Prevalence of Anaemia, Iron Deficiency, and Iron Deficiency Anaemia in Women of Reproductive Age and Children under 5 Years of Age in South Africa (1997-2021): A Systematic Review.

Eunice Turawa,Debbie Bradshaw,Demetre Labadarios,Victoria Pillay-Van Wyk,Muhammad Ali Dhansay,Annibale Cois,Oluwatoyin Awotiwon

doi:10.3390/ijerph182312799

Abstract

Using a systematic review method, the prevalence of anaemia, iron deficiency (ID), and iron deficiency anaemia (IDA) in women of reproductive age (WRA) and children under 5 years of age was obtained to inform priorities in health planning and policy in South Africa. We searched electronic databases for articles published between 1997 and 2021. A total of 713 articles were identified, of which 14 articles comprising 9649 WRA and 4085 children were included. Since most of the included studies were of low quality, we did not pool data in a meta-analysis due to heterogeneity (I2 > 75%). In WRA, anaemia prevalence ranged from 22.0% to 44.0%; ID from 7.7% and 19.0%; and IDA from 10.5% to 9.7%. The prevalence of anaemia in pregnancy was 29.0% to 42.7%; and 60.6% to 71.3% in HIV-infected pregnant women. Three national surveys reported anaemia in children at 28.9%, 10.7%, and 61.3%, respectively. Overall, among the children under 5 years old, anaemia was more prevalent in 1-year-olds (52.0%) compared to the other age groups. Between 2005 and 2012, ID increased by 3.8% and IDA decreased by 83.2% in children. Anaemia in WRA and children under 5 years in South Africa was a moderate public health concern. Therefore, interventions addressing anaemia should be intensified, and policies on iron supplementation and food fortification need to be revised and aligned to the WHO multiple micronutrient supplementation recommendations.

Highlights

This study systematically reviewed the available literature to determine the prevalence of anaemia, iron deficiency (ID), and iron deficiency anaemia (IDA) among women of reproductive age (WRA) (15–49 years), and children under 5 years of age in South
It is unlikely that South Africa will achieve the global nutritional target of a 50% reduction in anaemia in WRA by 2025
It is crucial that policymakers, economists, and programme managers involved in the designing and implementation of food and nutrition programmes decide on appropriate nutrition actions required to prevent and control anaemia and ID

Summary

Introduction

Anaemia in women of reproductive age (WRA) and children under 5 years of age is a global public health problem associated with increased morbidity and mortality [1,2,3]. It is an indicator of poor nutrition and wellbeing and is associated with poor cognitive and motor-neurological development in children [4]. The prevalence of anaemia in pregnant women varies widely across the regions of the world. In 2019, the global prevalence of anaemia was 36.5% among pregnant women, 4.0/)

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