Anemia as a Public Health Issue in Mashhad, Iran: Evidence from the First Population-Based Study
Anemia is one of the main conditions that impose an adverse impact on the socioeconomic state of any country; however, evidence on the prevalence of anemia is scant in Northeastern Iran. This study was conducted to determine the overall and age- and sex-specific prevalence of anemia in the city of Mashhad, Iran. In a cross-sectional, population-based survey, 1675 individuals aged 1-90 years (29.1±18.5 years) were selected from approximately 2.4 million residents by a multistage cluster sampling method during May to September 2009. Blood samples were evaluated to determine erythrocyte indices and anemia was defined according to hemoglobin (Hb) levels based on World Health Organization (WHO) guidelines. The prevalence of anemia was 9.7% with considerable difference between both sexes; 6.2% and 12.7% in males and females, respectively (P<0.001). The higher prevalence of anemia was detected in females of 15-54 and ≥ 65 years old (16% and 12.5%, respectively). However, the higher rates were observed in males 65 years and older as well as boys below 5 years old (16.3% and 14.6%, respectively). Current findings show that anemia is a considerable public health problem in the population of Mashhad, Iran, especially among the pre-school children, adult women and the elderly. Great attention should be paid to the pre-school boys who are more affected by anemia than what was previously assumed.
McLean E, Cogswell M, Egli I, et al. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr 2008;12(4):444-54.
Sharman A, editor. Anemia testing in population-based surveys: General information and guidelines for country monitors and program managers. Calverton, Maryland, USA: ORC Macro 2000: p..
Ministry of Health and Medical Education, UNICEF. Multi Center Study on Iron Deficiency Anemia among 15 to 49 Year Old Women in the Islamic Republic of Iran. Tehran, Iran: Ministry of Health and Medical Education, 1995.
The database on Anaemia includes data by country on prevalence of anaemia and mean haemoglobin concentration. World Health Organization. (Accessed on August 2014, 12, at http://www.who.int/vmnis/anaemia/data/database/countries/ir n_ida.pdf.).
Keikhaei B, Zandian K, Ghasemi A, et al. Iron-deficiency anemia among children in southwest Iran. Food Nutr Bull 2007;28(4):406-11.
Akramipour R, Rezaei M, Rahimi Z. Prevalence of iron deficiency anemia among adolescent schoolgirls from Kermanshah, Western Iran. Hematology 2008;13(6):352-5.
Veghari GR, Mansourian AR, Marjani AJ. The Comparison of the Anemia in Pregnant and Non-Pregnant Women in the Villages of the South-East of Caspian Sea- Gorgan-Iran. J Med Sci 2007;7(2):303-6.
Kolahi S, Farzin H, Khoshbaten M. Hypochromic microcytic anemia in Northwestern of Tabriz, Iran. Eur J Gen Med 2008;5(3):178-80.
Fathimoghaddam F, Hedayati-Moghaddam MR, Bidkhori HR, et al. The prevalence of Hepatitis B antigen-positivity in the general population of Mashhad, Iran. Hepat Mon 2011;11(5):346-50.
Rafatpanah R, Hedayati-Moghaddam MR, Fathimoghadam F, et al. High prevalence of HTLV-I infection in Mashhad, Northeast Iran: A population-based seroepidemiology survey. J ClinVirol 2011;52(3):172-6.
DeMaeyer EM, Dallman P, Gurney JM, et al. Preventing and controlling iron deficiency anemia through primary health care. WHO. (Accessed on August 2014, 16, at http://www.who.int/nutrition/publications/micronutrients/a naemia_iron_deficiency/9241542497.pdf).
Yip R, Johnson C, Dallman PR. Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr 1984;39(3):427-36.
van Zeben D, Bieger R, van Wermeskerken RK, et al. Evaluation of microcytosis using serum ferritin and red blood cell distribution width. Eur J Haematol 1990;44(2):106-9.
Viswanath D, Hegde R, Murthy V, et al. Red cell distribution width in the diagnosis of iron deficiency anemia. Indian J Pediatr 2001;68(12):1117-9.
