Anemia Translational Research

Posted: January 4th, 2023

Anemia Translational Research

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Anemia Translational Research

Anemia is defined as a condition of reduced circulatory healthy red blood cells. The red blood cells determine the level of hemoglobin in the blood. A low red blood cell level condition is called anemia. The level of hemoglobin varies with gender and age (Turk et al. 2016). Anemia affects all individuals irrespective of either sex or age and manifests itself from mild to severe anemia. Mild anemia cases are commonly undiagnosed compared to severe anemia, which quickly manifests the signs and symptoms. The severe clinical form of anemia manifests mostly in children and pregnant women. The developed countries have been able to control anemia due to advanced technology used in diagnosis, low incidences of malnutrition, and low incidences of infectious and vector-borne diseases. However, the developing nations are faced with varying challenges varying from malnutrition, infectious, and vector-borne diseases to inadequate resources, making anemia challenging to control (Turk et al. 2016).  

Problem

Iron-deficiency anemia is a common infection associated with childhood. It has a high prevalence in developing nations (Turk et al. 2016). This could be mainly contributed by the high level of malnutrition experienced within these nations. Therefore, the need for health care education within these nations to provide primary health care irrespective of the financial challenges. State of malnutrition must be dealt with as a means of controlling anemia. Malnutrition is usually caused by poorly balanced diets and insufficient nutrients in the body. Severe anemia contributes to high morbidity and mortality due to low-quality machines in diagnosis, giving false results and the low number of blood banks across the developing nations to supplement the severely anemic patients (Jager et al. 2020)

 Therefore, healthcare sensitization requires more evidence-based tactics like healthcare educations on the signs that could prompt the diagnosis and control measures of anemia in these developing nations.

Background

According to World health organization records, the developing nations present a higher rate of anemia than the developed countries, which account for 43% and 9%, respectively (Turk et al. 2016). Anemia is one of the leading causes of mortality among children below five years in developing countries. The prevalence of severe anemia is more variable within the communities with higher proportions of extreme anemic conditions than mild anemic conditions (Kassebaum et al. 2014). Presentation of anemia with other complications like surgery increased birth rate, and other illnesses increase the death rate among the anemic. 

Ottawa model of research is ideal in the translational research model on anemia. This model of research suits the research in the application of its three phases; assessing barriers and supports, monitoring interventions and degree of use and finally obtaining the outcomes (Jager et al. 2020). In the first phase, the model identifies the various obstacles in the professionalism of the healthcare system, political and economic challenges within the area of study. It also seeks to establish the potential adopters to address the challenges identified. These potential adopters include; increasing the awareness of the disease or on management mechanisms of the disease, positive attitude change among nurses and community healthcare leaders within the locality on their view on anemia by equipping them with modern skills and knowledge in addressing anemia the subject of the study. In this phase, it also includes the practical environment within the area of jurisdiction. It addresses the socio-cultural status of the community which influences appropriate approaches to use, recognizes the uncontrolled occurrences such as natural calamities and the economic challenges faced and how to utilize the available resources particularly in the developing nations where they are resource challenged to achieve the expected results (Jager et al. 2020). In the second phase; there is the implementation of the strategies set-up in phase one and the follow-up to obtain results. This then translates to the final stage of the results.

Table 1

Figure 1. Ottawa model of research

Note: Adapted from The Ottawa model for nursing curriculum renewal (p 87) by Jager et al. 2020, copyright 2020 by Jager et al.

In addressing the iron-deficiency anemia, there is the urge to use a translational framework. In this method, there will be a point to point evidence-based research work done across various populations in developing countries where anaemia is a major concern with high anemia associated mortalities. M’baya, Mbingwani, Mgawi, Mkochi, Bates, White, and Allain (2014) found that early diagnosis of anemia leads to better disease management and cushioning of the disease. This is a great challenge in the developing nations where the healthcare providers lack the modern approaches in identifying the signs and symptoms. In endemic regions, there is a high prevalence of severe anemia, and so is the mortality rate (Kassebaum et al. 2014).

 Community health education is regarded as the most ideal in addressing anemia. Different strategies have been improvised across various regions to create anemia awareness. Healthcare leaders’ education has been applied globally to educate them on the signs and symptoms of anemia which aid in early diagnosis. Early anemia diagnosis is crucial in reducing the anemia mortality rates and in the application of preventive and management measures (Kassebaum et al. 2014).

