Iron deficiency (ID) is the most common nutritional deficiency in sub‐Saharan Africa (SSA). The burden of ID in SSA is further amplified by high rates of infectious diseases, hemoglobinopathies, and health system challenges. Early and accurate diagnosis of ID is necessary to reduce the clinical and public health impact of ID, particularly among vulnerable groups such as children and pregnant women. Identifying ID before the onset of anemia is especially important, as anemia represents a late manifestation of depleted iron stores. Achieving earlier detection in SSA requires improved geographic and financial access to iron status testing, as well as diagnostic approaches that are appropriate for local epidemiological contexts. This review evaluates current strategies for diagnosing ID in SSA and points out key limitations that reduce their effectiveness. We emphasize that the interpretation of commonly used iron biomarkers is frequently confounded by inflammation, malaria, and inherited blood disorders, leading to misclassification and underestimation of the actual disease burden in SSA. These biological challenges are also compounded by systemic barriers, including high testing costs, limited laboratory infrastructure, reliance on distant referral facilities, and gaps in awareness at both healthcare providers and community levels. We further argue that improving ID diagnosis in SSA will require a multifaceted approach that includes the adoption of affordable, context‐appropriate diagnostic platforms and the development of regionally derived reference ranges and diagnostic decision frameworks. Such strategies would better reflect the physiological and environmental diversity across SSA and support more accurate identification of both ID with and without anemia. These efforts could provide a practical pathway toward improving early detection, guiding targeted interventions, and reducing the burden of ID across the region.

Introduction Pregnancy‐related anaemia is associated with high maternal, foetal, and infant morbidity and mortality in rural communities where access to resources for healthcare may be limited. Comprehending the perceptions of rural women concerning the contributing factors to anaemia is essential. The aim was to explore women’s perspectives regarding factors associated with anaemia during pregnancy in a rural village in Mpumalanga Province, South Africa. Methods Qualitative, exploratory and descriptive designs were used. The study targeted pregnant women aged 20–35 years who presented with anaemia in late pregnancy (34–38 weeks of gestation) at the selected clinic in rural villages. Twenty (20) participants were recruited from the clinic register and followed up at their homes using nonprobability purposive sampling. Permission to access the village was obtained from the Chief, and ethical clearance from the University Research Ethics Committee was obtained. Data were collected through unstructured in‐depth interviews and analysed using open‐coding analysis. Trustworthiness was ensured through dependability, confirmability, transferability and credibility. Results The associated factors were found to be low socioeconomic status, late antenatal care booking, poor adherence to iron supplements, dietary myths, restricting a nutritious and balanced diet, and a preference for attending traditional healers rather than skilled attendants, resulting in adverse health outcomes. Conclusion Creation of awareness on utilisation of preconception care services and encouragement to initiate ANC during the first trimester for the provision of comprehensive assessment, early detection, referral and management. Provide contextual health education, including the WHO’s four anaemia‐preventive strategies.

Background The World Health Assembly (WHA) resolution urges African countries with a high burden of sickle cell anemia (SCA) to design and implement national programs emphasizing early identification through newborn screening (NBS) and prompt access to adequate preventive care. Despite this recommendation, NBS and early prophylactic interventions remain insufficiently implemented in many sub‐Saharan African countries. This pilot program aimed to establish and evaluate NBS for sickle cell disease (SCD) as a health intervention in Côte d’Ivoire, determine the birth prevalence of SCD, and assess the feasibility of linkage to comprehensive care. Methods We conducted a prospective, multicenter cross‐sectional study from June 2022 to December 2024. The study population included all women who delivered in five maternity hospitals and received pre‐ and post‐test counseling. Umbilical cord blood samples from all live newborns were screened using a rapid diagnostic test (RDT) (HemotypeSC). All positive RDT results were confirmed using reference capillary electrophoresis. Results A total of 6,337 newborns were screened using RDTs, of whom 825 (13.02%) had abnormal hemoglobin profiles (including 9.45% HbS and 3.57% HbC). Among the 825 RDT‐positive cases, only 506 newborns underwent confirmatory capillary electrophoresis. Confirmatory testing showed 84 (16.6%) with normal hemoglobin (HbAA); 112 (22.13%) with SCD—including 1.98% HbSS, 2.17% HbSC, 1.38% HbS/β 0 ‐thalassemia, and 16.60% HbS/β + ‐thalassemia; 217 (42.8%) with sickle cell trait (HbAS); and 93 (18.3%) with HbAC. Among the 112 infants confirmed with SCD, only 68 were successfully enrolled in comprehensive care services. Conclusions This study represents the first report of an NBS program for SCD implemented as a public health intervention in Côte d’Ivoire. The findings demonstrate that NBS is both necessary and feasible within the country. Low‐cost RDTs present a practical first‐line screening option but require confirmation with gold‐standard diagnostic tools such as capillary electrophoresis. Immediate linkage to comprehensive care for infants diagnosed with SCD remains a critical component of program success and warrants further strengthening.

