A HAEMATOLOGICAL AND AETIOLOGICAL PROFILE OF ANAEMIA AMONG CHILDREN AGED 6 MONTHS TO 5 YEARS: A RETROSPECTIVE STUDY AT A TERTIARY CARE CENTRE IN TAMIL NADU

Abstract

Background: Paediatric anaemia remains an important public health and clinical concern, particularly during early childhood when iron requirements are high. Childhood anaemia is predominantly caused by iron deficiency, which should be differentiated from other nutritional and haematological causes when assessed by haemoglobin (Hb) alone. The haematological profile, severity, and aetiology of anaemia, with a focus on iron deficiency, in children aged 6 months to 5 years were examined. Methods: A retrospective observational study has been carried out in the Department of Pathology at a tertiary-care centre in Chennai, Tamil Nadu, using medical records from March 2023 to March 2024. Children aged 6 months to 5 years with anaemia and appropriate records were included. Red cell indices such as MCHC, MCV, MCH, RDW, serum iron, ferritin, TIBC, transferrin saturation, and reticulocyte count were assessed. The severity of anaemia was categorised according to the age-specific WHO 2024 Hb cut-offs. Data were analysed using IBM SPSS version 24. Student’s t-test and Pearson’s correlation were used, with p<0.05 considered statistically significant. The study included 100 children. Results: Among the 100 children, 63% were male, and 38% were aged 6 months to <1 year. Moderate anaemia was the predominant severity category (61%), followed by severe (25%) and mild anaemia (14%). Iron deficiency anaemia was the most common aetiology, accounting for 70% of cases. The mean Hb was 7.74±1.58 g/dL, with a predominantly microcytic hypochromic pattern (MCV 64.43±8.11 fL; MCH 17.99±4.11 pg) and elevated RDW (20.44±4.49%). Hb, MCV, MCH, MCHC and RDW varied significantly across severity categories. Serum iron, ferritin, TIBC and transferrin saturation differed significantly between iron-deficient and non-iron-deficient groups (all p<0.001), whereas Hb and RDW did not. No significant correlations were observed between the assessed iron parameters and Hb or reticulocyte count. Conclusion: Iron deficiency anaemia was the predominant cause of paediatric anaemia in this cohort, with a predominantly microcytic hypochromic haematological pattern. Although routine red-cell indices provided useful information regarding morphology and severity, they did not reliably distinguish iron-deficient from non-iron deficient anaemia. The findings support the use of appropriate iron-profile investigations alongside the routine haemogram for a more reliable and practical evaluation of paediatric anaemia.