10 questions to ask yourself if you have anemia in Kenya

Anemia is one of the common conditions noted amongst the Kenyan population. This is especially so in children under 6 years and in women of productive age. It is rarer in men. Anemia may be suspected where symptoms are suggestive, or it may be discovered incidentally during a blood test or it may be actively sort for if one is known or suspected to be suffering from a condition that may lead to anemia. Any one worried about anaemia should have a Total Blood Count done to confirm or allay their fears. Once confirmed, they should ask themselves (or healthcare provider should ask) the following questions:

  1. What is my diet like? – Anemia is very common in children suffering from Blog-anemia4malnutrition due to lack of access to healthy diets. But, in our current set-up, majority of children who are anemic come from families that can be able to provide the basic affordable foods that help fight anemia. Iron is readily available in all meats (beef, chicken, fish) and in many vegetables like tomatoes and also in green leafy vegetables (kales/sukuma wiki, spinach, traditional vegetables). Strict vegetarians also tend to get anemic especially due to lack of the right vegetables to ensure adequate iron intake.
  2. Could I have worms? – Worms suck blood. A child with obvious worms in stool Blog-anemia3should be treated immediately. Others can have the worms noted incidentally on stool examination for whatever reason. But, rather than go to all this trouble, just de-worm all children under 5 at least twice a year. Can be more often depending on conditions in which they live. For older children and adults, it is not a must that you de-worm but can also be done once or twice a year. It is affordable and easy to use and you avoid the complications of dealing with the consequences of worms.
  3. Are my monthly periods heavy and/or prolonged? – There are women who have heavy periods from their very first period and experience it every month. These women should visit their health practitioners for advice on ways that this can be managed and be informed of the benefits versus risks involved. On the other hand, many women suffer from abnormal bleeding. This could mean prolonged bleeding for more than seven days, periods re-appearing after less than 21 days from previous period or spotting in-between periods. All women with abnormal, prolonged or very heavy menses should be evaluated for any predisposing conditions. These could be things like fibroids, endometriosis, uterine/cervical cancers etc.
  4. Could my contraceptives be the cause? – In my encounters, I have realized that a lot Blog-anemia2of women choose contraceptives based on their perceived benefits. They use it because it is cheap, easy to use, convenient and available. They do not ask and/or are not advised on the potential risks of each contraceptive method. They are not told if the contraceptive method is appropriate for their calender age, reproductive age or their sexual lifestyle. Contraceptives can cause heavy, prolonged menstrual bleeding. In some women, this necessitates the withdrawal of the contraceptive because they will soon become anemic as the effects of the contraceptives are on-going until it runs out.
  5. Are my pregnancies poorly spaced? – It is at times the desire of women to have children close together so that they can move on to a different chapter in their lives. In other instances, a subsequent pregnancy may be unplanned for. Any woman who is breastfeeding and pregnant requires to have their hemoglobin very closely monitored because she needs higher amounts of iron in order to have adequate amounts for herself, her baby and the growing fetus. In some instances, a woman may decide to stop breastfeeding but if her iron stores were already low as a result of the previous pregnancy, she will still need to be supplemented so as to have a healthy pregnancy.
  6. Am I having complications in pregnancy? – Normal pregnancy should have no bleeding within the pregnancy and minimum to moderate blood loss during the delivery process. Unfortunately, many women experience complications of bleeding in pregnancy and they are considered high risk pregnancies who should be monitored very closely. In early pregnancy, a woman may have a threatened abortion, an incomplete abortion or an ectopic pregnancy. The management of these women is different but should be as soon as possible as bleeding could become profuse with anemia or even shock (due to excess blood loss) occurring. In some instances, a woman may bleed for most or all of her pregnancy and she must be followed up very very closely as the risk of severe blood loss due to long term bleeding or sudden increased acute bleed is very real. Finally, any woman who is concerned about the amount of bleeding after delivery should go back for an evaluation. It is normal for bleeding to continue for up to 2 weeks after delivery but this should be significantly decreasing in amount after the first few days.
  7. Do I have or could I have a chronic illness? –. Any disease that you have for a long time will cause your body to utilize more elements than usual to try and be healthy. Common chronic illness in our set-up include; HIV, TB, Cancers, heart diseases, and Diabetes. So if you suffer from any chronic illness and are advised to do some annual tests, do comply so that you can pre-empt complications.
  8. Do I have a bleeding disorder?– One can bleed overtly through the nose (nose bleeding), mouth (vomiting blood), anus (bloody diarrhea) , urethra (blood in urine), vagina, under the skin or one can bleed internally. Many conditions affecting the spleen, liver or blood components (platelets, red cells or bone marrow) can predispose to bleeding. Common conditions in Kenya include; malaria, typhoid, Sickle cell disease, alcoholic liver disease, leukemia, cancers, hemophilia. These illnesses must be ruled out in any patient with long standing anemia or long standing bleeding disorder.
  9. Are the medications I am taking the cause? – Look out for drugs like aspirin and Blog-anemiaNSAIDs. NSAIDS are painkillers commonly used in Kenya and include ibuprofen, mefenamic acid and diclofenac. Short term use is okay but long term use must be under the care of a health provider so that they can adjust drugs when needed and look out for side effects of the drugs. A major side effect we look out for in relation to anemia is bleeding and presenting with vomiting blood or passing dark faeces (due to losing altered blood in stool).
  10. Have I been in an accident or had surgery done? – People may loose a lot of blood in major trauma or during surgery. This is acutely known and transfusions may be done immediately if indications warrant it. Some of these people may later be given blood builders in order to increase the hemoglobin levels. So if you have been in an accident or through surgery and still feel tired, lightheaded or with persistent headache, you should be checked out for anemia amongst other things.

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