Women and children progressed slower than adult men: Lancet study on global anaemia burden

New Delhi: Compared to men, twice as many women were found to have anaemia in 2021, with the prevalence factor being more than three times during their reproductive age, new research published in The Lancet Haematology said.

Anaemia affected nearly 2 billion people in 2021, the study covering three decades of global anaemia data (1990–2021) said. Regionally, Western sub-Saharan Africa (47.4 per cent), South Asia (35.7 per cent), and Central sub-Saharan Africa (35.7 per cent) revealed the highest anaemia prevalence.

Further, women and children showed much slower rates of progress relative to men, the study conducted by the Institute for Health Metrics and Evaluation (IHME), US, and its Global Burden of Disease anaemia collaborators said.

"We know the global picture around anaemia has improved, but there are still wide disparities when you narrow the focus on geography, gender, and age," said Nick Kassebaum, senior author of the study.

Globally, in 2021, 31.2 per cent of women had anaemia compared with 17.5 per cent of men.

Comparing men and women in their reproductive ages, anaemia prevalence in women was 33.7 per cent versus 11.3 per cent in men.

The researchers modelled 37 underlying causes for anaemia, which they said were important for clinicians to treat in parallel to the anaemia itself.

"We hope they use these data to design more comprehensive intervention and treatment plans, especially for the most vulnerable - women of reproductive age, children, and the elderly," said Kassebaum.

That adult men fared better than women (aged 15–49) and children younger than 5 years presented a "nuanced situation that revolves around access to nutrition, socioeconomic status, unmet need for contraception, and the ability to identify and treat underlying causes of anaemia," said Will Gardner, IHME researcher and lead author of the paper.

Dietary iron deficiency was revealed to be the leading cause of anaemia in 2021, accounting for 66.2 per cent of the total cases. However, the study said, many other conditions are major drivers of anaemia along with an inadequate intake of iron.

Among women of reproductive age, gynaecological disorders and maternal hemorrhage were important contributors to anaemia burden.

"For many young women and girls, there's an education gap about blood loss during menstruation, inadequate options for effectively managing menstrual problems in those who have them, and not enough knowledge about how to manage and/or reverse anaemia when it occurs," said Theresa McHugh, scientific writer at IHME.

Previous studies have shown anaemia to be associated with increased rates of anxiety and depression and higher rates of preterm labour, postpartum hemorrhage, low birthweight, short gestation, stillbirth, and infections for both the child and the mother.

For children younger than 5 years, the main cause of anaemia was dietary iron deficiency, but hemoglobinopathies (presence of abnormal blood proteins), other infectious diseases, HIV/AIDS, and malaria were also important contributors in geographic locations where these diseases are prevalent.

"This (study) speaks to the need for a shift to multisectoral approaches and improved cultural awareness to make sure women and children are not left behind," said Gardner.