Genetic Hemoglobin Disorders and Anemia in Cambodian Women of Reproductive Age
Crystal D. Karakochuk *
Department of Human Nutrition, The University of British Columbia, Vancouver, BC, Canada and Child and Family Research Institute, Vancouver, BC, Canada.
Kyly C. Whitfield
Department of Human Nutrition, The University of British Columbia, Vancouver, BC, Canada and Child and Family Research Institute, Vancouver, BC, Canada.
Suzanne Vercauteren
Child and Family Research Institute, Vancouver, BC, Canada and Department of Hematopathology, British Columbia Children's Hospital, Vancouver, BC, Canada.
Aminuzzaman Talukder
Helen Keller International, Phnom Penh, Cambodia.
Judy McLean
Department of Human Nutrition, The University of British Columbia, Vancouver, BC, Canada.
Timothy J. Green
Department of Human Nutrition, The University of British Columbia, Vancouver, BC, Canada and Child and Family Research Institute, Vancouver, BC, Canada.
*Author to whom correspondence should be addressed.
Abstract
Objectives: To examine associations between anemia (Hb <120 g/L) and genetic hemoglobin disorders in Cambodian women (18-45 y).
Methods: Blood samples of 450 women from Prey Veng province were analyzed with consent. A complete blood count was performed and the presence and typing of hemoglobin disorders was carried out by PCR and hemoglobin electrophoresis. Serum ferritin, serum transferrin receptor, c-reactive protein and other micronutrients were also assessed.
Results: Overall, the prevalence of anemia in women was 33.1%, of which 61% was microcytic (Hb <120 g/L and MCV <80 fl). The prevalence of genetic hemoglobin disorders was > 55% (most commonly alpha-thalassemia, Hb E and Hb Constant Spring) and were significantly correlated with anemia. Of women with anemia, over two-thirds had an abnormal genetic hemoglobin type. Less than 5% of women had a low serum ferritin (< 15 µg/L).
Conclusions: The most common form of anemia in Cambodian women is microcytic anemia. Genetic Hb disorders are major contributors to anemia in this region. Low serum ferritin was uncommon suggesting that iron deficiency is not a major problem. However, genetic Hb disorders and concurrent infections may be confounding the interpretation of ferritin and leading to an underestimation of iron-deficiency anemia. Other indicators of iron status and other micronutrients involved in anemia are being examined.