cancers, severe internal blood loss, etc.
One needs to be especially careful and watch out for following conditions:
- When anaemia develops in a short span of time
- Bleeding from any part of the body
- Lymph nodes or swelling in any part of the body
- Sudden loss of weight or appetite
- Long standing fever
Pregnant women should specially be aware of these symptoms, because low Hb levels may affect both mother and unborn baby’s health. Children born to anaemic mothers may have developmental abnormalities or may be malnourished.
Treatment depends upon underlying disorder. Although most cases can be treated with proper nutritional supplements, it is important to look for warning signs mentioned above.
Due to its severe effects on young children and women in reproductive age group, the Government of India has launched a programme called Anaemia Mukt Bharat Abhiyaan for prevention of this disease at the macro level. The programme aims to reduce incidence of anaemia in children and women by about 20 per cent in six years. Under this programme, six groups of eligible beneficiaries with estimated 450 million target population, have been identified to benefit from this scheme. Intervention planned under this scheme are as follows:
- Iron and folic acid supplementation
- Deworming of children
- Testing of anaemia using digital methods and point of care treatment
- Intensified year-long behavioural change communication programme (solid body, smart mind), with focus on delayed cord clamping
- Focus on other causes of anaemia including malaria, hemoglobinopathies
- Mandatory provision of iron and folic acid fortified foods in government schemes
Along with government programmes, it is also important for us to be aware of how to prevent this problem. This includes knowledge about iron-rich foods that should be included in our daily diet. The daily requirement in adult is about 18 mg, which can go up to 27 mg in pregnancy and lactation. Some iron-rich foods include spinach, broccoli, beetroot, potato, watermelon, apple, pomegranate, chicken, eggs, brown rice, oats, nuts, etc.
Women with severe iron deficiency can increase their Hb levels by 2 g in a month just by increasing daily intake of iron to 60-120mg of elemental iron. However, all this may not be possible with only increasing dietary iron intake. Most Indian women require iron and folic acid tablets during pregnancy and lactation. Public awareness about anaemia is important as an iron-rich nutritious diet beside supplements can help in preventing this problem.
- Anaemia occurs when your blood doesn’t have enough red blood cells.
- Your body doesn’t make enough red blood cells.
- Bleeding causes you to lose red blood cells more quickly than these can be replaced.
- Your body destroys red blood cells.
- Pale or yellowish skin
- Irregular heartbeat
- Shortness of breath
- Dizziness or lightheadedness
- Chest pain
- Cold hands and feet
— The writer is clinical haematologist, Action Cancer Hospital, New Delhi
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