The Variation in Anaemic Parameters in the Ethnic Groups of Pakistan

Aims: To observe any diversity of pattern in the anaemic parameters in the major ethnic groups of Pakistan.

Study Design: Observational, cross-sectional.

Place and Duration of Study: Department of Medicine, Creek general Hospital, Korangi, Karachi, Pakistan from October 2017 to March 2018.

Methodology: 1200 adults above 18 years were included. Pregnant females, age less than 18 years, any severe organ insufficiency, stroke, neurodegenerative disease, known blood dyscrasias or terminal illness at baseline evaluation were excluded. Their ethnic background was grouped into Urdu speaking, Punjabi, Balochi Sindhi, Pashtun, Bengali, and Gilgit according to their place of origin, mother tongue or parents’ place of origin. The complete blood picture was performed to identify anaemia, grade the severity, classify the red cell indices and exclude any blood dyscrasias in each of the ethnic group.

Results: Out of 1200 adults, 626(52%) were anaemic. In decreasing order, the most anaemic were Bengalis (57.6%), Sindhis (55%), Urdu speaking (54%), Pashtuns (54%), Balochis (52%), Gilgits (49%) and Punjabis (45%). In males, Sindhis (60%), Pashtuns (57%), Bengalis (56%), and Urdu speaking (51%) were most anaemic. In females, Balochis (71%), Bengalis (64%), Urdu speaking (55%) were most anaemic. Anaemia was prevalent in the younger age group of the Urdu speaking, Pashtun and Sindhis community, while in the rest of the ethnic groups anaemia was most common in the middle age group. In males, anaemia was highest in the young age group of Urdu Speaking, Sindhis, and Pashtuns while in females in all the ethnic groups the middle age group was most anaemic and had least anaemia in elderly females except in Bengalis where the least was in young females. Mild anaemia was most common overall and in both genders. Regarding red cell indices, Punjabis and Bengalis were normocytic while in the rest the most were microcytic. In the males, Urdu speakers, Punjabis and Bengalis were significantly more normocytic anaemic, while Sindhis were more microcytic. In females, in all the ethnic groups’ microcytic anaemia was prevalent. Anaemia was three times more in the Sindhi group of smokers compared to the Sindhi nonsmokers while in the rest of the ethnic groups there was no specific correlation.

Conclusion: This survey specifies that in Pakistan the key measures of health status are albeit dependent on the financial status, literacy rate, sanitation, access to primary care facilities, effective role of health providers but the genetic composition and cultural norms also play their part.