World Journal of Microbiology

Vol. 5(3), pp. 168-171, October, 2020. © www.premierpublishers.org. ISSN: 0379-9160

Research Article

Prevalence of hypochromic microcytic anemia in

the Hematology-oncology department of the Donka
National Hospital
BAH MLY¹, WANN TA¹, KANTE AS², BALDE MS¹, BARRY AOB², BAH MA², KEITA S².
¹Internal Medicine Department, National Hospital Donka, Conakry, Guinea.
²Hematology-Oncology Department, National Hospital Donka, Conakry, Guinea.

Introduction: Microcytic hypochromic anemia is a distinct morphologic subtype of anemia with

well-defined etiology and treatment. Anemia is a major public health problem worldwide despite
the remarkable improvement in living conditions. This study aimed to determine the prevalence
of hypochromic microcytic anemia and to identify the different etiologies in patients
hospitalized in the ward during the study period. Methods: This was a retrospective study two
years, including patients hospitalized in the Hematology-oncology department. Results: Out of
a total of 114 patients hospitalized for anemia, we collected 65 cases of hypochromic microcytic
anemia (57.02%). The mean age was of 37.43 years. The sex ratio was 1.95. Pallor was the
physical sign predominantly 100% of the cases. The most predominant associated pathology
was malaria (95.38%). Twenty one patients (32.3%) had a hemoglobin level between 4 and 5 g/dl.
The most incriminated causes in the occurrence of hypochromic microcytic anemia were
anemia due to iron deficiency 50.77% and anemia due to inflammatory syndrome 43.08%.
Conclusion: Our study shows that hypochromic microcytic anemia has various etiologies and
its prevalence is not negligible in the Hematology-oncology department of Donka Hospital.

Keywords: prevalence, anemia, microcytic, hypochromic, Donka.

INTRODUCTION

Hypochromic microcytic anemia is characterized by a thalassemia), or to anomalies of synthesis of the heme

quantitative deficit in the synthesis of hemoglobin and
morphological alterations in red blood cells leading to a
decrease in the average globular volume (VGM<82 fl) and
the average corpuscular hemoglobin concentration
(CCMH <32%) (Bencheqroun R, Kabbaj N, Acherki M,
2003).
Hypochromic microcytic anemia usually results from iron
deficiency due to either insufficient dietary iron intake,
digestive malabsorption or excessive losses, including
repeated and distilling bleeding. However, there are rarer
forms which are of genetic origin which result from a deficit
in the production of hemoglobin by the erythrocytes. They
can be due either to anomalies of synthesis of globin and
one speaks then of hemoglobinopathy (as the case of
(Puy H et al, 2016).
Microcytic hypochromic anemia is a distinct morphologic
subtype of anemia with well-defined etiology and
treatment. Iron overload is a known complication in
undiagnosed thalassemia patients who are erroneously
given iron therapy. Similarly reversible sideroblastic
anemia due to acquired causes is treatable and requires
removal of the inducing agent.
Corresponding author: Mamadou Lamine Yaya BAH,
Internal Medicine, Donka National Hospital, Conakry,
Guinea.
Tel: + 224622882887;
E-mail: mlambah1@yahoo.fr

Prevalence of hypochromic microcytic anemia in the Hematology-oncology department of the Donka National Hospital
Mamadou et al 169

