Infections of any type account for a large proportion of the total anemia burden, particularly in regions with a high anemia prevalence. Interactions between anemia and infection are complex and may be bidirectional.

Anemia may influence susceptibility to infection by modulating the host’s immune response and/or by limiting the iron supply. Iron deficiency anemia contributes to a suppressed immune response since iron is essential for the development and function of immune cells. Hemolytic anemia, a condition characterized by fragile red blood cells (RBCs), may also modulate responses to bacterial infections through dysfunction of immune system cells.

Infections strongly associated with anemia include parasitic infections such as malaria, hookworm, and schistosomiasis; viruses such as HIV; and bacterial infections such as tuberculosis and non-typhoidal Salmonellae. On the other hand, iron deficiency anemia can provide protection from certain infections, including malaria, as iron is a substrate for bacterial growth and a deficiency of iron impedes spread of the infection.

Inflammation is the body’s defense mechanism and is produced by a functioning immune system as a response to infections and diseases. The presence of Inflammation can have profound impact on the mechanism of absorption, utilization, and storage of nutrients and thus, can confound the interpretation of nutritional biomarkers when trying to assess nutritional status.

Research priorities regarding anemia and infection include measuring the effects of infection on the risk of developing anemia as well as the understanding of the proportion of anemia that occurs for limiting infections.