Background: Megaloblastic anemia is a type of macrocytic anemia primarily caused by vitamin B12 and/or folate deficiency. Early diagnosis is crucial to prevent complications, particularly neurological impairments associated with vitamin B12 deficiency. Blood film examination is a cost-effective diagnostic tool for identifying macrocytic anemia. Objective: This study evaluates the diagnostic value and sensitivity of blood film in detecting Megaloblastic anemia and its association with vitamin B12 deficiency. Methods: A retrospective cross-sectional observational study was conducted on 31 patients diagnosed with macrocytic anemia using blood film. Laboratory investigations included complete blood count (CBC), red blood cell indices, and serum vitamin B12 levels. Data analysis was performed using statistical software, with significance set at p < 0.05. Results: The median age of patients was 65 years, with 71% being female. The mean hemoglobin level was 7.52 g/dL. Among the patients, 67.7% had macrocytic anemia, while 32.3% had non-macrocytic anemia. A highly significant association was found between macrocytic and vitamin B12 deficiency (p = 0.035). Multivariate analysis confirmed that low vitamin B12 levels were a strong predictor of macrocytic anemia (p = 0.048). Conclusion: Blood film examination is a sensitive and reliable method for diagnosing macrocytic anemia. The study highlights the strong correlation between vitamin B12 deficiency and macrocytosis, reinforcing the importance of routine screening for vitamin B12 levels in anemic patients.

Keywords: Megaloblastic anemia, Macrocytic anemia, Vitamin B12 deficiency, Folate deficiency, Macrocytosis, CBC.