Browsing by Subject "Anaemia"

Now showing 1 - 5 of 5
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    Community perceptions of paediatric severe anaemia in Uganda
    (PLOS, 2019-01-03) Dhabangi, Aggrey; Idro, Richard; John, Chandy C.; Dzik, Walter H.; Siu, Godfrey E.; Opoka, Robert O.; Ayebare, Florence; van Hensbroek, Michael B.; Pediatrics, School of Medicine
    BACKGROUND: Severe anaemia remains a major cause of morbidity and mortality among children in sub-Saharan Africa. There is limited research on the beliefs and knowledge for paediatric severe anaemia in the region. The effect of these local beliefs and knowledge on the healthcare seeking of paediatric severe anaemia remains unknown. OBJECTIVE: To describe community perceptions of paediatric severe anaemia in Uganda. METHODS: Sixteen in-depth interviews of caregivers of children treated for severe anaemia and six focus group discussions of community members were conducted in three regions of Uganda between October and November 2017. RESULTS: There was no common local name used to describe paediatric severe anaemia, but the disease was understood in context as 'having no blood'. Severe anaemia was identified to be a serious disease and the majority felt blood transfusion was the ideal treatment, but concomitant use of traditional and home remedies was also widespread. Participants articulated signs of severe pediatric anemia, such as palmar, conjunctival, and tongue pallor. Other signs described included jaundice, splenomegaly, difficulty in breathing and poor appetite. Poor feeding, malaria, splenomegaly and evil spirits were perceived to be the common causes of severe anaemia. Other causes included: human immunodeficiency virus (HIV), haemoglobinuria, fever, witchcraft, mosquito bites, and sickle cell. Splenomegaly and jaundice were perceived to be both signs and causes of severe anaemia. Severe anaemia was interpreted to be caused by evil spirits if it was either recurrent, led to sudden death, or manifested with cold extremities. CONCLUSION: The community in Uganda perceived paediatric severe anaemia as a serious disease. Their understanding of the signs and perceived causes of severe anaemia to a large extent aligned with known clinical signs and biological causes. Belief in evil spirits persists and may be one obstacle to seeking timely medical care for paediatric severe anaemia.
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    Global Phase 3 programme of vadadustat for treatment of anaemia of chronic kidney disease: rationale, study design and baseline characteristics of dialysis-dependent patients in the INNO2VATE trials
    (Oxford University Press, 2021-11-09) Eckardt, Kai-Uwe; Agarwal, Rajiv; Farag, Youssef Mk; Jardine, Alan G.; Khawaja, Zeeshan; Koury, Mark J.; Luo, Wenli; Matsushita, Kunihiro; McCullough, Peter A.; Parfrey, Patrick; Ross, Geoffrey; Sarnak, Mark J.; Vargo, Dennis; Winkelmayer, Wolfgang C.; Chertow, Glenn M.; Medicine, School of Medicine
    Background: Erythropoiesis-stimulating agents (ESAs) are currently the mainstay of treatment for anaemia of chronic kidney disease (CKD). Vadadustat is an investigational oral hypoxia-inducible factor prolyl-hydroxylase inhibitor that stimulates endogenous erythropoietin formation. The INNO2VATE programme comprises two studies designed to evaluate the safety and efficacy of vadadustat versus the ESA darbepoetin alfa in ameliorating anaemia in patients with dialysis-dependent CKD (DD-CKD). Here we describe the trial design along with patient demographics and baseline characteristics. Methods: Two Phase 3, open-label, sponsor-blind, active-controlled trials enrolled adults with anaemia of CKD who recently initiated dialysis and had limited ESA exposure (incident DD-CKD trial) or were receiving maintenance dialysis with ESA treatment (prevalent DD-CKD trial). Study periods include correction/conversion (Weeks 0-23), maintenance (Weeks 24-52), long-term treatment (Weeks 53 to end of treatment) and safety follow-up. The primary safety endpoint is the time to the first major adverse cardiovascular event and the primary efficacy endpoint is the change in haemoglobin (baseline to Weeks 24-36). Results: A total of 369 and 3554 patients were randomized in the incident DD-CKD and prevalent DD-CKD trials, respectively. Demographics and baseline characteristics were similar among patients in both trials and comparable to those typically observed in DD-CKD. Conclusions: The two INNO2VATE trials will provide important information on the safety and efficacy of a novel approach for anaemia management in a diverse DD-CKD population. Demographics and baseline characteristics of enrolled patients suggest that study results will be representative for a large proportion of the DD-CKD population.
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    Management of anaemia in CKD-the relative importance of erythropoietin and iron
    (Oxford University Press, 2011-06) Agarwal, Rajiv; Department of Medicine, IU School of Medicine
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    The silent tragic reality of Hidden Hunger, anaemia, and neural-tube defects (NTDs) in India
    (Elsevier, 2022-09-17) Antony, Aśok C.; Vora, Ravindra M.; Karmarkar, Santosh J.; Medicine, School of Medicine
    Hidden Hunger arising from nutritional iron-, folate-, and vitamin-B12-deficiencies is exceedingly common in India and has profound negative impacts on anaemia, on pregnancy, and on embryonic-foetal neurodevelopment in utero, which predisposes to NTDs and psychological-psychiatric manifestations in childhood. Whereas younger-to-middle-aged Indians fail to perform at maximum potential, the elderly are at risk for calamitous neurologic events. However, these micronutrient-deficiencies are eminently correctable through food-fortification. Therefore, the Indian Government can no longer afford the luxury of inaction by either denying or downplaying the gravity of this problem. What is critically needed from India's leaders is an urgent, clear-eyed reappraisal and act of anagnorisis—(an often startling self-recognition and discovery of a profoundly serious error and tragic flaw)—in failing to confront this problem for decades. Only when closely followed by a metanoia—(a transformative change of heart that triggers remedial action)—can they help India avoid a catastrophic tryst with destiny.
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    The silent tragic reality of Hidden Hunger, anaemia, and neural-tube defects (NTDs) in India
    (Elsevier, 2022-11) Antony, Aśok C.; Vora , Ravindra M.; Karmarkar, Santosh J.; Medicine, School of Medicine
    Hidden Hunger arising from nutritional iron-, folate-, and vitamin-B12-deficiencies is exceedingly common in India and has profound negative impacts on anaemia, on pregnancy, and on embryonic-foetal neurodevelopment in utero, which predisposes to NTDs and psychological-psychiatric manifestations in childhood. Whereas younger-to-middle-aged Indians fail to perform at maximum potential, the elderly are at risk for calamitous neurologic events. However, these micronutrient-deficiencies are eminently correctable through food-fortification. Therefore, the Indian Government can no longer afford the luxury of inaction by either denying or downplaying the gravity of this problem. What is critically needed from India's leaders is an urgent, clear-eyed reappraisal and act of anagnorisis—(an often startling self-recognition and discovery of a profoundly serious error and tragic flaw)—in failing to confront this problem for decades. Only when closely followed by a metanoia—(a transformative change of heart that triggers remedial action)—can they help India avoid a catastrophic tryst with destiny.