Anaemia: Causes, Determinants, Epidemiology and National Strategies for Prevention

2. Background
Anaemia is a non-transmissible disease which is speedily expanding equally in developed as
well as developing countries. It is one of the key challenges of well-being that is reducing the
global development in the present century. (1) The human health and socio-economic
development is devastated by the effects of anaemia. (2) Anaemia is a medical ailment in
which the red blood cells lose its capacity to carry oxygen all over the body. This is observed
when the amount and the mass of red blood cells decreases below the optimum value. It is a
sign of deprived nourishment and health among individuals. (3) Anaemia is defined as a
critical state in which the sum of red blood cells or the total haemoglobin count in the blood
is significantly lowered than normal.
When there is inadequate iron for the development of red blood cells, iron deficiency
anaemia (IDA) is observed. It is typically triggered by unsatisfactory iron intake, prolonged
blood loss with an amplified iron demand in the body. For efficient management and
assessment of anaemia, recognition of aetiology with diagnostic and therapeutic issues need
to be carried out. (5)
Iron is a mineral which is required in the body for proper functioning like oxygen support in
the blood. When there is an absence of this nutrient from the body, an imbalance of the intake
of iron, its absorption and loss is hampered. It can be evaluated that iron insufficiency is the
first root source of anaemia.
Fortification of homes with micronutrient powders, fortification of essential foods and
dressing and activities to mend food retreat and dietetic assortment are some of the strategies
that have been implemented to control IDA. Global guidelines have been revised by the
World Health Organization to control IDA. Although, the protection of predictable iron
additive in regions where transmissible diseases have been widespread remains uncertain.

Careful standard epidemiologic valuation, collection of applicable interventions suiting the
concerned populace and continuing observing to ensure maximum safety and efficiency are
implemented by programs of organizations to control the prevalence of anaemia. (7)
3. Determinants
The social conditions in which people live and work that influence the occurrence of
problems in the health and the risk factors that are associated with it, such as type of housing,
lifestyle, income and the economic policy of the country of residence is generally considered
as social determinants of health. (9)
The two determinants in anaemia of iron deficiency
There are two determinants that have been observed in the public health context of IDA,
immediate and upstream determinants.
Immediate determinants: Food factors influence the absorption of iron in intestines.
Upstream determinants: Low dietary iron content, consumption of predominantly nonheme
iron, and co-consumption of iron with inhibitors of absorption (cereals, grains) result in

inadequate iron intake. People in low-income (especially rural) settings may not be able to
access fortified foods. Inadequacy in iron intake is generally observed because of low content
of iron in the diet, predominant nonheme iron consumption and consuming iron with the
presence of inhibitors of absorption like cereals and grains. People residing in rural areas or
low-income regions might not be able to get a proper access to foods which are fortified.
4 . Aetiology
There are many factors like age, gender and socio-economic status which determine the cause
of anaemia in individuals. Anaemia is an outcome of scarce intake of iron, lessened
absorption and loss of blood. In case of older patients, blood loss is the most common reason
for anaemia. During pregnancy, there is an increased probability of suffering from anaemia
due to low dietary intake, and an increase in the systemic requirements. In newborns,
breastfeeding, is protective against iron deficiency due to the higher bioavailabity of iron in
breast milk compared to cow’s milk. It is observed that IDA is the most common form of
anaemia in young children who are regular in drinking cow’s milk. In developing countries, a
parasitic infestation is also a significant cause of iron-deficiency anaemia. Nutritional
resources of iron are green vegetables, red meat, and iron-fortified milk formulas. (11)
4. Epidemiology including rate and risk groups
Anaemia is a noteworthy community healthiness problem which affects around 800 million
women and children universally. (6) In spite of development in scientific and economic areas,
there is more than a quarter of the population of the world which suffers from anaemia and of
which half is an outcome of IDA. Women and pre-school children are among the most
prevalent populations to experience IDA. (7)