Tuberculosis continues to represent one of the main public health challenges in our context, and its complications go far beyond the respiratory system.

In the last June episode of “Vamos Falar de Saúde” journalist Lucrécia Miguel conducted an in-depth interview with Dr. Juzelmira Nzau, a pulmonologist, about anemias associated with tuberculosis, as well as their mechanisms, risks, and forms of prevention.

How Tuberculosis Causes Anemia

According to the specialist, anemia associated with tuberculosis is part of the group of anemias of chronic disease. Thus, when the body is infected by Mycobacterium tuberculosis, a prolonged systemic inflammation is triggered.

Consequently, this inflammation interferes with the production of red blood cells in the bone marrow. Furthermore, it blocks the proper use of iron stored in the body. Therefore, even when iron reserves exist, the body cannot use them efficiently, resulting in a decrease in hemoglobin.

Types of Anemia Most Frequent in Clinical Practice

In hospital practice, Dr. Juzelmira Nzau highlighted that there are different types of anemia frequently observed. Among the main ones are:

• Nutritional deficiency anemia, frequently associated with poor diet in patients with tuberculosis;
• Sickle cell anemia, which has a strong genetic component in the region and requires rigorous monitoring.

Furthermore, the clinical approach tends to focus on the underlying causes, allowing for more effective and targeted treatment.

Diagnosis: Importance of a Complete Evaluation

For an accurate diagnosis, the doctor emphasized the need for a rigorous examination protocol.

First, a complete blood count is performed. Then, iron parameters such as ferritin, serum iron, and iron-binding capacity are evaluated. This data is essential to differentiate anemia due to inflammation from anemia due to deficiency.

On the other hand, in the context of tuberculosis, bacteriological examinations such as sputum smear microscopy and rapid molecular tests are equally important. Furthermore, chest X-rays allow for the assessment of the extent of lung infection and the response to treatment.

Pregnancy, tuberculosis, and anemia: a high-risk scenario

Regarding maternal and child health, the specialist warned that the combination of pregnancy, tuberculosis, and anemia represents a high-risk clinical scenario.

On the one hand, the mother may experience extreme weakness, greater vulnerability to infections, and an increased risk of hemorrhage during childbirth. On the other hand, the fetus may suffer from intrauterine growth retardation, premature birth, and low birth weight.

In addition, the doctor clarified that transmission of tuberculosis from mother to baby via the placenta is rare. However, the most significant risk occurs after birth, through the respiratory tract.

Prevention and care before and after childbirth

Therefore, early screening during prenatal care becomes fundamental. When diagnosed, the pregnant woman should begin immediate and supervised treatment, which is safe when properly monitored.

After delivery, additional protective measures are adopted. Among them, the use of a mask during breastfeeding, chemoprophylaxis in newborns, and BCG vaccination, as clinically indicated, stand out.

Nutrition and prevention of anemia

At the end of her presentation, the doctor reinforced the importance of nutrition in preventing anemia. In fact, the combination of iron-rich foods with vitamin C significantly improves the absorption of this mineral.

Among the recommended foods are beans and pork liver, both important sources of iron.

In addition, the specialist made an appeal for blood donation. In situations of severe anemia or hemorrhagic complications, the availability of blood can be crucial to saving lives.

Internet user participation
Question (Wanzanza Paladar): How does tuberculosis contribute to anemia?

Answer: Chronic inflammation reduces iron utilization and decreases red blood cell production, leading to anemia of chronic disease.

Question (Talziana Amadeu): Are yellowish or very white eyes signs of anemia?

Answer: Pale eyes can indicate anemia. However, yellowing is usually associated with liver problems or accelerated destruction of red blood cells.

Question (Carla Holo): Can a mother transmit tuberculosis to her baby?

Answer: Yes, especially after birth through the respiratory tract. Therefore, preventive measures and proper treatment are essential.

Watch the full interview on the Liberatos Group’s digital platforms: Facebook and Instagram.