Aulakh R, Sohi I, Singh T, et al. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr 2009;76(3):265-8.
Das Gupta A, Hegde C, Mistri R. Red cell distribution width as a measure of severity of iron deficiency in iron deficiency anaemia. Indian J Med Res 1994;100:177-83.
Monzon CM, Beaver BD, Dillon TD. Evaluation of Erythrocyte Disorders With Mean Corpuscular Volume (MCV) and Red Cell Distribution Width (RDW). Clin Pediatr 1987;26(12):632-8.
Aslan D, Gümrük F, Gürgey A, et al. Importance of RDW value in differential diagnosis of hypochromeanemias. Am J Hematol 2002;69(1):31-3.
National nutrition survey 2001-02. Allama Iqbal University. (Accessed in August 2014, 18, at http://www.aiou.edu.pk/FoodSite/NationalNutritionSurvey ofPakistan2001-02.doc.
Report on the study of food fortification In Oman. Ministry of Health, Sultanate of Oman. (Accessed in August 2014, 18, at http://www.moh.gov.om/reports/FFFS_report_draft_October0 9.pdf).
Sayyari AA, Sheikhol-Eslam R, Abdollahi Z. Prevalence of anaemia in 2–12-year-old Iranian children. East Mediterr Health J 2006;12(6):804-8.
Kadivar MR, Yarmohammadi H, Mirahmadizadeh AR, et al. Prevalence of iron deficiency anemia in 6 months to 5 years old children in Fars, southern Iran. Med SciMonit 2003;9(2):CR100-4.
Domellöf M, Lönnerdal B, Dewey KG, et al. Sex differences in iron status during infancy. Pediatr 2002;110(3):545-52.
Morasso Mdel C, Molero J, Vinocur P, et al. Iron and vitamin A deficiencies and prevalence of anemia in boys and girls between 6 to 24 months of age in Chaco, Argentina. Arch Latinoam Nutr 2003;53(1):21-7.
Vendt N, Grünberg H, Leedo S, et al. Prevalence and causes of iron deficiency anemias in infants aged 9 to 12 months in Estonia. Medicina (Kaunas) 2007;43(12):947-52.
Wieringa FT, Berger J, Dijkhuizen MA, et al. Sex differences in prevalence of anaemia and iron deficiency in infancy in a large multi-country trial in South-East Asia. Br J Nutr 2007;98(5):1070-6.
Emond AM, Hawkins N, Pennock C, et al. Haemoglobin and ferritin concentrations in infants at 8 months of age. Arch Dis Child 1996;74(1):36-9.
Sherriff A, Emond A, Hawkins N, et al. Haemoglobin and ferritin concentrations in children aged 12 and 18 months. ALSPAC Children in Focus Study Team. Arch Dis Child 1999;80(2):153-7.
Yousefinejad V, Darvishi N, Arabzadeh M, et al. The evaluation of iron deficiency and anemia in male blood donors with other related factors. Asian J Transfus Sci 2010;4(2):123-7.
An investigation of under-nutrition in Iran year 1380 (2001). WHO. (Accessed in 2014, 17, at http://apps.who.int/nutrition/landscape/mddetails.aspx?sou rcecode=325379&template=nutrition).
Verster A, van der Pols JC. Anaemia in the Eastern Mediterranean Region. EastMediterr Health J 1995;1(1):64-79.
Kianfar H, Kimiagar M, Ghaffarpour M. Effect of daily and intermittent iron supplementation on iron status of high school girls. Int J Vitam Nutr Res 2000;70(4):172-7.
Sheikholeslam R, Abdollah iZ, Haghighi FN. Managing nutritional programmes in developing countries. East Mediterr Health J 2004;10(6):737-46.
Tettamanti M, Lucca U, Gandini F, et al. Prevalence, incidence and types of mild anemia in the elderly: the “Health and Anemia” population-based study. Haematologica 2010;95(11):1849-56.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.