In addition to public health education, there is a need to use better and compatible diagnostic tools to prevent and treat anemia (Kassebaum et al. 2014). Clinical pallor is a modern diagnostic technique which incorporates the use of body sites like the conjunctival pallor, skin pallor and palmar pallor. This is due to the high hemoglobin concentration associated with clinical pallor. Palmar crease indicates severe anemia among children. However, this technique is insensitive to mild anemia detection. Community Education on this technique has shown to yield positive results as lactating women can seek medical attention for their children as many are always reluctant to take iron-folic acid supplement tablets (Turk et al. 2016).

The community leaders must also be enlightened regarding the economic utilization of the available scarce resources in monetary terms on the affected individuals to combat the malnutrition level. Notification of the whole public on the importance of using fortified and iron-rich supplements through advertisements on billboards and marketing boards in the private and public sectors helps in reducing malnutrition (Turk et al. 2016). Also, with the healthcare leaders and nurse’s education, they will recommend the intake of iron-rich foods as a mechanism to prevent anemia to the pregnant women during the prenatal care. Government’s approval and implementation of specific policies could aid in better management of anemia (Kassebaum et al. 2014). For instance, a free regular hemoglobin checkup among women can help in anemia prevention and iron and folic acid-free administration among young children.

Health care education on factors that contribute to anemia can prevent anemia (Kassebaum et al. 2014). Malaria for instance, is a causative agent of anemia in the endemic regions. This is because it leads to the hemolysis of red blood cells, which leads to the clearance of both diseased and uninfected red cells by the spleen (Turk et al. 2016). Healthcare education has shown to lead to the enlightenment of the pregnant mothers to use mosquito nets to prevent getting malaria infection and consequently, anemia. 

Better and utilization of available compatible diagnostic tools among the healthcare help in the accurate diagnosis of anemia. This avoids misdiagnosis, which often leads to late anemia diagnosis, leading to late anemia related complications. In Luanda Angola’s study case, a Point of Care(POC) assay method yielded results correlating to the reference hemoglobin value as opposed to the spectrophotometric method. POC assay method had a sensitivity of 92.2% and a specificity of 82.9%in detection of severe anemia (Kassebaum et al. 2014). Spectrophotometry method can still be used in anemia diagnosis, but there is a need for better tools in Anemia diagnosis.

Aim

To investigate if brief training for nurses and healthcare leaders living in three resource-limited communities helps in accurate anemia diagnosis in the population compared to no training sessions. 

Impacts

Translational anemia research is anticipated to help curb the high levels of mortality across various developing nations though the health education on mechanisms of prevention and need of supplementing diets with iron-rich components to prevent malnutrition and anemia. It is also expected to equip healthcare providers with modern knowledge on anemia which will help in early diagnosis of the anemia condition. The overall potential impact will be the eradication of anemia condition.

Determination

Anemia translational research is likely to be faced with various challenges. Limited resources, both the healthcare providers and the diagnostic tools, will be addressed by adopting the more economical methods of diagnostic like pallor and equipping the available healthcare providers and leaders with the knowledge to handle it. High malnutrition levels in developing countries will be addressed with the recommendation and advertisement on billboards to feed on iron-rich foods. Some women’s reluctance to take iron-folic acid supplements or give them to their children will be encountered with early anemia detection and recommendation of the appropriate medication. This will align with the use of the Ottawa model of research to achieve the study objectives.

References

M’baya, B., Mbingwani, I., Mgawi, L., Mkochi, V., Bates, I., White, S. A. and Allain, T. J. (2014). Validation of the haemoglobin colour scale for screening blood donors in Malawi. Malawi medical journal, 26(2), 30-33.

Jager, F., Vandyk, A., Jacob, J. D., Meilleur, D., Vanderspank-Wright, B., LeBlanc, B., … & Alain, D. (2020). The Ottawa model for nursing curriculum renewal: An integrative review. Nurse Education Today, 87, 104344.

Kassebaum, N. J., Jasrasaria, R., Naghavi, M., Wulf, S. K., Johns, N., Lozano, R.and Flaxman, S. R. (2014). A systematic analysis of global anemia burden from 1990 to        2010. Blood, 123(5), 615-624.

Turk, T., Spohrer, R., Manus, C., Khan Van T. K., Nga, T. T., Nguyen, M. and GS, G. (2016). Using formative research to increase purchase intention of fortified foods to prevent micronutrient deficiencies in Vietnam. Journal of Nutrition & Food Sciences, 6, 540. https//doi.org/ 10.4172/2155-9600.2016.1000540.