South African Medical Journal

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

B Nojilana, R Norman, M A Dhansay, D Labadarios, M E van Stuijvenberg, D Bradshaw, South African Comparitive Risk Assessment Collaboration Grou


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 and
perinatal 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.

South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 741-746

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