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Anaemia in Bangladesh: a review of prevalence and aetiology

Published online by Cambridge University Press:  02 January 2007

Faruk Ahmed
Faruk Ahmed*
Affiliation:
Institute of Nutrition and Food Science, University of Dhaka, Dhaka-1000, Bangladesh
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

This paper provides a comprehensive review of the changes in the prevalence and the extent of anaemia among different population groups in Bangladesh up to the present time. The report also focuses on various factors in the aetiology of anaemia in the country.

Design and setting

All the available data have been examined in detail, including data from national nutrition surveys, as well as small studies in different population groups.

Results

Over the past three decades a number of studies including four national nutrition surveys (1962/64; 1975/76; 1981/82 and 1995/96) have been carried out to investigate the prevalence of anaemia among different population groups in Bangladesh, and have demonstrated a significant public health problem. Since the 1975/76 survey the average national prevalence of anaemia has not fallen; in 1995/96, 74% were anaemic (64% in urban areas and 77% in rural areas). However, age-specific comparisons suggest that the rates have fallen in most groups except adult men: in preschool children in rural areas it has decreased by about 30%, but the current level (53%) still falls within internationally agreed high risk levels. Among the rural population, the prevalence of anaemia is 43% in adolescent girls, 45% in non-pregnant women and 49% in pregnant women. The rates in the urban population are slightly lower compared with rural areas, but are high enough to pose a considerable problem. It appears that severe anaemia in the Bangladeshi population is less frequent, possibly present among only 2–3% of the population. The data on the aetiology of anaemia reveal that iron deficiency may be a substantial cause of anaemia in the Bangladeshi population. Other dietary factors in addition to parasitic infestations may also precipitate the high prevalence of anaemia.

Conclusions

While the overall prevalence of anaemia among the Bangladeshi population is still very high, the rates of severe anaemia are almost non-existent. A large proportion of anaemia can be attributed to iron deficiency. There is a need for a comprehensive strategy for the prevention and control of anaemia in Bangladesh.

Keywords

AnaemiaIron statusBangladeshAetiologyPrevalence
Type
Research Article
Information
Public Health Nutrition , Volume 3 , Issue 4 , December 2000 , pp. 385 - 393
Copyright
Copyright © CABI Publishing 2000

