Iron deficiency (ID) can result from insufficient iron intake, inadequate iron mobilization or absorption, or a combination of these.The hepatic iron regulatory hormone hepcidin governs the amount and distribution of body iron by controlling the entry of iron into the circulation for delivery for red blood cell production and tissue use. When hepcidin is low, stored iron is released into the bloodstream. Hepcidin is suppressed when there is an increased need for iron from body stores to form new red blood cells or when the levels of iron or oxygen circulating in the blood are low. In contrast
Red blood cell production and associated biological systems are complex. In addition to iron, other micronutrients are essential for the function of a healthy blood system and thus, play a role in the prevention of anemia. The body must maintain red blood cell production to replace cells lost through natural removal of aged or damaged cells from circulation or to offset bleeding. The lifespan of normal red blood cells is approximately 120 days; the body requires sufficient amounts of key nutrients to support the replacement of red blood cells at a rate of 1 percent daily.From a research
Infections account for a large proportion of anemia, especially in regions with a high anemia burden such as sub-Saharan Africa and Oceania. In these regions, young children have the highest prevalence of anemia and total years lived with disability due to anemia. Several infections are strongly associated with anemia, including parasitic infections such as malaria, hookworm, and Salmonella.Anemia may also complicate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Anemia and infections that cause anemia are major causes of hospitalization and death in children in endemic areas.
Hundreds of hereditary disorders can cause anemia. Their diagnosis and management require medical resources available only in specialized centers. Progress in understanding the underlying mechanisms of genetic disorders has been made and new therapeutic approaches are entering human trials. For example, public health programs to ameliorate the clinical course of sickle cell disease with hydroxyurea are underway in Africa. Related research priorities include better genetic epidemiology, including micro mapping of red cell variants; and the development of improved methods for reliable genetic
The assessment of anemia in a clinical setting begins with careful history taking and a detailed physical examination. The patient’s medical history should include questions about history of anemia symptoms such as fatigue or malaise, bleeding (in particular, gastrointestinal or heavy menstrual bleeding), family history of genetic disorders, current medication use, living in or travel to malaria endemic areas or areas affected by other anemia-causing infectious diseases, and diet history.Anemia prevalence in a population is determined by the percentage of individual cases below a recommended
It is important to recognize the relationships among nutritional and non-nutritional causes of anemia; each may affect and be affected by the other. For example, an individual may have acute inflammation due to an illness, and the elevated hepcidin caused by the inflammation could lead to functional iron deficiency. Inflammation would also interfere with iron absorption, so supplementation/fortification would be most effective after resolution of the inflammation.In 2010, four of the five most common causes of anemia were non-nutritional: hookworm disease, sickle cell disorders, thalassemias
Anemia-related survey data can inform programmatic decision-making. You can collect hemoglobin data alongside data about conditions known to cause anemia, to inform public health anemia control programs. Quantifying the contributions of multiple anemia causes that often overlap with one another can be complex. Examining prevalence estimates of conditions known to cause anemia (e.g., inherited blood disorders, infectious diseases, or micronutrient deficiencies) is a first step in understanding the ecology of the anemia.A frequent next step is to examine the bivariate associations between the
Non-dietary interventions for the treatment of anemia include a broad range of approaches including clinical interventions to treat individuals with anemia and other anemia-related conditions or broader public health programs. Non-dietary interventions to reduce anemia include prevention of and treatment for malaria, helminthiasis, tuberculosis, human immunodeficiency virus (HIV), acute or chronic blood loss, and hemolytic genetic disorders.Malaria Prevention and TreatmentMalaria control in pregnancy and childhood can take many forms: intermittent preventive regimens in pregnant women through
Improving dietary quality and diversity is a potentially critical intervention strategy to combat micronutrient deficiencies. Dietary quality in low- and middle-income countries is often limited by a lack of dietary diversity, the presence of food insecurity, and limited food access and availability. The impact of climate change on crop yields and nutrient composition complicates efforts to improve dietary quality. Adding animal source foods and use of traditional food processing techniques, such as fermentation, germination, and dehulling to improve iron status and bioavailability, are
Iron and micronutrients supplementation has been used widely to correct specific nutritional deficiencies linked to anemia. Oral iron supplements are the first-line treatment for iron deficiency and iron deficiency anemia in women of reproductive age. Gastrointestinal side effects from iron supplement intake are commonly reported, but can be decreased by following proper dosing regimens. Iron preparations available on the market vary widely in dosage, formulation, cost, and bioavailability.Highly bioavailable ferrous iron is generally the most effective formulation for replenishing hemoglobin