Skip to main content

It is important to recognize the relationships among nutritional and non-nutritional causes of anemia; each may affect and be affected by the other. For example, an individual may have acute inflammation due to an illness, and the elevated hepcidin caused by the inflammation could lead to functional iron deficiency. Inflammation would also interfere with iron absorption, so supplementation/fortification would be most effective after resolution of the inflammation.

In 2010, four of the five most common causes of anemia were non-nutritional: hookworm disease, sickle cell disorders, thalassemias, and malaria. Public health practitioners increasingly recognize that the proportion of anemia attributable to iron deficiency within populations may not be as large as previously assumed. Nevertheless, the Global Burden of Disease identified iron deficiency as the leading cause of anemia. Therefore, the toolkit emphasizes assessment of inherited blood disorders, infections, and iron status to understand the ecology of anemia. Figure 1 provides a framework for assessing etiologies of anemia in populations and highlights several core concepts.

Figure 1. Decision Tree to Inform What Information on the Underlying Causes of Anemia to Consider Including in Population-Based Surveys

1. Review Anemia situation 2. Is data available to estimate the proportion of Anemia that is iron deficiency anemia? 3. Is data available to contextualize IDA data? 4. Is data available to estimate the proportion of anemia due to blood loss? 5. Is data available to characterize non-iron?

We found 43 resource(s)

Exploring the Anemia Ecology PART II: Application of the Ecological Approach to Anemia Assessment—Experiences from the Field Webinar
Webinar published by USAID Advancing Nutrition in
The USAID Advancing Nutrition Anemia Task Force (ATF) was created to develop a new approach to address the global challenge presented by anemia. Recognizing that anemia is a multi-dimensional condition affected by both internal (biological, genetics, health/infections, and nutrition) and external (socio-demographic, behavioral, food systems, and…
A Cross-Sectional Study of the Associations between Biomarkers of Vitamin D, Iron Status, and Hemoglobin in South African Women of Reproductive Age: the Healthy Life Trajectories Initiative, South Africa
Journal Article published by Curr Dev Nutr in
This study aimed to assess the associations between serum vitamin D and biomarkers of iron and anemia in a cohort of women of reproductive age from Soweto, South Africa, within a cross-sectional substudy of the Healthy Life Trajectories Initiative South Africa pilot trial.
The Prevalence of Anemia in Children Aged 6–23 Months and Its Correlates Differ by District in Kapilvastu and Achham Districts in Nepal
Journal Article published by Curr Dev Nutr in
This study analyses the predictors of anemia in young Nepali children aged 6–23 months in two districts of Nepal: Kapilvastu and Achham.
Spatial Variation and Attributable Risk Factors of Anaemia Among Young Children in Uganda: Evidence from a Nationally Representative Survey
Journal Article published by PLOS Glob Public Health in
This study describes the spatial variation and attributable risk factors of anemia at the national level in Uganda among children aged 6–59 months, using data from the 2016 Uganda Demographic and Health Survey.
Comparison of Current World Health Organization Guidelines with Physiologically Based Serum Ferritin Thresholds for Iron Deficiency in Healthy Young Children and Nonpregnant Women Using Data from the Third National Health and Nutrition Examination Survey
Journal Article published by Journal of Nutrition in
This study uses data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) to examine the relationships of serum ferritin with hemoglobin and erythrocyte zinc protoporphyrin to identifying the onset of iron-deficient erythropoiesis.
Integrating and Coordinating Programs for the Management of Anemia Across the Life Course
Literature Review published by Ann N Y Acad Sci in
This narrative review describes the determinants of anemia and outlines opportunities for comprehensive anemia programming, systems strengthening, and implementation research approaches for preschool children, adolescent girls, and pregnant and nonpregnant women of reproductive age
Accelerating Action to Reduce Anemia: Review of Causes and Risk Factors and Related Data Needs
Literature Review published by Ann N Y Acad Sci in
This narrative review describes the causes and risk factors, and related data needs for reducing anemia for different population subgroups within a country and presents principles for the design and implementation of effective strategies to prevent and treat anemia.
Factors Associated with Anaemia in a Nationally Representative Sample of Nonpregnant Women of Reproductive Age in Nepal
Journal Article published by Maternal & Child Nutrition in
This secondary analysis of cross-sectional data from the 2016 Nepal National Micronutrient Status Survey evaluates the factors associated with anemia, derived from altitude- and smoking-adjusted hemoglobin concentration values, among nationally representative sample of nonpregnant women 15– 49 years.