References

1WHO/UNICEF/UNU. Indicators and Strategies for Iron Deficiency and Anaemia Programmes. Report of Consultation, Geneva, 6–10 December 1993. Geneva: WHO, 1997.Google Scholar
2FAO/WHO. Theme paper no. 6. In: International Conference on Nutrition: Major Issues for Nutrition Strategies. Geneva: WHO, 1992; 12.Google Scholar
3Hallberg, L. Iron. In: JS, Garrow, WPT, James, eds. Human Nutrition and Dietetics. London: Churchill Livingstone, 1993; 174–207.Google Scholar
4FAO/WHO Expert Consultation. Requirements of Vitamin A, Iron, Folate and Vitamin B 12. Rome: FAO, 1990.Google Scholar
5Stoltzfus, RJ, Chwaya, HM, Tielsch, JM, Schulze, KJ, Albonico, MSavioli, L.Epidemiology of iron deficiency anaemia in Zanzibari schoolchildren: the importance of hookworms. Am. J. Clin. Nutr. 1997; 65: 153–9.CrossRefGoogle ScholarPubMed
6Hershko, C, Peto, TEAWeatheral, DJ. Regular review. Iron and infection. BMJ 1988; 296, 660–4.CrossRefGoogle Scholar
7Mejia, LA. Role of vitamin A in iron deficiency anemia. In: Fomon, SJ, Zlotkin, S, eds. Nutritional Anemias. Nestle Nutrition Workshop Series, Vol. 30. Vevey, Switzerland: Nestle Ltd/New York: Raven Press, 1992, 93–101.Google Scholar
8INACG. Action strategy for combating iron deficiency anaemia, a summary of the XII INACG Meeting. Washington, DC: International Nutritional Anaemia Consultative Group, 1990.Google Scholar
9Viteri, FE. The consequences of iron deficiency and anaemia in pregnancy on maternal health, the foetus and the infants. SCN News 1994; 11: 14–18.Google Scholar
10WHO. In Control of Nutritional Anaemia with Special to Iron Deficiency. Technical Report Series No. 580. Geneva: WHO, 1975; 6.Google Scholar
11MOHFW. Bangladesh Country Paper on Nutrition. Dhaka: Ministry of Health and Family Welfare, Government of Bangladesh, 1995.Google Scholar
12Barker, DJP. Mothers, Babies and Disease in Later Life. London: BMJ Publishing House, 1994.Google Scholar
13Edgerton, VR, Gardner, GW, Ohira, Y, Gunawardena, KA, Senewiratne, B.Iron deficiency anaemia and its effect on work productivity and activity patterns. BMJ 1979; 2: 1546–9.CrossRefGoogle ScholarPubMed
14Pollitt, E, Saco-Pollitt, C, Leibell, RL, Viteri, FE. Iron deficiency and behavioral development in infants and preschool children. Am. J. Clin. Nutr. 1986; 43: 555–65.CrossRefGoogle ScholarPubMed
15Ross, J, Horton, S. Economic Consequences of Iron Deficiency. Ottawa, Canada: Micronutrient Initiative, 1998.Google Scholar
16DeMaeyer, EM, Adiels-Tegman, M.The prevalence of anaemia in the world. World Health Stat. Q. 1985; 38(3): 302–16Google ScholarPubMed
17US-DEHW. Nutrition Survey of East Pakistan, March 1962–January 1964. Dhaka: United States Department of Education, Health and Welfare, Public Health Service, 1966.Google Scholar
18INFS. Nutrition Survey of Rural Bangladesh, 1975–76. Dhaka, Bangladesh: Institute of Nutrition and Food Science, University of Dhaka, 1977.Google Scholar
19INFS. Nutrition Survey of Rural Bangladesh, 1981–82. Dhaka, Bangladesh: Institute of Nutrition and Food Science, University of Dhaka, 1983.Google Scholar
20Jahan, K, Hossain, M. Nature and Extent of Malnutrition in Bangladesh. Bangladesh National Nutrition Survey, 1995–96. Dhaka, Bangladesh: Institute of Nutrition and Food Science, University of Dhaka, 1998.Google Scholar
21HKI/IPHN. Iron Deficiency Anaemia Throughout the Lifecycle in Rural Bangladesh. National Vitamin A Survey, 1997–98. Dhaka, Bangladesh: Helen Keller International/Institute of Public Health Nutrition, 1999.Google Scholar
22Saha, A, Ahmad, K.Anaemia in two rural Bangladesh communities, with and without the supply of safe drinking water. Bangladesh J. Nutr. 1991; 4(1): 1–8.Google Scholar
23Rahman, M, Islam, S. Iron deficiency anaemia of children. In: Seventh Bangladesh Nutrition Conference, Dhaka. Dhaka: Nutrition Society of Bangladesh, 1997; 14 (abstract).Google Scholar
24Sultana, W. Nutritional status and dietary pattern of under-5 children of Dhaka University employees belonging to low socio-economic status. MSc. thesis, University of Dhaka, Dhaka, Bangladesh, 1995.Google Scholar
25Nahar, L, Barua, S, Firoz, G, Hossain, A.Nutritional anaemia amongst underprivileged urban children – a study in a mother and child health centre in Dhaka city. Bangladesh J. Nutr. 1995; 8: 21–7.Google Scholar
26Salamatullah, Q, Yusuf, HKM. Report of the iodine deficiency disorders indicator study in Savar, Bangladesh. Dhaka, Bangladesh: University of Dhaka, 1997.Google Scholar
27Hyder, SMZ, Chowdhury, SA, Chowdhury, AMR. Anaemia among apparently healthy males and females. In: Prevalence of Anaemia and Intestinal Parasites in a Rural Community of Bangladesh. Research Monograph Series No. 12. Dhaka, Bangladesh: Bangladesh Rural Advancement Committee, 1998; 1–11.Google Scholar
28Veveka, P, Ahmed, F, Gebre-Medhin, M, Greiner, T.Relationships between vitamin A, iron status, and helminthiasis in Bangladeshi school children. Public Health Nutr. 2000 3(1): 83–9.Google Scholar
29Ahmed, F, Khan, MR, Mohiduzzaman, M, Shaheen, N, Barua, S, Bhuyan, MAH. Relationship between growth and nutrient status in school children of urban Bangladesh. In: Said, HM, Rahman, MA, Abdulla, M, Vohora, SB, Athar, M, eds. Elements and Liver: Proceedings of the International Symposium on Trace Elements and Liver Diseases. Karachi, Pakistan: Hamdard Foundation, 1996; 26–33.Google Scholar
