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The Complexity of Pregnancy Anemia in Dar-es-Salaam

Massawe S.N.a · Urassa E.N.J.a · Mmari M.b · Ronquist G.c · Lindmark G.d · Nystrom L.e
Departments of aObstetrics and Gynaecology, and bHaematology, Muhimbili Medical Centre, Dar-es-Salaam, Tanzania; Departments of cClinical Chemistry, and dObstetric and Gynaecology, University Hospital, Uppsala, and eDepartment of Epidemiology and Public Health, Umeå University, Umeå, Sweden Gynecol Obstet Invest 1999;47:76–82 (DOI:10.1159/000010067)


Objectives: To investigate the main causes of anemia in pregnancy in Dar-es-Salaam and identify appropriate investigations at all levels of care. Materials: All pregnant women booking for antenatal care at 2 clinics (n = 2,235) were screened for anemia. Investigations for etiology of anemia were done in all anemic women (Hb <10.5 g/dl) (n = 361). Methods: Blood cell counts, microscopy of blood films, S-ferritin, C-reactive protein, HIV, stool parasite and bone marrow analysis were performed. Results: Iron deficiency dominated in 86% and malaria in 1/3 of anemia cases. Since 42% had indication of ongoing inflammation, S-ferritin was less useful as indicator of iron deficiency but blood film microscopy identified most cases.


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