💉 Men's Health

Anaemia Types in Nigeria — Causes & Treatment

Q: Can I take iron tablets bought from a pharmacy without a test?

Self-treating with iron is common in Nigeria but not always appropriate. Iron tablets will not help anaemia caused by malaria, sickle cell, or B12 deficiency — and excess iron in the setting of infection or SCD can worsen outcomes. A blood test to confirm iron deficiency takes 15 minutes and costs very little.

Q: Does eating liver and red meat cure anaemia?

Dietary iron helps prevent and treat mild iron deficiency anaemia. Liver, red meat, beans, and dark green vegetables are iron-rich. However, dietary changes alone take months and may be insufficient for moderate-to-severe anaemia — iron tablets are much faster and more reliable.

Q: Why do pregnant women often get anaemia?

Pregnancy dramatically increases iron and folate demand — blood volume expands by 40% but iron stores often can't keep pace. This is why daily iron and folic acid supplements are given at the first ANC visit and continued throughout pregnancy.

Q: Is giving a blood transfusion dangerous?

Modern blood transfusion in a hospital setting is carefully screened for HIV, hepatitis B, C, and syphilis in Nigeria. Transfusion reactions occur but are monitored during the infusion. The risk of a properly indicated, screened transfusion is far lower than the risk of untreated severe anaemia.

Not all anaemia is the same — understanding the causes changes the treatment

Anaemia — a haemoglobin level below 12 g/dL in women and 13 g/dL in men — is one of the most common medical conditions in Nigeria. It affects approximately 68% of children under 5, 55% of pregnant women, and 30% of adults. Anaemia is not a diagnosis in itself — it is a sign with many causes. Treating anaemia with iron when the cause is malaria, sickle cell, or B12 deficiency is ineffective and delays recovery. Understanding the type of anaemia is essential for correct treatment.

Signs and Symptoms

✓ Fatigue and weakness disproportionate to exertion

✓ Pallor: pale conjunctiva (inside lower eyelid), pale palms, pale tongue

✓ Breathlessness on mild exertion

✓ Rapid heartbeat (palpitations)

✓ Dizziness or light-headedness, especially on standing

✓ Headache

✓ Cold hands and feet

✓ In severe anaemia: chest pain, confusion, heart failure signs

✓ Pica (craving for non-food items — soil, chalk, ice): classic sign of iron deficiency in Nigerian women

Risk Factors

Iron deficiency: poor diet, heavy menstrual periods, pregnancy, hookworm infestation, chronic blood loss (peptic ulcer, haemorrhoids)
Malaria: most common cause of acute anaemia in children and adults in endemic areas
Sickle cell disease: chronic haemolytic anaemia with acute crises
Vitamin B12 deficiency: rare dietary deficiency; common with strict vegetarian diets or metformin use
Folate deficiency: poor diet, pregnancy, sickle cell disease (high cell turnover)
Chronic kidney disease: reduced erythropoietin production
HIV: direct marrow suppression and drug side effects
Chronic inflammation (TB, rheumatoid arthritis): anaemia of chronic disease

When to Seek Help

Haemoglobin < 7 g/dL or rapidly fallingSevere anaemia — risk of heart failure, especially in the elderly or those with heart disease. May need transfusion

Symptoms at rest: breathlessness while sitting or lyingCompensatory mechanisms failing — urgent hospital assessment

Pallor + feverMalaria or severe infection — needs blood film and urgent treatment

Pallor in pregnancyAnaemia in pregnancy increases risk of preterm birth, low birth weight, and maternal mortality — check Hb at every ANC visit

Children with pallor and fast breathingSevere anaemia in children can cause heart failure rapidly — emergency

Tests & Diagnosis

🧪 Full blood count (FBC)

Haemoglobin level, red cell size (MCV), and red cell appearance guide diagnosis. Low MCV = iron deficiency or thalassaemia. Normal/High MCV = B12/folate deficiency or haemolytic anaemia

🧪 Peripheral blood film

Sickle cells, malaria parasites, hypersegmented neutrophils (B12 deficiency), target cells — a skilled look at the blood film is invaluable

🧪 Malaria rapid test or blood film

In any febrile anaemic patient in Nigeria — malaria is the most common treatable cause

🧪 Serum ferritin

Best indicator of iron stores. Low ferritin = iron deficiency. Normal ferritin with low Hb = anaemia of chronic disease or other cause

🧪 Vitamin B12 and folate levels

If MCV high or neurological symptoms (tingling, weakness, memory loss)

🧪 Reticulocyte count

High reticulocytes = haemolytic anaemia or acute blood loss (marrow responding). Low reticulocytes with anaemia = marrow failure or B12/iron deficiency

🧪 Haemoglobin electrophoresis

If sickle cell or thalassaemia suspected

🧪 Stool microscopy for ova and parasites

Hookworm is a significant cause of iron deficiency in rural Nigeria

Treatment Options

Iron deficiency anaemia

Oral ferrous sulphate 200mg three times daily (or ferrous gluconate) with vitamin C to enhance absorption. Take on empty stomach. Side effects: black stools, constipation. Treat underlying cause — identify and address blood loss

Malaria-related anaemia

Appropriate antimalarials (artemether-lumefantrine first line) — anaemia resolves as malaria clears. Iron supplementation after malaria treatment if FBC confirms iron deficiency

Sickle cell anaemia

Hydroxyurea, folic acid, transfusion for severe episodes. See dedicated SCD guide

Vitamin B12 deficiency

IM hydroxocobalamin 1000mcg every other day for 2 weeks, then monthly (if deficiency due to absorption). Oral B12 if dietary deficiency only

Folate deficiency

Folic acid 5mg daily for 4 months. Identify underlying cause — poor diet, malabsorption, increased demand (pregnancy, SCD)

Anaemia of chronic disease

Treat the underlying condition. Erythropoietin injections if CKD-related and available

Blood transfusion

Reserved for Hb < 7 g/dL with symptoms, or higher if cardiac disease, pregnancy with symptoms, or pre-operatively

Frequently Asked Questions

Can I take iron tablets bought from a pharmacy without a test?

Self-treating with iron is common in Nigeria but not always appropriate. Iron tablets will not help anaemia caused by malaria, sickle cell, or B12 deficiency — and excess iron in the setting of infection or SCD can worsen outcomes. A blood test to confirm iron deficiency takes 15 minutes and costs very little.

Does eating liver and red meat cure anaemia?