30Ahmed, F, Khan, MR, Karim, R et al. , Serum retinol and biochemical measures of iron status in adolescent schoolgirls in urban Bangladesh. Eur. J. Clin. Nutr. 1996; 50: 346–51.Google ScholarPubMed
31Sultana, N, Khan, MR, Ahmed, F. Nutritional status and dietary pattern of adolescent school girls in a rural area. In: Seventh Bangladesh Nutrition Conference, Dhaka. Dhaka: Nutrition Society of Bangladesh, 1997; 58. (abstract).Google Scholar
32Ahmed, F, Khan, MR, Islam, M, Kabir, I, Fuch, G.Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh. Eur. J. Clin. Nutr. 2000; 54.Google ScholarPubMed
33Huq, SF. Nutritional profile and prevalence of anaemia in female garment workers. MSc. thesis, University of Dhaka, Dhaka, Bangladesh, 1994.Google Scholar
34Ahmed, F, Hasan, N, Kabir, Y.Vitamin A deficiency among adolescent female garment factory workers in Bangladesh. Eur. J. Clin. Nutr. 1997; 51: 698–702CrossRefGoogle ScholarPubMed
35Huffman, SL, Wolff, M, Lowell, S.Nutrition and fertility in Bangladesh: nutritional status of nonpregnant women. Am. J. Clin. Nutr. 1985; 42: 725–38.CrossRefGoogle ScholarPubMed
36Osendarp, S, Wahid, MA, Baqui, AH, Determinants of haemoglobin level during pregnancy and relationship with pregnancy outcome in Bangladeshi urban poor. In: Khan, MSI, Rahim, MA, eds. Seventh Annual Scientific ConferenceBangladeshInternational Center for Diarrhoeal Disease Research 1998; 72 (abstract).Google Scholar
37Hyder, SMZ, Chowdhury, SA, Chowdhury, AMR. Anaemia in pregnancy. In: Prevalence of Anaemia and Intestinal Parasites in a Rural Community of Bangladesh. Research Monograph Series No. 12. Dhaka, Bangladesh: Bangladesh Rural Advancement Committee, 1998; 12–20.Google Scholar
38Ahmed, FU, Das, AM, Mostafa, MG, Begum, S, Haque, YA. The Distribution of Birth Weight in an Urban Maternity Centre of Bangladesh. Dhaka: UNICEF, 1992.Google Scholar
39Quazi, S, Nahar, B, Rahman, MM, Sayeed, S.Blood haemoglobin, total protein and albumin levels at different stages of gestation. Bangladesh J. Nutr. 1993; 6: 23–9.Google Scholar
40Hasin, A, Begum, R, Khan, MR, Ahmed, F.Relationship between birth weight and biochemical measures of maternal nutritional status at delivery in Bangladeshi urban poors. Int. J. Food Sci. Nutr. 1996; 47: 273–9.CrossRefGoogle ScholarPubMed
41Sultana, A. Prevalence of anaemia in pregnancy in poor urban women. MSc. thesis, University of Dhaka, Dhaka, 1999.Google Scholar
42Gopalan, C, Ramasastri, BV, Balasubramanian, SC, Rao, BSN, Deosthale, YG, Pant, KC. Nutritive Value of Indian Foods. Hyderabad, India: Indian Council of Medical Research, 1993.Google Scholar
43Ahmed, F, Zareen, M, Khan, MR, Banu, CP, Haq, NJackson, AA. Dietary pattern, nutrient intake and growth of adolescent school girls in urban Bangladesh. Public Health Nutr. 1998; 1(2): 83–92.CrossRefGoogle ScholarPubMed
44Akhter, S, Pramanik, MMA, Ali, SMK. Nutritional status of girls (aged 17–24 years) residents of a college hostel. In: Seventh Bangladesh Nutrition Conference, Dhaka. Dhaka: Nutrition Society of Bangladesh, 1997; 42 (abstract).Google Scholar
45Sarker, BR, Abdullah, M, Sarker, SK. Dietary intake pattern among Bangladesh female workers in garment factories and their health problem. Bangladesh J. Nutr. 1993; 6: 73–8.Google Scholar
46Sultana, S, Nahar, B, Quazi, S.Dietary intake of micronutrients in normal state and during pregnancy. Bangladesh J. Nutr. 1990; 4, 19–25.Google Scholar
47Husain, N. Nutritional status of non-resident students of Dhaka University with special emphasis on trace elements. MSc. thesis, University of Dhaka, Dhaka, Bangladesh, 1996.Google Scholar
48Ahmed, F, Khandaker, MAI. Dietary pattern and nutritional status of Bangladeshi manual workers (rickshaw pullers). Int. J. Food Sci. Nutr. 1997; 48: 285–91.CrossRefGoogle Scholar
49Ahmed, F, Khan, MR, Jackson, AA. Weekly supplementation with iron/folate and vitamin A interact to improve anemia, iron status and vitamin A status in anemic teenage women in urban Bangladesh. Am. J. Clin. Nutr. 2000 (in press).Google Scholar
50Kolsteren, P, Rahman, SR, Hilderbrand, K, Diniz, A.Treatment for iron deficiency anaemia with a combined supplementation of iron, vitamin A and zinc in women of Dinajpur, Bangladesh. Eur. J. Clin. Nutr. 1999; 53: 102–6.CrossRefGoogle ScholarPubMed
51Martin, J, Keymer, A, Isherwood, R, Wainwright, S.The prevalence and intensity of Ascaris lumbricoides infections in moslem children from northern Bangladesh. Trans. R. Soc. Trop. Med. Hyg. 1983; 77: 702–6.CrossRefGoogle ScholarPubMed
52Hall, A, Anwar, KS, Tomkins, AM. Intensity of reinfection with Ascaris lumbricoides and its implications for parasite control. Lancet 1992; 330: 1253–7.CrossRefGoogle Scholar
53Hussain, MM. Aetiology of Anaemia in Bangladesh. MPhil. thesis, Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh, 1996.Google Scholar
54ACC/SCN. Controlling Iron Deficiency. Administrative Committee on Coordination/Subcommittee on Nutrition State-of-the-Art Series Nutrition Policy Discussion Paper No. 9. Geneva: United Nations, 1991.Google Scholar