The Proportion of Anemia Associated with Iron Deficiency in Low, Medium, and High Human Development Index Countries: A Systematic Analysis of National Surveys

Abstract

Iron deficiency is commonly assumed to cause half of all cases of anemias, with hereditary blood disorders and infections such as hookworm and malaria being the other major causes. In countries ranked as low, medium, and high by the Human Development Index, we conducted a systematic review of nationally representative surveys that reported the prevalence of iron deficiency, iron deficiency anemia, and anemia among pre-school children and non-pregnant women of reproductive age. Using random effects meta-analyses techniques, data from 23 countries for pre-school children and non-pregnant women of reproductive age was pooled, and the proportion of anemia attributable to iron deficiency was estimated by region, inflammation exposure, anemia prevalence, and urban/rural setting. For pre-school children and non-pregnant women of reproductive age, the proportion of anemia associated with iron deficiency was 25.0% (95% CI: 18.0, 32.0) and 37.0% (95% CI: 28.0, 46.0), respectively. The proportion of anemia associated with iron deficiency was lower in countries where anemia prevalence was >40%, especially in rural populations (14% for pre-school children; 16% for non-pregnant women of reproductive age), and in countries with very high inflammation exposure (20% for pre-school children; 25% for non-pregnant women of reproductive age). Despite large heterogeneity, our analyses suggest that the proportion of anemia associated with iron deficiency is lower than the previously assumed 50% in countries with low, medium, or high Human Development Index ranking. Anemia-reduction strategies and programs should be based on an analysis of country-specific data, as iron deficiency may not always be the key determinant of anemia.

Iron Deficiency Anaemia

“…In detail, results from studies conducted in the United States reported the prevalence of iron deficiency ranges from 4.5 to 18.0%. But the proportion of anaemia caused by iron deficiency in central Asia, south Asia and Andean Latin America were 64.7, 54.8 and 62.3%, respectively [8,40].…”

Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children

“…Before the point when screening identifies IDA, the critical development of the brain, heart, and other tissues may already have been permanently impaired by ID in those tissues (12,20). Further, the recent report by Petry et al (24) suggests that only w25% of anemia is attributable to ID. Therefore, improvements in screening will depend in part on improving indicators that are particularly informative of tissue ID.…”

Alimentos Fontes De Ferro E Vitamina C Consumidos Entre Lactentes Da Atenção Primária À Saúde

“…A ingestão de micronutrientes pelas crianças tem se mostrado inadequada, sobretudo em relação ao ferro, no cenário internacional (5)(6)(7)(8) e nacional (2,4) . Este nutriente é considerado como marcador de uma dieta de baixa qualidade e de práticas alimentares incorretas (2,4) .…”

“…A anemia ferropriva, patologia resultante da carência de ferro, tem atingido muitos lactentes (1,(5)(6)(7)10,11) . Nessa fase, a anemia está comumente relacionada com a interrupção precoce do aleitamento materno e a alimentação complementar oferecida de forma inadequada (3,10,12) .…”