Premium
High prevalence of anaemia among A frican migrants in G ermany persists after exclusion of iron deficiency and erythrocyte polymorphisms
Author(s) -
Müller Sophie A.,
Amoah Stephen K. B.,
Meese Stefanie,
Spranger Joachim,
Mockenhaupt Frank P.
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12530
Subject(s) - iron deficiency , alpha thalassemia , medicine , ferritin , thalassemia , hemoglobinopathy , demography , anemia , population , glucosephosphate dehydrogenase deficiency , disease , biology , glucose 6 phosphate dehydrogenase , dehydrogenase , genotype , genetics , environmental health , biochemistry , sociology , gene , enzyme
Objectives Haematological parameters differ between individuals of A frican and E uropean ancestry. However, respective data of first‐generation A frican migrants are virtually absent. We assessed these in G hanaian migrants living in B erlin, compared them with reference data from G ermany and G hana, and estimated the role of iron deficiency ( ID ) and erythrocyte polymorphisms in anaemia. Methods A total of 576 G hanaians (median age, 45 years) were analysed. Blood counts were performed, haemoglobinopathies and glucose‐6‐phosphate dehydrogenase ( G 6 PD ) deficiency were genotyped, and concentrations of ferritin and C ‐reactive protein were measured to define ID . Results Most individuals had resided in Germany for more than a decade (median, 18 years). By WHO definition, anaemia was present in 30.9% of females and 9.4% of males. Median haemoglobin ( H b) levels were lower than among Germans (women, −0.8 g/dl, men, −0.7 g/dl). However, applying reference values from Ghana, only 1.9% of the migrants were considered anaemic. Alpha‐thalassaemia, H b variants and G6 PD deficiency were observed in 33.9%, 28.3% and 23.6%, respectively. ID was highly prevalent in women (32.0%; men, 3.9%). The population fraction of anaemia cases attributable to ID was 29.0% (alpha‐thalassaemia, 13.6%; G 6 PD deficiency, 13.5%). Nevertheless, excluding ID , alpha‐thalassaemia, G 6 PD deficiency and sickle cell disease, anaemia prevalence remained high (women, 18.4%; men, 6.5%), and was also high when applying uncensored thresholds proposed for A frican A mericans (females, 19.3%; males, 7.8%). Conclusions Iron deficiency and erythrocyte polymorphisms are common among first‐generation Ghanaian migrants but explain only part of the increased prevalence of anaemia. Common H b thresholds for the definition of anaemia may not be appropriate for this group.