Iron deficiency anaemia
A few salient facts
- In developing countries every second pregnant woman and about 40% of preschool children are estimated to be anaemic.
- In many developing countries, iron deficiency anaemia is aggravated by worm infections, malaria and other infectious diseases such as HIV and tuberculosis.
- The major health consequences include poor pregnancy outcome, impaired physical and cognitive development, increased risk of morbidity in children and reduced work productivity in adults. Anaemia contributes to 20% of all maternal deaths.
Iron deficiency is the most common and widespread nutritional disorder in the world. As well as affecting a large number of children and women in developing countries, it is the only nutrient deficiency which is also significantly prevalent in Industralized Countries. The numbers are staggering: 2 billion people – over 30% of the world’s population – are anaemic, many due to iron deficiency, and in resource-poor areas, this is frequently exacerbated by infectious diseases. Malaria, HIV/AIDS, hookworm infestation, schistosomiasis, and other infections such as tuberculosis are particularly important factors contributing to the high prevalence of anaemia in some areas.
Iron deficiency affects more people than any other condition, constituting a public health condition of epidemic proportions. More subtle in its manifestations than, for example, protein-energy malnutrition, iron deficiency exacts its heaviest overall toll in terms of ill-health, premature death and lost earnings.
Iron deficiency and anaemia reduce the work capacity of individuals and entire populations, bringing serious economic consequences and obstacles to national development. Overall, it is the most vulnerable, the poorest and the least educated who are disproportionately affected by iron deficiency, and it is they who stand to gain the most by its reduction.
The response: a three-pronged offensive
Invisible yet ubiquitous in many developing countries, the true toll of iron deficiency and anaemia lies hidden in the statistics of overall death rates, maternal haemorrhage, reduced school performance and lowered productivity. Iron deficiency anaemia affects millions. The health consequences are stealthy but devastating, invisibly eroding the development potential of individuals, societies and national economies.
This need not be so. We not only know the causes; we also have solutions that are both inexpensive and effective. Because of their close links, iron deficiency and anaemia should be tackled simultaneously using a multifactorial and multi sectorial approach. It should also be tailored to local conditions and take into account anaemia's specific aetiology and the population groups affected.
It need not be so…
WHO has developed a comprehensive package of public health measures addressing all aspects of iron deficiency and anaemia. This package is being implemented in countries with high levels of iron deficiency and anaemia, malaria, helminth infections and schistosomiasis.
Increase iron intake. Dietary diversification including iron-rich foods and enhancement of iron absorption, food fortification and iron supplementation.
Control infection. Immunization and control programmes for malaria, hookworm and schistosomiasis.
Improve nutritional status. Prevention and control of other nutritional deficiencies, such as vitamin B12, folate and vitamin A.
Why stop iron deficiency anaemia?
The benefits are substantial. Timely treatment can restore personal health and raise national productivity levels by as much as 20%. To support countries in combating anaemia, WHO has developed guidelines on prevention and control of iron deficiency and anaemia together with a manual for assessing the magnitude of the problem and monitoring interventions.
Because iron deficiency anaemia drains the life and vitality out of development. We have both the means and potential to achieve widespread improvement. We need to apply both energetically.