Prevalence of Anemia and Hematological Profiles among Medical Students at Sana’a University: A High Altitude Cross-Sectional Study
Background: Anemia remains a significant global public health challenge. However, its prevalence among health professions students residing in high-altitude regions—where physiological adaptations may alter standard hematological parameters—is not well documented. This study aimed to determine the prevalence of anemia and evaluate the complete hematological profiles of medical students at Sana’a University, Yemen, a city situated at approximately 2,250 meters above sea level. Methods: A cross-sectional study was conducted among 100 undergraduate students (51 males and 49 females) aged 19–25 years at the Faculty of Medicine and Health Sciences, Sana’a University. Venous blood samples were collected and analyzed for Complete Blood Count (CBC) parameters using an automated Sysmex XN-330 hematology analyzer. Anemia was initially defined according to the World Health Organization (WHO) sea-level criteria (hemoglobin [Hb]
Results: The overall mean hemoglobin concentration was 15.63 ± 1.73 g/dL. Sex-stratified analysis revealed significantly higher mean Hb levels in males (16.96 ± 1.20 g/dL) compared to females (14.24 ± 0.91 g/dL) (p < 0.001). Other mean hematological indices were as follows: packed cell volume (PCV) 47.05 ± 4.73%, Red Blood Cell (RBC) count 5.43 ± 0.59 × 10¹²/L, Mean Corpuscular Volume (MCV) 86.39 ± 7.63 fL, and Mean Corpuscular Hemoglobin (MCH) 28.82 ± 2.24 pg. Using the unadjusted WHO sea-level criteria, the prevalence of anemia in this cohort was 0%. However, applying the recommended WHO altitude adjustment for Sana’a (+1.0 g/dL) revises the diagnostic thresholds to 14.0 g/dL for males and 13.0 g/dL for females, potentially identifying anemic cases, particularly among female participants. Conclusion: No anemia was detected in this sample of medical students using standard sea-level criteria, a finding likely attributable to high health literacy and physiological adaptation to Sana’a’s altitude. This study highlights the critical need to establish altitude-specific hematological reference ranges for the Yemeni population to prevent the misdiagnosis of anemia in high-altitude regions.
Ghadeer Y. Al-Anssi1, Khater Gh. H. AL-Hamoodi2, Mubarak Gh. H. AL-Hamoodi3, Tibyan Abd Almajed Altaher4, and Ghanem Mohammed Mahjaf5*