The photograph is representative of the peripheral blood smear of a five-month-old immigrant from Asia. Her mother was concerned that the child was not eating well. Her spleen was palpable.

The hemogram revealed the following:

Hb 9.6g/dL (normal 12.0 - 16.0 g/dL)

RBC 5.48 X 10¹²/L (normal 4.2 - 5.9 X 10¹²/L

HCT 30.4% (normal 37 - 48%)

MCV 55.4 fl (normal 86 - 98 fl)

MCH 17.5 pg (normal 27 - 32 pg)

MCHC 31.6 g/dL (normal 31 - 37 g/dL)

RDW 34.9% (normal 11 - 15%)

Reticulocyte count 10.9% (normal 0.5 - 1.5%)

Select the most likely diagnosis based on the clinical information and peripheral blood findings.

Please select the single best answer