Reporting new cases of anaemia in primary care settings in Crete, Greece: a rural practice study

All patients attending the rural primary health care units of twelve general practitioners (GPs) on the island of Crete for ten consecutive working days were eligible to participate in this study. Hemoglobin (Hb) levels were measured by portable analyzers. Laboratory tests to confirm new cases of anaemia were performed at the University General Hospital of Heraklion.One hundred and thirteen out of 541 recruited patients had a low value of Hb according to the initial measurement obtained by the use of the portable analyzer. Forty five (45.5%) of the 99 subjects who underwent laboratory testing had confirmed anaemia. The mean value of the Hb levels in the group with confirmed anaemia, as detected by the portable analyzer was 11.1 g/dl (95% Confidence Interval (CI) from 10.9 to 11.4) and the respective mean value of the Hb levels obtained from the full blood count was 11.4 g/dl (95% CI from 11.2 to 11.7) (P = 0.01). Sixteen out of those 45 patients with anaemia (35.6%) had IDA, with ferritin levels lower than 30 ng/ml.Keeping in mind that this paper does not deal with specificity or sensitivity figures, it is suggested that in rural and remote settings anaemia is still invisible and point of care testing may have a place to identify it.Anaemia is a common haematologic disorder which increasingly occurs in older age groups and its onset is usually insidious and slow [1]. As anemia worsens and due to insufficient circulatory adaptive mechanisms in the elderly, discomfort and functional impairment may be progressively installed [1]. Approximately, 11.0% of men and 10.2% of women ≥ 65 years are anaemic. One third of the elderly patients with anaemia present nutrient deficiencies, conditions which should be readily treated and cautiously linked with possible underlying disorders [2].Symptoms reported in general practice/family medicine (GP/FM) play an important role in diagnosing anaemia. Fatigue, palpitations, dyspnoea on exertion, and poor concentration are some of the ge