Scoping into Non Iron Deficiency Anemia: Reflection from the Rural India

Introduction Anaemia is one of the leading public health problems. India accounts for the highest prevalence of anaemia in the world. Anaemia programs in India focus on screening and management of anaemia based on haemoglobin estimation, treatment is being given irrespective of status of iron as well as other micronutrient storage. The present study assesses the prevalence of anaemia and iron deficiency (ID) based on low serum ferritin status among antenatal and postnatal women in Devbhoomi Dwarka District of Gujarat. Methods A total of 258 pregnant (AN) and postnatal (PN) women drawn from 27 primary health centres were studied. Anaemia was evaluated based on haemoglobin concentration obtained from venous whole blood, using auto-analyser. Serum ferritin was used to evaluate iron status in the study. Serum ferritin was assessed using the direct chemiluminescence method using MINI VIDAS which is a compact automated immunoassay system based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results Overall, Anaemia (low Hb) and ID (low s. ferritin) was observed in 65.9% and 27.1% respectively. Out of anaemic participants, about 38.2% reported ID while the remaining 61.8% had normal s. ferritin (i.e. non-iron deficient anaemia). Anaemia was reported 69.1% in AN women and 57.1% in PN women. The ID was reported higher (30.9%) in AN woman than PN women (17.1%). However, the prevalence of anaemia, as well as IDA decreased from the first to the third trimester. Conclusion Two out of every three women were anaemic; one out of four were anaemic with depleted iron storage. Importantly, two out of five women had anaemia but iron storage was sufficient. Strategy to prevent and correct anaemia must include screening for iron and non-iron deficiency anaemia and follow appropriate treatment protocol for both types of anaemia.