Also, genetic assessment and different management is
needed in suspected hereditary sideroblastic anemia
(Kafle S, Lakhey M, 2016).
Iron deficiency anemia is a major health problem
worldwide (De Falco L et al, 2013).
The martial deficit is the most widespread nutritional deficit
in the world and would reach a billion people. It concerns
both developing countries and also industrialized
countries, to the point that some of them have
implemented prevention programs with supplementation
of risk group and iron fortification of certain food (Ben
Ahmed I et al, 2011).
Ignorance of the etiological factors, especially in
developing countries, thus limits the scope of the strategy
implemented (Diouf S et al, 2015).
Kafle S, Lakhey M (2016), reported in their study that of
100 peripheral smears of patients with microcytic
hypochromic anemia, 49% were due to iron deficiency
anemia and 41% were anemia of chronic disease.
Hemolytic anemia including sickle cell anemia accounted
for 5% cases. Sideroblastic anemia was seen in 1% and in
4% the cause could not be determined.
El Hioui M (2006), reported frequencies of 39% microcytic
anemia and 63.4% hypochromic anemia.
identify the different etiologies in patients hospitalized in
the department during the study period.
MATERIALS AND METHODS
This was a two years retrospective descriptive study from
January 1, 2010 to December 31, 2012 carried out in the
Hematology-oncology Department of Donka National
Hospital. Patients hospitalized in the department for
hypochromic microcytic anemia were included during the
study period. Not included were all patients with an
unconfirmed diagnosis of hypochromic microcytic anemia.
The sampling was exhaustive based on hospitalization
registers and individual patient files. The study parameters
were age, sex, profession, clinical characteristics
(functional and physical signs, associated pathologies)
and biological (complete blood count, serum iron, ferritin,
total saturation capacity of siderophilin, C reactive protein,
rate of sedimentation, electrophoresis of hemoglobin).
Before starting the study, we obtained the approval of an
ethics committee. Our data were analyzed using Epi info
3.5.1 software, 2008.
RESULTS

The objective of this study was to determine the Out of a total of 114 patients, 65 were included in this study
prevalence of hypochromic microcytic anemia and to with a prevalence of 57.02%.

Table 1: Distribution of patients by age group.

Age (years) Number of cases Percentages (%)
15-24 18 27.69
25-34 14 21.54
35-44 13 20.00
45-54 7 10.77
55-64 9 13.85
≥ 65 4 6.15
Total 65 100

The 15-24 age group was the most affected, at a rate of
27.69% with an average age of 37.43 years. A clear
predominance of the female sex was observed (66.2%)
with a sex ratio (Male / Female) of 1.95. Housewives,
merchants and students were the most represented socio-
professional category with 33 cases (50.77%), 11 cases
(16.92%) and 8 cases (12.31%) respectively. We had
found that fever (90.8%), dyspnea (81.5%) and physical
fatigue (76.9%) were the most common symptoms. Among
the physical signs, conjunctival pallor was found in 65
patients, 100% followed by hypotension (90.8%) and
tachycardia (89.2%).

Table 2: Frequency according to associated pathologies.

Associated pathologies Number of cases Percentages (%)
Malaria 62 95.38
Salmonellosis 22 33.8
Intestinal parasitosis 14 21.5
Cancers 11 16.9
Peptic ulcer 11 16.9
Cirrhosis 11 16.9
HIV 9 13.8

Malaria was the most common associated pathology with 62 cases (95.38%).
Prevalence of hypochromic microcytic anemia in the Hematology-oncology department of the Donka National Hospital

