Introduction: Anemia is one of the leading public health problems. India accounts for the highest prevalence of anemia in the world. Anemia programs in India focus on screening and management of anemia based on hemoglobin estimation, treatment is being given irrespective of status of iron as well as other micronutrient storage. The present study assesses the prevalence of anemia and iron deficiency (ID) based on low serum ferritin status among antenatal and postnatal women in Devbhoomi Dwarka District of Gujarat. Methods: A total of 258 pregnant (AN) and postnatal (PN) women drawn from 27 primary health centers were studied. Anemia was evaluated based on hemoglobin concentration obtained from venous whole blood, using auto-analyzer. Serum ferritin was used to evaluate iron status in the study. Serum ferritin was assessed using the direct chemiluminescence method using MINI VIDAS which is a compact automated immunoassay system based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results: Overall, Anemia (low Hb) and ID (low s. ferritin) was observed in 65.9% and 27.1% respectively. Out of anemic participants, about 38.2% reported ID while the remaining 61.8% had normal s. ferritin (i.e. non-iron deficient anemia). Anemia was reported 69.1% in AN women and 57.1% in PN women. The ID was reported higher (30.9%) in AN woman than PN women (17.1%). However, the prevalence of anemia, as well as IDA decreased from the first to the third trimester. Conclusion: Two out of every three women were anemic; one out of four were anemic with depleted iron storage. Importantly, two out of five women had anemia but iron storage was sufficient. Strategy to prevent and correct anemia must include screening for iron and non-iron deficiency anemia and follow appropriate treatment protocol for both types of anemia.
IntroductionAnemia is an important public health concern, affecting almost 25% of the global population. In India, these statistics are even more worrisome with more than half of the children, non-pregnant and pregnant women being affected by the disease. Though the major cause of anemia is iron deficiency, other causes cannot be neglected considering the magnitude of the problem. The present study was designed to estimate the prevalence of non-iron deficiency anemia (NIDA) in Devbhoomi Dwarka District of Gujarat. MethodsFor this cross-sectional study, total of 258 mothers (antenatal and postnatal) were enrolled from 27 primary health centers. Apart from demographic details and obstetric history, hemoglobin and ferritin levels were measured from the participant's blood after obtaining consent. Clinical information such as the history of recent illness and fever were also noted through questionnaires. Prevalence was anemia was calculated using a standard threshold of blood hemoglobin and NIDM was defined using ferritin levels. ResultsAs per hemoglobin levels, anemia was present in 65.9% of the mothers, which was relatively higher in antenatal women (90%) as compared to postnatal women (57%). Ferritin levels showed that out of this total anemic mothers, 61.8% (105/258) have normal ferritin levels indicating the presence of non-iron deficiency. Trimester-wise analysis of anemia in AN showed that NIDM prevalence increases with increasing trimester in contrast to IDA where a considerable reduction was found with iron supplementation. ConclusionThe study indicated that two out of every three women were anemic and only one out of four were anemic with depleted iron storage. These findings have important policy implications as in India the anemia control programs address only iron deficiency anemia and not NIDA. The development of a framework for diagnosis and appropriate treatment can be recommended for integration into national guidelines.
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