Perspective: What Makes It So Difficult to Mitigate Worldwide Anemia Prevalence?

Area of Science:

• Hematology
• Nutritional Science
• Public Health

Background:

• Anemia results from decreased red blood cell production or increased loss, with diverse overlapping causes.
• Dietary factors (phytates, polyphenols) and poor hygiene contribute to anemia, particularly iron deficiency and anemia of inflammation.
• The complexity of anemia etiology hinders effective prevalence mitigation strategies.

Purpose of the Study:

• To highlight the challenges in diagnosing and treating anemia due to its multifactorial nature.
• To emphasize the need for reliable diagnostic biomarkers to differentiate anemia types.
• To discuss the potential of established and emerging biomarkers for anemia management.

Main Methods:

• Review of established diagnostic biomarkers for anemia in adults, including serum ferritin, soluble transferrin receptor (sTfR), serum iron, and sTfR/log ferritin ratio.
• Exploration of promising biomarkers like serum hepcidin, noting their current limitations in widespread use.
• Discussion on the challenges of establishing age-specific reference values for biomarkers in pediatric populations.

Main Results:

• Established biomarkers like serum ferritin and sTfR aid in adult anemia diagnosis.
• Serum hepcidin shows promise but requires further validation for clinical application.
• Lack of pediatric reference values complicates anemia diagnosis in children.

Conclusions:

• Accurate diagnosis through appropriate biomarkers is crucial for effective anemia treatment.
• Resource-rich societies demonstrate that common anemias, like iron deficiency, are preventable.
• Inborn anemias and those linked to chronic diseases necessitate robust healthcare systems for management.