Anaemia is a very common disorder, far more common than many people realize. Most laboratory requests, even those from the patients themselves, to private labs in town, always include Hb or Full Blood Count. A survey of these results shows very many of them to be lower than normal. Sometimes we tend to think that a person is anaemic only if he looks pale. This is not a reliable test of anaemia. And this is why some people argue with their doctor when they are told that they are anaemic, or that their child is anaemic. How can their son be anaemic when he doesn’t look pale? One patient once told her doctor to take a good look at her and decide whether something is not wrong with his lab finding. Many apparently healthy people may look pale, yet their blood count may be perfectly normal. On the other hand one may look OK, but may actually be anaemic. We should not judge by appearances.
Simply put anaemia is shortage of blood. A person becomes anaemic for two reasons. It is either that he has too few red blood cells circulating in his blood stream, or that there is not enough haemoglobin in the red blood cells. Such a person generally feels very low and weak. He has little or no energy. Some may even think he is lazy. One mother actually complained that her daughter is just lazy and couldn’t do anything in the house. When her results came out her Hb was 8.6 gm/dl. No, the problem is not with her mind, it is with her blood stream.
The blood circulating in our body consists of two major components, red blood cells and plasma. The red cells are produced in the bone marrow and released into the blood stream, according to the requirements of the body. The materials for building these red cells come from the foods we eat. A red blood cell lives for about 120 days on the average. This means that red blood cells must be constantly produced every day, a reasonable number, if the supply is to be kept up. If they die, and they are not replaced fast enough, anaemia develops. The three main causes of anaemia are (1) poor food, leading to deficiency in the supply of good building materials, (2) bone marrow problem, leading to a disturbance in the production of red blood cells within the marrow, and (3) excessive destruction of red blood cells, or excessive bleeding, leading to loss of blood.
Blood loss may occur from many causes. Parasites in the intestines may be causing little bleeding that gradually drain the person to a state of anaemia. Diseases like malaria, typhoid, pneumonia, diarrhea are common causes of anaemia in Nigeria. Also cancer, directly and indirectly, causes anaemia. Infections generally can lead to anaemia. All febrile conditions, that is, conditions that cause fever, cause anaemia. As a matter of fact experts say that anaemic heart failure is a common cause of death in malaria. Measles, tuberculosis, upper respiratory tract infections especially in children, are all conditions that can cause anaemia. The case of pregnancy is a different ball game. This is why in the ANC, pregnant women are routinely given haematinics, that is blood building tablets. It is important to understand these things. Sometimes, when doctors include some blood tablets like folic acid, B Co and fersolate, to the drugs they give to their patients, the patients will complain. They think that the doctor is only trying to pack drugs so that his bill will be high.
The diagnosis of anaemia is made after a lab study of the blood sample. This should include measurement of the amount of haemoglobin and complete blood count. A careful examination of the urine should also be made. The stool should be checked for evidence of bleeding. Certain indications may make the study of the bone marrow necessary to reach a correct conclusion. It is also advisable to x-ray the stomach and intestines to be sure there is no hidden bleeding in these organs. Barium meal, endoscopy, anything and everything that can help to show that there is nothing seriously wrong with the body, should be done. Only in this way can a complete diagnosis be made. Certainly this will cost money, but the money will be money well spent, even if all tests prove to be negative.
Anaemia is something we should take very seriously. Many a times what kills children, or even adults, is not the malaria or typhoid, or the disease entity, but the anaemia it caused that was not adequately dealt with. The “ugu” and other green vegetables we squeeze and give our sick children can never replace the blood. Neither can the killing of innocent chickens and fowls in the name of warding off “ogbanje” that is “sucking” the blood of our children help in any way. Treatment must be directed at the cause if it is known or discovered. Balanced diet must be given, blood pills taken and blood transfusion given when necessary to replace blood loss through haemorrhage. No casting and binding, but prayers for God’s healing.