Anaemia, Iron Deficiency, and Other Blood Conditions

Nadia Chaves, Georgia Paxton

Recommendations

  • Offer screening to all people from refugee-like backgrounds for anaemia and for other blood conditions with a full blood examination (FBE).
  • Offer screening for iron deficiency with serum ferritin to all children and to women of childbearing age and consider this in patients with unexplained fatigue.
  • Replace iron if ferritin <15µg/L and/or when clinical and haematological features indicate iron deficiency anaemia.
  • Educate about iron-rich diet and avoid excessive dairy intake in children
  • Investigate and treat causes of anaemia
  • Consider screening for vitamin B12 deficiency if arrival <6 months with a history of at least several years of significantly restricted food (especially meat) access e.g. patients from Bhutan, Afghanistan, Iran or the Horn of Africa; or if vegan diet.
  • Treat B12 deficiency if serum active B12 <35pmol/L or <reference range for children with oral or IM supplementation. Exclude concomitant folate deficiency. Consider Helicobacter pylori infection.

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Refugee Health Network of Australia

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The Australian Refugee Health Practice Guide received funding from the Australian Government.

Disclaimer

The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.