A prevalence survey of iron deficiency and iron deficiency anaemia in pregnant and lactating women, adult males and pre-school children in Zimbabwe

P L Sikosana, S Bhebhe, S Katuli
Central African Journal of Medicine 1998, 44 (12): 297-305

OBJECTIVE: To determine the prevalence of iron deficiency and iron deficiency anaemia (IDA) in selected population groups in Zimbabwe.

DESIGN: The study was a cross sectional, household prevalence survey. A structured questionnaire was used to interview study participants to elicit information on risk factors associated with iron status and IDA. Blood samples were collected for quantitative measurement of ferritin in serum and haemoglobin estimation as part of a full blood count.

SETTING: The study was conducted in four administrative provinces of the country, Mashonaland Central, Midlands, Matebeleland South and Matebeleland North covering three of the five agro-ecological regions of the country. Thirty clusters were randomly selected from 28 enumeration districts.

SUBJECTS: The multistage sampling technique was applied. The total sample consisted of 3,151 study participants made up of 746 pregnant women, 800 lactating women, 811 adult males and 799 pre-school children. Up to 202 results could not be used in the analysis.

MAIN OUTCOME MEASURES: R Stoltzfus, emphasizes that haemoglobin concentration is the key indicator for IDA surveillance. Serum ferritin levels measured against 10 ng/dl for females and 15 ng/dl for males as standards below which there is IDA. Serum ferritin levels of over 300 ng/dl above which there is iron overload. Haemoglobin levels were based on the World Health Organisation standards of 11 g/dl below which pregnant women and preschool children were considered to have IDA, 13 g/dl for adult males and 12 g/dl for lactating women. The proportion of individual households with protected water supplies, sanitation and levels of education as they influence the prevalence of IDA. Dietary habits with regards their influence on iron availability.

RESULTS: The overall prevalence of IDA was 24.1% of the total study sample. Of the preschool children surveyed 17.7% had IDA, 33.0% of pregnant women, 29.6% of lactating women and 16.5% of adult males had IDA. Of the population 9.1% surveyed had evidence of iron depletion on the basis of serum ferritin levels. More of the pregnant women had iron depletion, 14.8%, compared to adult males with 2.2%. Individuals in regions IV and V were much more affected by iron depletion and IDA than their counterparts in regions II and III in this study.

CONCLUSION: Iron deficiency anaemia (IDA) is a problem of public health significance in Zimbabwe and is associated with areas of food insecurity. From a policy perspective the prevention and control of IDA should be a priority on national nutrition and health agenda.

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