South African Medical Journal

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Estimating the burden of disease attributable to deficiency anaemia in South Africa in 2000

Beatrice Nojilana, Rosana Norman, Muhammad A Dhansay, Demetre Labadarios, Martha E van Stuijvenberg, Debbie Bradshaw


Objectives. To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000.
Design. The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/ dl and ferritin level < 12 μg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis.
Setting. South Africa.
Subjects. Children under 5 years and pregnant women 15 - 49
Outcome measures. Direct sequelae of IDA, maternal andperinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA.
Results. It is estimated that 5.1 % of children and 9 - 12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174 976 (95% uncertainty interval 150 344 - 203 961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA.
Conclusions. This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.

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