The most common anemia globally is Iron deficiency anemia (IDA). Estimated by World Health Organization (WHO), 25% of the world’s population are anemic, and about half of them suffer from IDA.

WHO describes anemia in an inhabitants as a mild, moderate, or severe public health problem, if its prevalence is 5-20%, 20–40%, or >40%, respectively. Maximum of the WHO countries have moderate-to-severe public health problem with anemia, i.e., over 20% of women and young children are affected. In emerging countries, diets with poor iron bioavailability are the main cause of IDA.

Maternal anemia in resource-poor nations is related with low birth weight, improved perinatal mortality, and decreased work productivity. Sustaining a normal iron balance in these settings is stimulating, as iron-rich foods with good bioavailability are of animal origin and either expensive and/or available in short supply.

Apart from uncommon intake of meat, insufficient vitamin C intake, and diets rich in inhibitors of iron absorption are added important risk factors for IDA in low-income countries. In-home iron protection of balancing foods with micronutrient powders has been shown to successfully reduce the risk of iron deficiency and IDA in infants and young children in emerging countries but is related with adverse changes in gut flora and introduction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only recurrent micronutrient deficiency. In the developed world, IDA is more common in infants further than the sixth month of life, in young females with heavy menstrual bleeding and in women of reproductive age and older people. Regular blood donors, endurance athletes, and vegetarians are other special at-risk populations for IDA in developed countries. Several medicinal ferrous or ferric oral iron products exist, and their use is not related with destructive effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. Though, further research is needed to explain the risks and benefits of supplemental iron for children exposed to parasitic infections in low-income countries, and for children hereditarily predisposed to iron overload.

Methods to prevent iron deficiency in industrialised countries must aim at particular population at risk, as methods to increase iron intake in the general population may be insecure for people affected with iron overload. In a setting with restricted resources, supplementary research is needed to explain the physiological procedures and appliances underlying the risks and profits of supplemental iron for children exposed to parasitic infections, like malaria. In low-income countries, iron deficiency should not be addressed alone, but insufficiencies of other micronutrients and hematinic factors, infections, and lead poisoning should be determined, too, and it will need measures to recover social and economic policies that fight poverty.

In conclusion, physicians of numerous specialties treating patients with iron deficiency and IDA of varied etiologies should acquaint themselves with the different causes of IDA and the several accessible therapeutic oral and parenteral iron products in order to well serve their patients.

Source: Mediterr J Hematol Infect Dis. 2020;12(1):e2020041. Published 2020 Jul 1. doi:10.4084/MJHID.2020.041