Lena Davidsson

1
Measurement of iron status how common is iron
deficiency anemia?

• Lena Davidsson
• Laboratory for Human Nutrition, Institute of
  Food Science and Nutrition, Swiss Federal
  Institute of Technology, Zürich, Switzerland

2
Etiology of anemia
Iron deficiency
Iron deficiency anemia
3
Iron deficiency
Vitamin A deficiency
Folate deficiency
Hemoglobinopathies
Vitamin B12 deficiency
Anemia
HIV infection
Malaria
Infectious/inflammatory disorders
Helminth infection
4
Etiology of anemia

• Assessing the magnitude of the problem
• prevalence of anemia and iron deficiency
  anemia (IDA) in the population or in vulnerable
  population groups

5
Etiology of anemia

Bone marrow iron in 88 anemic, pregnant women in
Malawi (van den Broek Letsky 2000)
6
Prevalence of anemia and iron deficiency anemia
Côte dIvoire

Iron deficiency based on a multi criteria model
(Staubli et al. 2001)
7
Iron supplements to anemic school children. Study
in Côte dIvoire
Placebo
Iron

Prevalence of anemia and IDA in school children
before and after iron supplementation (9 weeks
placebo or 60 mg iron/day, 4 days/week n68 and
64). Staubli, Davidsson, Adou Hurrell
unpublished
8
Micronutrient deficiencies in 150 anemic,
pregnant women in Malawi
No micronutrient deficiency
Iron
23
19
26
32
Vitamin A, B12 and/or folate
Iron plus vitamin A, B12, and/or folate
van den Broek Letsky 2000
9
Strategies to combat iron deficiency anemia
and/or anemia of other causes
Malaria control
Improved nutrition
Iron fortification Iron supplementation
Improved access to health care
Helminth control/ improved sanitation
10
Evaluation of interventions

• Functional outcomes
• Severe anemia Child mortality/Maternal mortality
• Mild/moderate anemia Child mortality?/Maternal
  mortality?
• Iron deficiency anemia Work productivity/Child
  development/Low birth weight?/Infectious disease
  (protective or adverse)?
• Iron deficiency Work productivity