Approaches to treating chronic anemia in developing countries

SUMMARY Anemia remains a major cause of mortality and morbidity in developing countries where resources to determine the underlying etiology remain poor. There are three basic mechanisms for developing anemia, namely: (i) blood loss (hemorrhage); (ii) decreased production of red cells; and (iii) increased destruction of red cells (hemolysis). In this review on the treatment of chronic anemia, the causes of chronic anemia that are of major public health importance in developing countries are discussed. These include nutritional deficiencies such as of iron, vitamin B12 and folate; inflammation resulting from chronic diseases like tuberculosis and human immunodeficiency virus; parasitic diseases like hookworm, schistosomiasis; and hemoglobinopathies, including sickle cell disease and glucose-6-phosphate dehydrogenase deficiency. Lastly, a practical approach to the diagnosis of chronic anemia is presented.