Anaemia is a big health problem in India. Deficient nutrition or malnutrition is the most common cause of anaemia amongst Indians. A lack of knowledge about nutrition, ignorance and poverty are the usual reasons leading to deficient nutrition.
Anaemia
A Fatal Disease of Blood
-Dr. Arvind Singh
Anaemia literally means a lack of blood. Therefore, anaemia is a disease of blood in which either the number of Red Blood Cells goes down or the concentration of haemoglobin in Red Blood Cells is reduced. Haemoglobin is iron containing red pigment of blood which carries oxygen from lungs to other parts of the body. The red colour of the blood is due to haemoglobin. Anaemia is a fatal disease and if not treated in time it may lead to death. Anaemia is one of the major causes of deaths particularly in pregnant women in developing nations of Asia, Africa and South America.
Anaemia is a big health problem in India. Deficient nutrition or malnutrition is the most common cause of anaemia amongst Indians. A lack of knowledge about nutrition, ignorance and poverty are the usual reasons leading to deficient nutrition.
Symptoms of Anaemia:
Anaemia is marked by varied symptoms which can besummarized as follows:
1. Weakness
2. Pale colour of the body
3. Feeling of breathlessness
4. Feeling of tiredness
5. Feeling of dizziness
6. Palpitations in the chest
7. Feeling of pain during swallowing
8. Hearing of noise in the ear
9. Mild fever
10. Swelling on the feet; and
11. Loss of sleep
Causes of Anaemia:
There are many causes of anaemia. In fact anaemia is not a primary disease, but it is manifestation of some underlying disease. The various causes of anaemia are summarized as follows:
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1. Malnutrition i.e. lack of iron, vitamin B12, folic acid and proteins in the diet.
2. Piles
3. Bleeding ulcers
4. Heavy menstrual periods
5. Hook-worm infection
6. Chronic infections
7. Chemical drugs
8. Radiations
9. Kidney failure
10. Malaria
11. Haemophilia; and
12. Cancer
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Types of Anaemia:
Anaemia may be broadly classified into two types i.e. non-hereditary anaemia and hereditary anaemia.
1. Non-hereditary anaemia:
This type of anaemia is not genetically fixed and is caused by non-genetic factors. Non-hereditary anaemia is categorized into five different types as follows:
(i) Aplastic anaemia: In this type of anaemia the bone marrow fails to produce new Red Blood Cells. This is the most fatal form of anaemia and bone narrow transplantation is the only cure of the disease. Antibiotic like Chloramphenicol has the tendency to cause aplastic anaemia.
(ii) Microcytic anaemia: It is caused due to deficiency of iron. In this type of anaemia number and size of Red Blood Cells and haemoglobin content is reduced.
(iii) Megablastic anaemia: It is caused due to the deficiency of folic acid and vitamin B12. Megablastic anaemia is characterized by presence of large, immature, nucleated Red Blood Cells in the blood system.
(iv) Pernicious anaemia: It is caused due to the deficiency of vitamin B12. Pernicious anaemia is characterized by large, immature, nucleated Red Blood Cells without haemoglobin.
(v) Haemolytic anaemia: Haemolytic anaemia is characterized by lack of enough Red Blood Cells due to the premature destruction of Red Blood Cells following infection. For instance invasion by Plasmodium spp. (malarial parasite) leads to haemolytic anaemia. Thus malaria is the cause of haemolytic anaemia.
2. Hereditary anaemia:
Hereditary anaemia is caused due to the presence of defective genes in body as a result of which body fails to produce normal haemoglobin. Hereditary anaemia is further categorized into two types i.e. sickle cell anaemia and thalassaemia.
(i) Sick cell anaemia: In this type of hereditary anaemia the Red Blood Cells becomes sickle shaped due to production of abnormal haemoglobin.
(ii) Thalassaemia(Mediterranean anaemia): It is a hereditary anaemia in which abnormal form of haemoglobin is produced. The disorder results in excessive destruction of Red Blood Cells which leads to anaemia. Thalassaemia is further categorized into two types i.e. Alpha thalassaemia and Beta thalassaemia.
(a) Alpha thalassaemia: It occurs when a gene or genes related to alpha globin protein are missing or mutated.
(b) Beta thalassaemia: It occurs when similar gene defects affects production of beta globin protein.
How the Hereditary Anaemia is a Boon in Malaria Hit Regions of the World?
The hereditary anaemia like sickle cell anaemia and thalassaemia are extremely helpful in coping up with malaria. In malaria hit regions of the world a person who has the sickle cell anaemia or the thalassaemia in heterozygous form experiences a much milder and far less lethal form of malaria than those who do not carry the traits of sickle cell anemia and thalassaemia.
In fact the abnormal haemoglobin produced in sickle cell anaemia and thalassaemia did not allow the malarial parasites to flourish consequently they are killed. In regions of high malarial incidence a high proportion of such genes are found in the population. Thalassaemia is found in malarial areas of Italy, Greece, some parts of Africa, Southern Asia and New Guinea. Sickle cell anaemia is commonly found in Negro populations concentrated in West Africa, however it is also seen in East Africa.
Thalassaemia is much less frequent in population of Italians and Greeks who immigrated to the new world from malarial regions of those countries. Similarly the West African population migrating to United States lacks the traits of sickle cell anaemia. The decrease in the frequency/ absence of the abnormal haemoglobin traits in immigrant populations is probably owing to decreased adaptive value of the thalassaemia and sickle cell anaemia in the United States where malaria is non-existent.
Similarly in parts of South-east Asia and Indonesia another abnormal form of haemoglobin named haemoglobin E is found, which in combination with thalassaemia genes act to protect those populations against the disease malaria.
Hereditary anaemia like sickle cell anaemia and thalassaemia can be prevented by regular transfusion of blood. However, aplastic anaemia can be cured by bone marrow transplantation.
Iron is available in the form of tablets, syrup and injections. Ferrous sulphate, chelated iron, ferrous fumarate are some of the common forms of iron that can be taken to avoid anaemia. Ferrous sulphate is very cheap and useful. However, it does not suit to everyone. It causes problems like vomiting, diarrhea and constipation.
When a rapid rise in haemoglobin is needed, injections can be given intra-muscularly or intraveinously. Tablets and injections of vitamin B12 and folic acid are also available which can be used according to intensity of disease.
Blood transfusion becomes essential to prevent anaemia in person bleeding with peptic ulcers and haemophilia. Red Blood Cells can be separated out from donated blood and can be transfused to compensate for Red Blood Cells and haemoglobin in critically ill patients of anaemia.
Anaemia can be prevented by regular consumption of plenty of green leafy vegetables, fish-meat-liver, milk and fruits.
To prevent hereditary anaemia like sickle cell anaemia and thalassaemia from cropping up in their children couples need to go in for genetic counselling before marriage. If both partners have these traits it is better to avoid marriage.
Conclusion:
Conclusively it can be said that anaemia is a non-infectious disease of blood caused either due to reduction in number of Red Blood Cells or haemoglobin content of the Red Blood Cells. Therefore the oxygen supply to the body is affected leading to weakness and breathlessness.
Hereditary anaemia like sickle cell anaemia and thalassaemia can be cured by regular blood transfusion whereas non-hereditary anaemia caused due to deficiency of iron, folic acid and vitamin B12 can be cured by the use of the same in the form of tablets, syrup and injections. Non-hereditary anaemia can be prevented by regular consumption of iron rich diet like green leafy vegetable, fruits, milk and meat.
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