Background Anaemia is a major public health problem globally. District and community estimates of anaemia burden are crucial for appropriate targeted interventions. We described the prevalence and risk factors of low haemoglobin (Hb) levels and anaemia in a cross‐sectional survey in the Navrongo Health and Demographic Surveillance. Methods We recruited participants aged < 1 to > 40 years from the Kassena‐Nankana districts in Northern Ghana. We estimated distributions of Hb concentrations by age, sex, district and Hb variant status. We defined anaemia based on the WHO threshold of Hb < 11.0 g/dL for children under 5 years, < 11.5 g/dL for children between 5 and 12 years, < 13 g/dL for men and < 12 g/dL for women. We then performed covariate‐adjusted logistic and linear regression models to investigate predictors of anaemia and Hb concentrations. Results The prevalence of anaemia was 53.2% (95% CI: 50.7–55.7) and was significantly higher in participants below 18 years. The lowest mean Hb levels (11.0 g/dL ± 1.32) were observed in children less than 5 years who contributed 84.1% of the anaemia. Participants with sickle cell condition had the highest prevalence of anaemia (68.2%). Male gender, positive malaria status and living in the Kassena‐Nankana West (KNW) were significantly associated with increased odds of anaemia. Conclusions Malaria, sickle cell conditions and male gender are some of the risk factors for anaemia in the study area. Health education should be continuous in the districts. Interventions to reduce anaemia should also target males, since it has clearly shown that male gender increases the risk of anaemia.

Introduction Anemia remains a significant public health problem among women and children in Ghana. Dietary intake is a significant predictor of anemia risk, yet the role of Ghanaian diets in the prevailing endemic anemia is little known. This study examined anemia prevalence and the association between Ghanaian mother–child dyads’ dietary patterns and anemia status. Methods The study utilized data from the 2022 Ghana Demographic and Health Survey, a nationally representative cross‐sectional survey. We analyzed data from 3744 mother–child dyads with complete dietary and hemoglobin measurements. Dietary patterns were derived using principal component analysis from reported food group consumption and categorized into tertiles. Anemia was defined using World Health Organization cut‐offs. Poisson regression with robust variance estimation was used to estimate crude and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs), adjusting for maternal education, household wealth, household head’s sex, interview month, number of children under 5 years, marital status, region, and residence. Results Anemia prevalence was 67.4% in children and 41.6% in mothers. Compared with the northern belt, children in the southern (aPR = 0.82; 95% CI: 0.69–0.98; p = 0.027) and middle belts (aPR = 0.68; 95% CI: 0.56–0.84; p = 0.0002) were less likely to be anemic; urban residence was protective (aPR = 0.95; 95% CI: 0.91–0.99; p = 0.040). Risks were higher for children from poorer households and those of younger mothers, while maternal education showed an inverse association with anemia. Anemia was more common among children whose mothers had anemia ( p < 0.001). Dietary patterns showed weak associations, limited to maternal westernized dietary pattern (PR = 0.97; 95% CI: 0.93–0.99; p = 0.047). Conclusion Anemia among Ghanaian mother–child dyads is primarily driven by structural, geographic, and intergenerational factors, with dietary patterns contributing minimally. Tackling socioeconomic inequities, enhancing malaria and infection control, and implementing family‐centered, regionally tailored strategies are essential to reducing Ghana’s anemia burden.

