The iron status of a healthy South African adult population

Phatlhane, Dineo V.; Zemlin, Annalise E; Matsha, Tandi E.; Hoffmann, Monika; Naidoo, Nasheen; Ichihara, Kitoshi; Smit, Francois; Erasmus, Rajiv T

doi:10.1016/j.cca.2016.06.019

Cited by 29 publications

(30 citation statements)

References 23 publications

(18 reference statements)

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“…Iron stores/red blood cells can also be diminished during menstruation, during bouts of infections, and as a result of chronic non‐communicable diseases (NCDs) . Hence, the research done in Africa has shown that this condition is more prevalent/common among women of reproductive age, people who have limited access to basic needs (such as sanitation and treated water), and people exposed to infectious diseases and those at risk of NCDs …”

Section: Introductionmentioning

confidence: 99%

“…These factors include inflammation due to infectious diseases (tuberculosis (TB) and HIV/AIDS), chronic diseases (especially chronic kidney failure), and selected drug therapies . These studies showed that, in SA, anemia appeared to be more prevalent in certain segments of the population (i.e., black ethnic groups, communities that grapple with poverty, and those that have limited access to basic and health services), as well as in people who are overweight or obese …”

Section: Introductionmentioning

confidence: 99%

“…4 Hence, the research done in Africa has shown that this condition is more prevalent/common among women of reproductive age, people who have limited access to basic needs (such as sanitation and treated water), and people exposed to infectious diseases and those at risk of NCDs. [5][6][7][8][9][10][11] Until recently, there has been a dearth of up-to-date data regarding the existence and manifestation of iron deficiency in a nationally representative sample of South African women of reproductive age. The only available data were collected in 2000 (the South African Comparative Risk Assessment (SA CRA)) 12 (NFCS-FB-I)).…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] These studies showed that, in SA, anemia appeared to be more prevalent in certain segments of the population (i.e., black ethnic groups, communities that grapple with poverty, and those that have limited access to basic and health services), as well as in people who are overweight or obese. 10,21 The South African National Health and Nutrition Examination Survey (SANHANES-1) 22 was introduced in 2012 to act as the suggested surveillance survey to assess the health and nutritional status (i.e., the anthropometry and nutrient deficiencies) of South Africans across their life span with respect to the prevalence of NCDs (specifically focusing on cardiovascular disease, diabetes, and hypertension) and their risk factors (food security, diet, physical activity, alcohol and tobacco use, stress disorders, as well as access to health services). The current research then builds on the data obtained from SANHANES-1 and further explores the extent of Hb and iron status of South African women of childbearing age (15-35 years).…”

Section: Introductionmentioning

confidence: 99%

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Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Mchiza

Parker

Sewpaul

et al. 2018

Annals of the New York Academy of Sciences

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The study compared hemoglobin (Hb) and serum ferritin levels between adolescent and adult women with different body mass indices, dietary intake, and sociodemography. A secondary analysis of data for 3177 South African women ⩾15 years of age who participated in the SANHANES-1 study was undertaken. Abnormal Hb (≤12 g/dL) and serum ferritin (<15 μg/mL) were based on the World Health Organization's criteria for nonpregnant women aged ⩾15 years. Data were analyzed using STATA version 11. Overall, anemia was detected in 740 (23.3%) participants. Of the individuals in the subsample (n = 1123, 15-35 years) who had serum ferritin measured, 6.0% presented with iron depletion (ID) and 10.8% presented with iron-deficiency anemia (IDA). The highest prevalences of anemia, ID, and IDA were in 15- to 18-year-olds (11.2%, 8.8%, and 20.2%, respectively). Black young adults (19-24 years) were up to 40 times more likely to present with ID compared with their non-black counterparts. While overweight adolescents were three times more likely to be anemic, overweight and obese young adults, as well as obese older adults (25-35 years), were less likely to be anemic compared with normal-weight women of all age groups. Overconsumption of dietary fat increased ID by up to 54- and 11-fold (adolescents and 25- to 35-year-olds, respectively). In South Africa, anemia is most prevalent in adolescents and black women. Anemia is also an indicator of overconsumption of dietary fat and a marker of socioeconomic disadvantage.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Mchiza

