Approach to Anaemia Diagnosis in Developing Countries: Focus on Aetiology and Laboratory Work-Up

Abstract

Introduction: Anaemia is a significant public health problem in developing countries. Anaemia is never normal. The etiology of the anaemia should always be sought. Diagnosis of its cause and early treatment is crucial to improving the quality of life among affected persons. There is a need to provide practicing physicians with a good theoretical framework and a practical algorithm for arriving accurately at anaemia diagnosis. Objective: This article seeks to collect, collate and concisely review anaemias with emphasis on the prevalent aetiologies and laboratory diagnosis in developing countries Results: The etiology of anaemia in developing countries is myriad and requires accurate diagnosis. Nutritional (substrate) deficiencies and chronic diseases account for a significant proportion of acquired anaemias. The predominating inherited causes include haemoglobinopathies, red cell enzymopathies and membranopathies. A systematic approach will help the physician paddle through the large list of differentials, to cone down on precise diagnosis. Relevant clinical history, physical examination and baseline investigations are imperative. Further evaluations should be conducted in unresolved cases using suggested practical algorithms such as the morphologic and/or kinetic approach. Conclusion: Baseline investigations including full blood count, reticulocyte count and peripheral blood film should be requested on patients presenting with anaemia. Relevant authorities should ensure availability of these basic tests in all health facilities. Consultations with hematology unit should be engaged when necessary.