A nutrition survey was conducted in the rural Lindi District of Tanzania to determine the magnitude of anemia and iron deficiency in different age and sex groups as related to nutritional status, parasitic infections, food iron intake, and socioeconomic factors. In a 30-cluster sampling design, 660 households were randomly selected and a total of 2320 subjects aged 6 mo to 65 y were examined. Iron status was assessed by measuring hemoglobin and erythrocyte protoporphyrin in a finger-prick sample: 55% of the subjects had anemia and 61% of the anemia was associated with iron deficiency (erythrocyte protoporphyrin > 125 mol/mol heme). Preschool children (aged < 5 y) were the most affected; 84% were anemic (hemoglobin < 110 g/L). Fifty percent of the nonanemic preschool children and Ϸ90% of all the severely anemic subjects were iron deficient. Hemoglobin was lower in schoolchildren (aged 5-14 y) and in adolescent and adult males (aged ≥ 15 y) with a low body mass index. Parasitic infections were only associated with anemia and iron deficiency in schoolchildren and adolescent and adult males. Malaria was associated with anemia (P < 0.001), whereas schistosomiasis was associated with anemia and iron deficiency (P < 0.001 and P < 0.05, respectively). Hookworm infestation was associated with iron deficiency (P < 0.05) and with anemia (P < 0.01) only in adolescents and adults. A mainly cereal-based diet with additional legumes and green vegetables was found by in vitro tests to contain high amounts of total iron but of low bioavailability. Estimation of the amount of iron absorbed confirmed inadequate iron nutrition. Although anemia is a result of a synergism of a variety of causes, iron deficiency remains the major cause.Am J Clin Nutr 1998;68:171-8.

The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency.

No abstract

Objective: To report on the haemoglobin concentrations and prevalence of anaemia in schoolchildren in eight countries in Africa and Asia. Design: Blood samples were collected during surveys of the health of schoolchildren as a part of programmes to develop school-based health services. Setting: Rural schools in Ghana, Indonesia, Kenya, Malawi, Mali, Mozambique, Tanzania and Vietnam.

Anaemia is one of the major public health problems affecting more than half of school children along the coast in Tanzania. Due to the multiplicity of its causes it sometimes becomes difficult to find appropriate intervention measures. In order to assist schools in implementing appropriate public health measures for anaemia in Tanga Region of Tanzania risk factors were investigated in school children. A total of 845 schoolchildren age 7-14 years were randomly selected in a cross-sectional survey conducted in 20 randomly selected schools for inclusion in the investigations. Socio-economic, environmental and biological data were collected, as well as academic information, health care and feeding practices. Diagnosis of anaemia was based on haemoglobin concentration below 115g/L determined by HemoCue meter. Serum Retinol was determined by High performance liquid chromatography and serum ferritin by an Enzyme linked immunosorbent assay. Urine from each child was tested for blood using a haematest reagent strip and those testing positive were examined microscopically by filtration method for Schistosoma haematobium ova. A faecal sample collected from them was also examined microscopically for ova and larvae of intestinal worms. To analyse variables associated with anaemia a stepwise multiple regression model was used. The prevalence of anaemia was 79.6%. Micronutrient deficiencies were highly prevalent. Iron deficiency (SF <20 µg/dl) was affecting 33%, vitamin A deficiency (SR < 20 µg/dL) 31.9% and 25% of the children had mild iodine deficiency (UIE < 20 µg/L). Intestinal helminths were also highly prevalent; 68% of children had hookworm and 54% had urinary schistosomiasis. Inadequate diet was a feature in >50% of children. About 10% of households had no latrines and multiple infection rank score was high especially in older age children. The risk of having anaemia was two times higher in children with iron deficiency (RR=2.1) and 49% higher in those with vitamin A deficiency. These deficiencies correlated significantly with the anaemia (P<0.05). Vitamin A deficiency and infections with hookworm and schistosomiasis were the most significant factors predicting for anaemia (r=0.318 and r2=0.101). We therefore conclude that high prevalence of infections and nutritional deficiencies are important risk factors for anaemia in this community. The high attributable fractions for hookworm, schistosomiasis, iron deficiency and vitamin A confirms that these are significant risk factors to be considered when designing public health measures for anaemia prevention in this community.