Abstract
Anemia and iron deficiency (ID) can impair quality of life and socioeconomic development. We evaluated the prevalence of anemia and ID in the adult Portuguese population in real-life contexts by gender, age, and pregnancy status. We performed a cross-sectional screening in adult individuals in mainland Portugal from 2013 to 2017. Participants completed a survey about demographics and signs or symptoms compatible with anemia, and ID and hemoglobin and ferritin concentrations were determined by point-of-care tests. We estimated and compared prevalence ratios (PR) of anemia and ID using Poisson regression with robust variance and the Wald chi-square test. We collected data from 11,030 individuals (26% men, 64% nonpregnant women, and 10% pregnant women). We found anemia in 51.8% (95% CI 50.1–53.4%) of nonpregnant women in fertile age, 46.6% (95% CI 44.7–48.6%) of nonpregnant women >51 years, 38.2% (95% CI 35.4–41.1%) of pregnant women, and 33.3% (95% CI 31.6–35.1%) of men. The prevalence of ID was 72.9% (95% CI 71.4–74.4%) in nonpregnant women in fertile age, 50.5% (95% CI 48.5–52.4%) in nonpregnant women >51 years, 94.8% (95% CI 93.3–96.0%) in pregnant women, and 28.9% (95% CI 27.3–30.6%) in men. We found significant associations between the prevalence of anemia or ID and nonpregnant women (PR: 1.50, 95% CI 1.42–1.59 or PR: 2.21, 95% CI 2.09–2.35, respectively), manifestation of signs or symptoms (PR: 1.19, 95% CI 1.53–1.23 or PR: 1.22, 95% CI 1.18–1.26), pregnant women (PR: 0.74, 95% CI 0.68–0.80 or PR: 1.30, 95% CI 1.27–1.33), and nonpregnant women ≤51 years (PR: 1.11, 95% CI 1.06–1.17 or PR: 1.42, 95% CI 1.36–1.48). In conclusion, anemia and ID represent moderate to severe public health problems, particularly among women in fertile age and in 3rd trimester, of pregnancy emphasizing the need to raise the public and health professionals' awareness of these problems and their prevention, diagnosis, and treatment.
Highlights
Anemia, defined as a decreased hemoglobin concentration [1], is a major global public health problem affecting about one-quarter of the world’s population [2]
Epidemiological data on anemia and Iron deficiency (ID) are sparse [4, 5, 9, 11, 18]. erefore, we aimed to evaluate the prevalence of anemia and ID in different groups of the adult Portuguese population stratified by age, gender, and in the case of women, by pregnancy status. is study was conducted in real-life contexts, in which the participants were asked to complete a survey as well as screening tests for anemia and ID
Study Design. is cross-sectional screening was promoted by the Anemia Working Group Portugal—Associação Portuguesa para o Estudo da Anemia—aiming to evaluate the prevalence of anemia and ID in different demographic groups of the adult Portuguese population. e screening was performed using a convenience sampling in real-life contexts, such as public locations and private entities frequented by the general population. e screening was carried out in several geographical locations in mainland Portugal from January 2013 to December 2017. e study was conducted by applying a survey as well as anemia and ID screening blood tests to the participants, in which hemoglobin and ferritin concentrations were determined by point-of-care tests
Summary
Anemia, defined as a decreased hemoglobin concentration [1], is a major global public health problem affecting about one-quarter of the world’s population [2]. In Europe, the World Health Organization (WHO) has estimated a prevalence of anemia of approximately 23% for children ≤5 years, 23% for nonpregnant women in fertile age, and 26% for pregnant women in 2011 [3]. In Portugal, recent studies have estimated a prevalence of anemia of 20% in the Portuguese general population, affecting women (21%), pregnant women (54%), and adults aged ≥65 years (21%) [4, 5]. Anemia may result from several causes, such as micronutrient deficiencies (iron, folate, and vitamin B12), genetic disorders, or other conditions that may induce iron loss or decreased iron absorption (acute or chronic infection, inflammatory bowel disease, chronic heart failure, chronic kidney disease, neoplasm, and autoimmune disease) [3, 6, 7]. Common causes of ID in the elderly population include disorders and/or acute or chronic hemorrhage through the gastrointestinal tract [8, 10]
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