New Delhi: A major fraction of cases of anaemia — commonly associated with iron deficiency — were linked to “other” causes, such as low vitamin B12 and air pollution, according to a study that analysed data from a community-level blood survey conducted in eight Indian states. The results, published in the European Journal of Clinical Nutrition, also showed that the prevalence of anaemia associated with iron deficiency was under a third of the overall prevalence.
Researchers, including those from the ‘Vitamin B12 India Study’ and Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN), Hyderabad, said that the findings suggested that as a cause of anaemia, iron deficiency did not appear to be predominant.
Therefore, “these results have policy implications for anaemia prevention and correction at the population level,” the authors wrote.
Anaemia, a blood disorder in which healthy red blood cells are insufficient or malfunction, is a public health problem and thought to be worsening, as trends in National Family Health Surveys (NFHS) have revealed, according to the authors.
They added that the National Family Health Survey (NFHS) surveys do not investigate the cause of anaemia, as they only measure finger prick-based capillary blood haemoglobin.
The team cited the 2019 Comprehensive National Nutrition Survey which analysed haemoglobin levels in blood samples of Indian children, taken from veins, and found a lower prevalence of anaemia.
However, iron deficiency is widely assumed to be the major cause of anaemia, driving the policy response to this problem, the authors said.
For this study, a total of 4,613 participants, including teenagers, adults and elderly, were recruited from states in northeast, central, east, south and west India.
“In this venous blood-based survey, the observed prevalence of anaemia for men and women was distinctly lower than that reported in the capillary blood-based NFHS-5 survey for the same states,” the authors wrote.
“In women, anaemia prevalence in the eight states that were surveyed here was 41.1 per cent in comparison with 60.8 per cent in the NFHS-5 for women aged between 15 and 49 years,” they wrote.
Similar trends were observed in teenage girls (44.3 per cent vs 62.6 per cent), teenage boys (24.3 per cent vs 31.8 per cent) and adult men (20.7 per cent vs 26 per cent).
Analysing venous blood for haemoglobin is likely why relatively lower anaemia prevalence was estimated in the study, instead of the capillary blood analysed in the NFHS-5, the authors said.
There is now an urgent need to determine the anaemia burden attributable to causes other than iron deficiency, and to examine precision in policy interventions for the prevention of anaemia, they said.