Background and Aims Hemoglobin (Hb) concentration is used clinically to determine the presence of anemia and other blood disorders. More than half of the under‐five children in South and Southeast Asia suffer from lower Hb concentration. The main goal of this study is to determine risk factors associated with lower Hb concentration among 6–59‐month‐old children of five selected South and Southeast Asian (SSEA) countries by developing a suitable multilevel model by accounting for cluster‐, region‐, and country‐level variations. Methods The study used Hb concentration data collected in the most recent Demographic and Health Surveys (DHS) conducted during 2011–2022 in five SSEA countries: Bangladesh, India (Seven Sister States), Nepal, Maldives, and Myanmar. The final analysis included 49,059 children between the ages of 6 and 59 months. Several multilevel models at SSEA and country levels have been developed considering the hierarchical geographical structure of the data to investigate the influence of risk factors on Hb concentration. Results The mean Hb concentration among the SSEA country’s children was 102.96 g/L (±0.11), with the highest mean Hb level in Nepal (111.84 ± 0.42 mg/dL) and the lowest in India (101.64 ± 0.42 g/L). A four‐level random intercept model considering children, cluster, region, and country as the consecutive hierarchical units was found as the best model based on the considered model selection criteria. The final model shows significant variations in the Hb concentration at children (166.60), cluster (26.96), region (9.02), and country (10.46) levels after accounting for children, mother, and household‐level associated risk factors such as the child’s age, morbidity, malnutrition, breastfeeding status, mother’s age, education status, current anemia, nutritional status, household wealth status, and toilet facilities. Country‐level analysis shows country‐specific risk factors, which are mostly common with some exceptions. Conclusions The results of this study suggest that various child‐, mother‐, and household‐level factors significantly influence the lower Hb concentration, and the variation in the Hb level is mainly at the individual level, followed by the cluster, region, and country level. The findings suggest that multidisciplinary interventions should be concentrated at least at the household and the community level to improve children’s and mothers’ health and nutrition status, mothers’ education status, and household socioeconomic status to improve children’s Hb concentration to combat childhood anemia.

Introduction The diagnosis of beta thalassemia trait is primarily based on an elevated HbA2 level (> 3.5%) measured by high‐performance liquid chromatography or capillary electrophoresis. Iron deficiency (ID) can influence HbA2 levels, raising concern about potential diagnostic misclassification, particularly in individuals with borderline HbA2 values. This study aimed to evaluate the effect of ID and its correction on HbA2 levels and the diagnosis of beta thalassemia trait. Methods A prospective interventional study conducted between June 2021 and June 2022 at a National Thalassemia Centre, Sri Lanka. Ninety‐two participants aged 12–57 years with low red cell indices (MCV ≤ 80 fL, MCH ≤ 27 pg) and HbA2 < 3.5% were included. All had serum ferritin < 30 ng/mL indicating ID. Hematological and iron parameters, including HbA2 levels, were assessed before and after 3 months of oral iron therapy. Comparisons were made between subgroups with serum ferritin levels of < 15 ng/mL and 15–30 ng/mL. Correlations between Hb, HbA2, ferritin, and other iron indices were also examined. Results A significant positive correlation was observed between Hb and HbA2 levels prior to treatment. Following iron therapy, HbA2 levels increased significantly in iron‐deficient individuals ( p < 0.001). In three of eight participants with borderline HbA2 levels, treatment raised HbA2 above the 3.5% diagnostic threshold. Conclusions Oral iron therapy significantly affects HbA2 levels in iron‐deficient individuals and may cause borderline values to cross the diagnostic threshold for beta thalassemia trait. Iron status should therefore be considered when interpreting HbA2 results in thalassemia screening.

