Iron deficiency anaemia--an old enemy

Area of Science:

• Public Health
• Nutritional Science
• Epidemiology

Background:

• Anaemia is a pervasive public health concern in the Eastern Mediterranean Region.
• Prevalence rates are high across various demographics, including preschool children, adolescents, and women of childbearing age.
• Using anaemia prevalence as a sole proxy for iron deficiency anaemia is unreliable due to complex or unknown aetiologies and potential co-existing micronutrient deficiencies.

Purpose of the Study:

• To highlight the widespread nature of anaemia in the Eastern Mediterranean Region.
• To emphasize the limitations of using anaemia prevalence as a proxy for iron deficiency anaemia.
• To advocate for an integrated, multifactorial, and multisectoral approach to combat anaemia.

Main Methods:

• Review of anaemia prevalence data across different population segments in the Eastern Mediterranean Region.
• Analysis of the aetiological complexity of anaemia, including co-existing micronutrient deficiencies (folate, vitamin B12, vitamin A).
• Proposal of a comprehensive intervention strategy.

Main Results:

• Anaemia prevalence varies significantly, ranging from 17% to over 70% in preschool children, 14% to 42% in adolescents, and 11% to over 40% in women of childbearing age.
• The aetiology of anaemia is often complex and may involve multiple micronutrient deficiencies, invalidating the sole use of anaemia prevalence as an indicator for iron deficiency.
• An integrated approach is necessary for effective anaemia control.

Conclusions:

• Effective anaemia control in the Eastern Mediterranean Region necessitates an integrated, multifactorial, and multisectoral strategy.
• Interventions should include targeted iron supplementation for vulnerable groups, particularly pregnant women.
• Food-based approaches like fortification and dietary diversification, alongside other measures addressing co-existing deficiencies, are crucial.