Scoping into Non Iron Deficiency Anemia: Reflection from the Rural India

Abstract

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.