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For the quarter of a billion or more affected children in the developing world, such neglect has heavy if invisible consequences. Mental growth can be retarded by neurological damage, and there is strong evidence to show a measurable loss of IQ points in anaemic children. In more severe cases, child death rates rise.
As recorded in The Progress of Nations 1994, anaemia also affects about 40% of the developing world's women - a figure that rises to over 50% in pregnant women (leading to increased risks of maternal death and low birth weights). In many countries, about a quarter of adult men have also been found to be anaemic.
Anaemia on this scale, says a recent report from WHO and UNICEF, lowers the productivity of entire populations.
The most common cause of anaemia is low absorption of iron from food. Breastfeeding gives adequate iron for the first six months. But most weaning foods - including milk products and cereals - are low in iron unless specifically fortified.
Increasing iron intake is only part of the answer. Drinking tea with a meal, for example, reduces iron absorption, while eating meat or fruit rich in vitamin C means that two or three times as much iron is absorbed.
The diets of the poor - and particularly of the vegetarian poor, who cannot always afford fruit - therefore pose a significant risk.
As with vitamin A deficiency, there are three possible solutions - changing cooking and eating habits, fortifying staple foods, or distributing iron supplements in tablet or syrup form where iron deficiency anaemia is known to be a problem. UNICEF and WHO recommend simultaneous action on all three fronts (including supplementation for children aged six months to five years where anaemia is a problem).
WHO and UNICEF are now working with governments to develop national anaemia plans by the end of 1995, and to reach the goal of eliminating iron deficiency anaemia as a major problem by the year 2000.
The latest research findings could help. Part of the problem with iron tablets has always been that they taste bad, turn faeces black, and have to be taken daily. Recent research suggests that taking the tablets once a week is almost as effective - and likely to be more effective because more widely accepted. A study in Indonesia has also shown that iron supplements alone reduce the problem by about 70% - but by over 95% if iron supplements are combined with a small dose of vitamin A.
Anaemic statistics
% of under-fives suffering from iron deficiency anaemia, around 1980 (WHO regions)
Africa 56 South Asia 56 Latin America 26 East Asia 20 Oceania 18 Europe 14 North America 8Source: E. DeMaeyer and M. Adiels-Tegman, `The prevalence of anaemia in the world', World health statistics quarterly, no. 38, 1985.
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Half of South Asia's children anaemic. |