Anemia with infection

Anemia is a global public health problem affecting both developing and developed countries.
It occurs at all stages of the life cycle, but it is more prevalent in pregnant women and young
children. Globally, anemia affects 1.62 billion people, which corresponds to 24.8% of the
population.1The highest prevalence is in preschool children (47.4%) and the lowest is in men
(12.7%).1World Health Organization (WHO) defines anemia according to the hemoglobin threshold in
different age group which is as follows:1

Age Hemoglobin threshold (gm/dl)

Children (0.5-4.9 yrs) 11.0

Children (5.0- 11.9 yrs) 11.5

Children (12-14.9 yrs) 12.0

Most of the children (73.3%) had mild anemia. Almost one third of the children were
suffering from acute lower respiratory tract infections including pneumonia and wheeze associated
lower respiratory tract infections. One of the hospital based study done in Pokhara reported low
hemoglobin level to be the risk factor for acute lower respiratory tract infections.1

When anemia exists in acute infections, it is due to several factors. Clearly, in a patient with
malaria the main reason for anemia is the destruction of red blood cells by the parasite. In
parvovirosis, on the other hand, anemia is secondary to the inhibition of medullary erythropoiesis
caused by this virus. In a patient, usually a child without previous contact with the virus, the degree
of anemia will depend on whether the child has a concomitant hemolytic anemia or is healthy. In the
latter case, the anemia may go unnoticed because the drop in hemoglobin is very slow, there is a
rapid recovery of erythropoiesis in one to two weeks and the average life span of red blood cells may
reach 100-120 days.2

1. Anna S., Abhisek G., Sujata P. Prevalence of anemia in children aged 6 months to 15
years: a hospital based study. J Pathol Nep. 2017;7:1168-71.
2. Viana MB. Anemia and infection: a complex relationship. Rev Bras Hematol Hemoter.
2011;33(2):90-95.