Table 3: Patient distribution by hemoglobin level.
Hemoglobin (g/dl) Number of cases
2–3 3 4.6
4-5 21
6-7 18
8-9 7 10.8
Total 65
We found that the majority of patients had Hemoglobin levels between 4 to 5 g/dl or 32.3% of the cases on the one hand
and 6-7 g / dl or 27.7% of the cases.
Table 4: Patient distribution by anemia etiology
Etiology Number of cases
Iron deficiency anemia 33
Inflammatory anemia 28
Hemoglobinopathy anemia 4 6.15
Total 65
Etiologies of iron deficiency anemia: peptic ulcer,
gastrectomy, pregnancy, menometrorrhagia.
Etiologies of inflammatory anemia: HIV, malignant
hemopathy.
Etiologies of hemoglobinopathy anemia: sickle cell
anemia, thalassemia.
Anemia due to iron deficiency observed in 33 cases
(50.77%) and anemia of inflammatory origin 28 cases
(43.08%) were the most common etiologies.
DISCUSSION
Out of a total of 114 patients, 65 were included in this study
with a prevalence of 57.02%. This result is close to that
reported by (Zinebi A et al, 2017) in their study which found
56% of cases of hypochromic microcytic anemia. These
results corroborate the data in other study which affirm that
microcytic anemia constituted the most frequent pathology
in hematological consultation (Morice V, 2006).The 15-24
and 25-34 age groups were the most affected with 27.69%
and 21.54% respectively. This result is different from that
of (El Hioui M, 2006) who reported that the 16-30 age
group were the most affected, with 37%. These results
corroborated with that of (Gaxiola-Fernandez AD-R, LM,
2011), asserting that among the groups of individuals at
high risk of iron deficiency anemia are premenopausal
women due to chronic iron depletion caused by
menstruation. A clear predominance of the female sex was
observed (66.2%) with a sex ratio (Male / Female) of
1.95.This female predominance could be explained by
chronic bleeding of the genital origin which women are
confronted with. Among the socio-professional strata,
housewives were the most represented with a frequency
of 50.77%, followed by merchants and students with
respective frequency of 16.92% and 12.31%. The high
frequency of anemia among housewives could be
explained by their high number in the general population
Prevalence of hypochromic microcytic anemia in the Hematology-oncology department of the Donka National Hospital
World J. Microbiol. 170
Percentages (%)
32.3
27.7
100
Percentages (%)
50.77
43.08
100
with a very low socioeconomic level on the one hand,
these housewives were also of reproductive age on the
other hand. In our study, we had found that fever (90.8%),
dyspnea (81.5%) and physical fatigue (76.9%) were the
most common symptoms. The high frequency of these
symptoms is related to the fact that the patient consult
most often at the intolerance stage of anemia and the high
number of cases of fever is linked to the numerous
associated febrile pathology. Among the physical signs,
conjunctival pallor was found in 65 patients (100%),
followed by hypotension (90.8%) and tachycardia
(89.2%).These signs indicate an intolerance of anemia by
the patients. Also, our study discovered that malaria
(95.38% of cases) was the most frequently encountered
associated pathology. This high rate in our context shows
once again that Guinea is in a malaria endemic area. We
found that the majority of patients had Hemoglobin levels
between 4 to 5 g/dl or 32.3% of the cases on the one hand
and 6-7 g / dl or 27.7% of the cases. This could be
described that patients consulted late because of the
chronic characteristics of microcytic anemia which is long
tolerated by the patients. Moreover, we noted a
predominance of hypochromic microcytic anemia by iron
deficiency and those by inflammatory syndrome with
respectively 50.77% and 43.08%. Zinebi A et al (2017),
reported that 60% of cases of anemia due to iron
deficiency and 3.33% of cases of anemia of inflammatory
origin. Ben Ahmed I et al (2011) also investigated that out
of 40 cases of iron deficiency anemia, 83% had a deficient
diet, 8.4% had a gynecological cause and 8.4% had
digestive bleeding. This incidents caused by the fact that
parasitic diseases, chronic bleeding and poor nutrition are
constantly encountered in the population.
CONCLUSION
Our study shows that hypochromic microcytic anemia has
various etiologies and its prevalence is not negligible in the
Mamadou et al 171

hematology and oncology department of Donka Hospital. Accepted 2 September 2020

Moreover hypochromic microcytic anemia poses a real
problem in terms of etiological diagnosis, particularly in Citation: Bah MLY, Wann TA, Kante AS, Balde MS, Barry
developing countries. AOB, Bah MA, Keita S. (2020). Prevalence of hypochromic
microcytic anemia in the Hematology-oncology
CONFLICTS OF INTEREST: department of the Donka National Hospital. World Journal
of Microbiology, 5(3): 168-171.
None.

ACKNOWLEDGEMENTS

Dr Mamadou Saliou BALDE, Pr Alpha Oumar BAH,
Department of Nephrology, Donka National Hospital. Dr
Mamadou Aliou BAH Department of Hematology-
oncology, Donka National Hospital.
Copyright: © 2020 Mamadou et al. This is an open-
access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are cited.

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Prevalence of hypochromic microcytic anemia in the Hematology-oncology department of the Donka National Hospital