This week we have two different cases to share with you, both of severe anaemia.
The first is a 17 day old baby who came with a temperature and difficulty breastfeeding. However when we checked her haemoglobin level it was 3.2 g/dL (in a baby of this age we would expect above 17!). Further questioning revealed that at the time of delivery in hospital the umbilical cord was cut while it was not clamped, allowing blood from the baby to flow out freely. We also checked a test for sickle cell disease (another very common cause of anaemia here) but this was negative. And there was no other obvious reason for this baby to be so anaemic. Therefore we believe that the most likely cause of this baby's anaemia is this error at the time of delivery. Untreated this anaemia would lead to significant problems with growth and development but luckily we were able to give this baby a blood transfusion to raise the haemoglobin to a normal level.
The other case is a 45 year old man who complained of feeling weak, dizzy and had palpitations. He was very pale on examination and his haemoglobin level was only 2.8 g/dL. Thorough questioning revealed no obvious cause of this anaemia - he had no history of blood in his stool, urine, vomiting or coughing. He also had no history of significant weight loss or any other symptoms suggestive of cancer. We checked for malaria and sickle cell disease and these were both negative. At Kivunge we don't have access to any further investigations into the possible cause of anaemia, and many people are anaemic due to a poor diet. Therefore we gave this man two units of blood, some iron supplements and advice on a healthy diet. He left the hospital feeling much better than when he arrived!
And in exciting news at Kivunge, an extension of the lab is currently under construction so that we can process and store blood for donation ourselves. At the moment we get all of our blood from Stone Town (about one and half hours away by car) - which can be too long in an emergency if we have run out.