Prevalence of Iron Deficiency and Iron Deficiency Anemia in the Northern and Southern Provinces of Rwanda

• Published in: Food and nutrition bulletin Vol. 38; no. 4; pp. 554 - 563
• Main Authors: Donahue Angel, Moira, Berti, Peter, Siekmans, Kendra, Tugirimana, Pierrot Lundimu, Boy, Erick
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-12-2017; SAGE
• Subjects: Adult; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - epidemiology; Anemia, Iron-Deficiency - etiology; Child, Preschool; Cluster Analysis; Cross-Sectional Studies; Family Characteristics; Female; Ferritins - blood; Humans; Infant; Male; Nutritional Requirements; Original; Prevalence; Rwanda - epidemiology; Surveys and Questionnaires; prevalence; iron deficiency; anemia; Rwanda
• ISSN: 0379-5721; 1564-8265
• DOI: 10.1177/0379572117723134

Background:
Anemia remains a public health problem in Rwanda, affecting 38% of young children and 17% of reproductive-aged women (Demographic and Health Survey [DHS] 2010). The importance of iron deficiency (ID) as a cause of anemia in Rwanda is not known.
Objective:
We aimed to estimate the prevalence of ID and iron deficiency anemia (IDA) among young children and women in 2 provinces of Rwanda.
Methods:
We conducted a cluster randomized survey, selecting 408 rural households each in the Northern and Southern Provinces of Rwanda in 2010. Anemia was defined as hemoglobin <110 g/L in children and <120 g/L in nonpregnant women after correction for altitude. We defined ID as (1) serum transferrin receptor (TfR) >8.3 mg/L or (2) serum ferritin (SF) <12 μg/L in children and <15 μg/L in nonpregnant women after correction for inflammation.
Results:
The prevalence of anemia was 30.9% (95% confidence interval [CI], 26.4-35.8) in children (n = 577) and 11.2% (95% CI, 8.4-14.7) in women (n = 595). The prevalence of ID in children was 3.1% (95% CI, 1.8-5.1) as defined by high TfR and 5.9% (95% CI, 4.0-8.4) as defined by low SF. Similarly, 3.0% (95% CI, 1.8-4.8) of women had high TfR and 4.8% (95% CI, 3.2-7.2) had low SF. The prevalence of IDA (low SF with concurrent anemia) ranged from 1.4% (95% CI, 0.5-3.6) among women in the North to 5.6% (95% CI, 3.1-10.0) among children in the South.
Conclusions:
ID is likely not an important contributor to anemia in the Northern and Southern Provinces of Rwanda. This finding warrants further investigation into other causes of anemia.