Sickle cell disease (SCD) is a major public health concern in Africa. SCD healthcare expenses are covered by personal finances in the Congo due to the absence of universal public health insurance. Various strategies have been implemented to minimize this economic burden, including an outpatient management strategy. The present study evaluated the costs associated with outpatient management of uncomplicated sickle cell crises. Patients presenting to the National Sickle Cell Center’s emergency room between December 2023 and February 2024 were included in this study for a total of 114 subjects with uncomplicated crises from SCD. Chief complaint, diagnosis, treatment, health insurance coverage, and cost of care were recorded for each subject. We further assessed the consistency of treatment with published standards of care. Mean patient age was 16 ± 13 years, where more than one‐third were adults (36.5%). The ratio of males to females was 1.09. Only 26.2% were employed. Monthly income was lower in individuals with SCD ($310.32 ± 120.93) compared to those without SCD ($386.92 ± 471). Managing uncomplicated SCD as an outpatient costs an average of $99.86 ± 49, where medications represented 55.7% of the total expense. Sixty‐six patients (57%) received prescription medications and investigation with no rational basis, resulting in an inflated cost of $15.96 per person. The present study did not demonstrate any financial benefits to managing uncomplicated SCD in outpatient settings.

IntroductionThalassemia trait generally has minimal clinical impact, but physiologic changes during pregnancy may increase the risk of anemia, transfusion requirements, and hypertensive disorders. Existing evidence on pregnancy outcomes in this population is limited, with some conflicting data. This study aims to evaluate pregnancy‐related outcomes in patients with thalassemia trait using a large, multicenter database.MethodsFor this retrospective cohort study, we used data from the TriNetX US Collaborative Network. Females aged 18–45 with ICD‐10 codes indicating pregnancy (Z33.1, O00–O9A, Z34, or Z3A) were included. Patients with pregnancy and coexisting thalassemia trait (D56.3) were assigned to the thalassemia cohort (n = 22,913), while those without any thalassemia diagnosis comprised the nonthalassemia cohort (n = 5,611,147). Propensity score matching was performed to balance age, race/ethnicity, obesity, smoking status, essential hypertension, and Type 2 diabetes mellitus. After 1:1 matching, 22,770 patients remained in each cohort (total N = 45,540). Outcomes were assessed within 1 year of the index date, including anemia during pregnancy, blood transfusion, preeclampsia/eclampsia, cesarean delivery, venous thromboembolism (VTE), heart failure/cardiomyopathy, preterm delivery, intrauterine growth restriction (IUGR), and intrauterine fetal demise (IUFD). Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.ResultsThalassemia trait was associated with higher risks of anemia during pregnancy (RR: 3.00 and 95% CI: 2.87–3.13), needing blood transfusion (RR: 1.90 and 95% CI: 1.69–2.20), preeclampsia/eclampsia (RR: 1.54 and 95% CI: 1.47–1.61), cesarean delivery (RR: 1.43 and 95% CI: 1.36–1.51), preterm delivery < 37 weeks (RR: 1.40 and 95% CI: 1.31–1.65), and IUGR (RR: 1.96 and 95% CI: 1.72–2.23), all were statistically significant with a p < 0.001. Increased risk was also observed for VTE (RR: 1.57 and 95% CI: 1.12–2.20, p < 0.001) and IUFD (RR: 1.37 and 95% CI: 1.087–1.75, p < 0.001). No significant association was found with heart failure/cardiomyopathy (RR: 1.28 and 95% CI: 0.93–1.76, p = 0.124).ConclusionThalassemia trait in pregnancy was associated with increased rates of anemia, transfusion, and adverse maternal and fetal outcomes. Such adverse outcomes include pre‐eclampsia/eclampsia, cesarean delivery, preterm birth and IUGR. These findings underscore the need for tailored peripartum care strategies in this high‐risk population.