Abstract
Nearly half of women of reproductive age (WRA) in Cambodia are anemic. To guide interventions, national data on nutritional causes of anemia, including iron deficiency and vitamin A deficiency, are needed. In 2012, a national household survey in WRA on antibodies to routine vaccine-preventable disease immunity was performed. We used serum samples from this survey to estimate the prevalence of iron and vitamin A deficiency in 2112 Cambodian WRA, aged 15 to 39 years. Iron deficiency was classified as low or marginal iron stores (ferritin concentrations corrected for inflammation <15 μg/L and <50 μg/L respectively; Fer), iron deficient erythropoiesis (soluble transferrin receptor concentrations >8.3 mg/L; sTfR), or low total body iron (TBI) derived from Fer and sTfR concentrations (<0 mg/kg). Vitamin A status was classified using retinol binding protein (RBP) concentrations corrected for inflammation as deficient (<0.70 μmol/L) or marginal (<1.05 μmol/L. Overall, the prevalence of low iron stores, low TBI and iron deficient erythropoiesis was 8.1%, 5.0% and 9.3% respectively. Almost 40% of the women had marginal iron stores. Iron status was better in women living in urban areas compared to rural areas (p < 0.05 for TBI and sTfR). The prevalence of vitamin A deficiency was <1%. These findings suggest that the contribution of iron and vitamin A deficiency to the high prevalence of anemia in Cambodian WRA may be limited. The etiology of anemia in Cambodia needs to be elucidated further to guide current policies on anemia.
Highlights
Iron deficiency is considered to be the most prevalent micronutrient deficiency worldwide, with over 2 billion people affected [1]
In certain populations, malaria and inflammation could be more important etiologies of anemia than iron deficiency [7]. Other micronutrient deficiencies, such as vitamin A, folic acid or vitamin B12 deficiency could lead to anemia [8,9]
Of the women lived in rural areas (Table 1)
Summary
Iron deficiency is considered to be the most prevalent micronutrient deficiency worldwide, with over 2 billion people affected [1]. Anemia can result from different etiologies, both nutritional and non-nutritional, iron deficiency is the leading cause globally [2]. Even without anemia, affects cognitive function and neurodevelopment of infants and children [3,4,5] and iron deficiency anemia in women has been. In certain populations, malaria and inflammation could be more important etiologies of anemia than iron deficiency [7]. Other micronutrient deficiencies, such as vitamin A, folic acid or vitamin B12 deficiency could lead to anemia [8,9]. Populations in Africa and Southeast Asia where hemoglobinopathies (e.g., thalassemia) are relatively common [10]
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