10 August 2023

Anaemia cases among women and children remain stubbornly high worldwide, according to a major new analysis.

Researchers from the Institute for Health Metrics and Evaluation (IHME), Seattle, USA, and collaborators from the Global Burden of Disease analysed global anaemia data from 1990–2021.

The analysis has revealed a complex picture of how key factors play into the divergence in success stories among men, women, and children, the researchers say.

Anaemia affected nearly 2 billion people in 2021, with 31.2% of women having the condition compared with 17.5% of men.

However, the sex disparity was particularly marked when they examined the reproductive years, ages 15-49, where anaemia affected 33.7% of women compared to 11.3% of men.

Sub-Saharan Africa and South Asia have the greatest burden. In 2021, Western sub-Saharan Africa (47.4%), South Asia (35.7%), and Central sub-Saharan Africa (35.7%) had the highest anaemia prevalence, while the regions with the lowest anaemia are Australasia (5.7%), Western Europe (6%), and North America (6.8%).

The findings are reported in The Lancet Haematology.

Senior study author Dr Nick Kassebaum, head of IHME’s Neonatal and Child Health team and professor in anaesthesiology at the University of Washington, said: “From this 30-year study, we know the global picture around anaemia has improved, but there are still wide disparities when you narrow the focus on geography, gender, and age.

“We modelled 37 underlying causes for anaemia. It’s very important for clinicians to treat these causes in parallel to the anaemia itself. We hope they use these data to design more comprehensive intervention and treatment plans, especially for the most vulnerable women of reproductive age, children, and the elderly.”

The study found that gynaecological disorders and maternal haemorrhage were important contributors to anaemia burden among women of reproductive age, although dietary iron deficiency remained the largest contributor to anaemia for this group.

For children under five years, the main cause was also dietary iron deficiency. However, in youngsters, hemoglobinopathies, other infectious diseases, HIV/AIDS, and malaria were also important contributors in geographic locations where these diseases are prevalent.

Previous studies have shown that anaemia is associated with increased rates of anxiety and depression and higher rates of preterm labour, postpartum haemorrhage, low birthweight, short gestation, stillbirth, and infections for both child and mother.

Regional variation in disease distribution was also reflected in cause-specific anaemia burden. For example, HIV/AIDS was the second largest contributor to years lost to disability (YLDs) for anaemia in Southern sub-Saharan Africa. Anaemia due to malaria was most prominent in the Central, Eastern, and Western sub-Saharan Africa regions.


GBD 2021 Anaemia Collaborators (2023) “Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021.” Lancet Haematology, doi: 10.1016/52352-3026(23)00160-6

Link: https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(23)00160-6/fulltext

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