Parker

Sewpaul

et al. 2018

Annals of the New York Academy of Sciences

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“…WPBTS started using quantitative finger prick Hb assessment exclusively in 2007 and implemented the higher Hb cutoff for male donors in 2011 (written communication, Greg Bellairs, June 2, 2017). A Cape Town study published in 2016 that assessed ID among healthy South Africans used a ferritin cutoff of 30 ng/dL . This resulted in 39.8% of participants being classified as iron deficient, with even higher rates among women (56.6%) and Black Africans (50.7%).…”

Section: Discussionmentioning

confidence: 99%

The iron status of South African blood donors: balancing donor safety and blood demand

Berg

Swanevelder

Ingram³

et al. 2018

Transfusion

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BACKGROUND: Several studies in developed countries have demonstrated high levels of iron deficiency (ID) among blood donors. There is a paucity of data for developing countries where blood shortages remain a major concern.STUDY DESIGN AND METHODS: A total of 4412 donors were enrolled in the study. Specimens were collected for full blood count, iron, transferrin saturation, and ferritin assessment. Donor demographics were recorded. ID was indicated by a ferritin level of less than 20 ng/mL for men and less than 12 ng/mL for women. Anemia was defined as hemoglobin levels less than 12.5 g/dL. Regression models for predictors of ID were developed. RESULTS:A total of 17.5% of all donors had ID, with 16.3% prevalence in women and 18.6% in men. Low hemoglobin had the highest association with ID (adjusted odds ratio [AOR], 11.078; 95% confidence interval [CI], 7.915-15.505); male donors had twice the odds of ID compared to female donors (AOR, 2.501; 95% CI, 1.964-3.185), while increasing age was associated with lower odds (AOD, 0.965; 95% CI, 0.956-0.975). Among male donors, an interdonation interval of less than 3 months (AOR, 2.679; 95% CI, 1.929-3.720) was associated with ID. Compared to other females combined, colored female donors (AOR, 2.335; 95% CI, 1.310-4.160) had higher odds and black female donors (AOR, 0.559; 95% CI, 0.369-0.845) lower odds of ID. CONCLUSION: ID is common among South African donors; low hemoglobin, gender, ethnicity, and past donation history is independently associated with ID. Recommendations aimed at protecting donor health may increase blood shortages in South Africa. ABBREVIATIONS: AOR = adjusted odds ratio; CHr = reticulocyte hemoglobin content; CI = confidence interval; ID = iron deficiency; IDA = iron-deficiency anemia; NHLS = National Health Laboratory Services; POC = point-of-care; SANBS = South African National Blood Service; TS = transferrin saturation; WPBTS = Western Province Blood Transfusion Service.From the * Ethnicity categories: white = 0 (reference), all others = 1. † ≤20 = 1, all others = 0 (reference). ‡ 21-30 = 1, all others = 0 (reference). § White = 1, all others = 0 (reference). ** Colored = 1, all others = 0 (reference). † † Black = 1, all others = 0 (reference). AIC = Akaike information criteria; BIC = Bayesian information criteria; CI = confidence interval; Hb = hemoglobin.

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Fractional anisotropy of white matter, disability and blood iron parameters in multiple sclerosis

et al. 2018

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In patients with high disability scores the mean FA was significantly lower (0.34 ± 0.067) than in the control group (0.45 ± 0.036; p = 0.04), while patients with low disability had mean FA values (0.44 ± 0.014) similar to controls (p = 0.5). Positive associations were found between FA and the iron parameters serum iron, ferritin and percentage transferrin saturation (%Tfsat) in all the white matter tracts. For % Tfsat, the associations were highly significant in 14 tracts (p < 0.01; r-values 0.74-0.84) and p < 0.001 (r = 0.83) in the superior fronto occipital fasciculus (LH). In the whole patient group a trend was found towards an inverse association between the EDSS and the %Tfsat (r = -0.26, p = 0.05) after excluding male gender and smoking as confounders, suggesting reduced disability in the presence of higher blood iron parameters. Additionally, significant inverse associations between disease duration and haemoglobin (p = 0.04) as well as %Tfsat (p = 0.02) suggested that patients with MS may experience a decrease in blood iron concentrations over time.

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The iron status of a healthy South African adult population

Cited by 29 publications

References 23 publications

Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

The iron status of South African blood donors: balancing donor safety and blood demand

Fractional anisotropy of white matter, disability and blood iron parameters in multiple sclerosis

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