Anemia-an Unnoticed Entity in Asian Males A Focus on the Anemic Parameters of Adult Males in Pakistan

Background: There is a general lack of awareness that anemia could be present in a significant number of apparently healthy adult males which might then lead to a misdiagnosis and a prolonged suffering of the patient. This study questions the frequency of anemia in healthy adult males which if found high will be an eye opener and an alarm for the doctors.

Aims: This study was to determine the extent of anemia and its related parameters in apparently healthy adult males of a general population.

Study Design: A cross sectional, observational study.

Place and Duration of Study: The research was done in a tertiary care hospital, Creek General Hospital, Karachi from May 2016 to August 2016.

Methodology: we included 493 healthy adult males by convenient sampling. The exclusion criteria included males less than 18 years or with any organ insufficiency, terminal illness or blood dyscrasias or hemoglobinopathies. Complete Blood Count was done to mark anemia and to assess its severity. The Mean Corpuscular Volume was categorized as normocytic, microcytic, and macrocytic. The data was analyzed on SPSS version 20.

Results: Out of the 493 males, 238(51.4%) were anemic out of which114 (47.8%) were normocytic, 98(41.1%) were microcytic and 26(11%) were macrocytic (P=0.00). The severity of anemia among the 238 anemic males showed 164(69%) males to have mild anemia, 44(18.4%) to have moderate and 30(12.6%) to have severe anemia. (P=.000). The mean hemoglobin in males is 12.5 (STD±2.4).In younger age group (<30 years) of 210 males, 102 (42%) were anemic. In the middle age group (31- 50 years), out of the 165 that presented 76 (46%) were anemic while 118 patients in the elderly age group (> 50 years), 60 (51%) had anemia (P=0.72). There were 45 diabetic males, out of which 27(60%) were anemic and among them 20 had mild (74%) anemia and 18 (67%) were normocytic (P=0.049). In accordance to ethnicity, in decreasing order, 60% of Sindhis, 54% of Pashtuns, 51% of the Urdu speaking sector, 51% of Bengalis,46% of Gilgitis, 35% of Punjabis and 22% of Balouchis were anemic (p=0.04). 49% of Muslims, 35.7% of Christians were anemic. 168 were smokers in which 72 (42.8%) were anemic (P=0.132) with 46% being normocytic and 33% being microcytic. Logistic regression did not show any correlation between hemoglobin and age in the study.

Conclusion: Anemia is highly prevalent in the adult males- a fact which has remained unnoticed.