Interpreting tests for iron deficiency among adults in a high HIV prevalence African setting: routine tests may lead to misdiagnosis.

We evaluated peripheral blood tests to diagnose iron deficiency on medical wards in Blantyre, Malawi, where infection and HIV are prevalent. We compared full blood count, ferritin and serum transferrin receptor (TfR) levels with an estimation of iron in bone marrow aspirates. Of consecutive adults admitted with severe anaemia (haemoglobin <7 g/dl), 81 had satisfactory bone marrow aspirates.

Treatable factors associated with severe anaemia in adults admitted to medical wards in Blantyre, Malawi, an area of high HIV seroprevalence.

Severe anaemia is a common presentation in non-pregnant adults admitted to hospital in southern Africa. Standard syndromic treatment based on data from the pre-HIV era is for iron deficiency, worms and malaria. We prospectively investigated 105 adults admitted consecutively to medical wards with haemoglobin < 7 g/dl.