Iron deficiency anaemia, an underlying threat

NIGERIA is endangered as iron deficiency anaemia remains a widespread public health problem with grave consequences on its people’s health as well as on thesocial and economic development. According to the Nutrition Society of Nigeria, one in two Nigerian women of childbearing age suffers from anaemia, which depicts a huge burden of anaemia among these women and their children. Iron deficiency is seen as the culprit as it continues to be the top-ranking cause of anaemia globally. It is the most common nutritional deficiency in the world affecting more than a quarter of the world’s population with about two million people who are iron deficient. About 90 per cent of anaemia have iron deficiency as a contributory factor. The statistics are that 49 per cent of women of child bearing ages have anaemia, 24.3 per cent have low iron reserve and 12.7 of the women are iron deficient.

As a type of micro nutrient deficiency, iron deficiency anaemia is also the only nutrient deficiency that is significantly prevalent in industrialised/developed countries of the world and it is more common in women than in men. Iron deficiency anaemia is a condition in which there is a decreased total iron body content which causes a decrease in the number of red blood cells or the amount of haemoglobin in the blood, thereby resulting in diminished oxygen-carrying capacity of the blood. It occurs when iron deficiency is sufficient enough to cause the development of anaemia. This invariably means that an individual may be iron deficient but not anaemic and there are mild-to-moderate forms of iron deficiency in which, although anaemia is absent, tissues are still not functioning well. Anaemia is the most common indicator used to check or screen for iron deficiency and it is a life threatening condition. Research has also shown that despite the fact that many Nigerian women are in the know about food sources rich in iron and it benefits,the consumption of iron rich food is still low and iron deficiency anaemia is still prevalent.

The victims of iron deficiency anaemia aremostly the vulnerable part of the population which are the women (of reproductive ages, pregnant women, teenage girls) and children (infants and the under-5), which makes it a major cause of maternal and child deaths which screams the need for long lasting intervention.Some vegetarians and frequent blood donors are people who are also at the risk of having Iron Deficiency Anaemia because of their eating habit and lifestyle.

The major causes of iron deficiency anaemia range from increased need for iron due to blood loss which is a direct consequence of menstruation, pregnancy, failure of iron absorption, haemorrhage during childbirth, repeated pregnancies, bleeding connected to the use of intrauterine devices (IUDs) for birth control, to prolonged milk feeding alone without supplements of iron containing foods for six months old, low birth weight and infections. Others are deficient absorption for infants and children, and low bioavailability of iron in diets; shortage in quantity of dietary iron available compared to the needs in specific life stages such as infancy, adolescence and pregnancy. Hook worm infestation and schistosomiasis causing chronic blood loss are also key causes of iron deficiency anaemia.

At the beginning, iron deficiency anaemia can be so mild that it goes without being noticed even for years, especially since it is caused by a micro nutrient (iron) deficiency. But as the body becomes more deficient in iron and anaemia aggravates, the sign and symptoms become more obvious. The signs and symptoms may include, extreme tiredness, weakness, pale skin, chest pain, shortness of breath, headache, dizziness, cold hands and feet, poor appetite, especially in infants and children, missed menstrual cycle, fragile nails, soreness of the tongue and unusual cravings for non-nutritive substances such as ice, starch, clay or dirt.

Some of the major health consequences include poor pregnancy outcome such as low birth weight, shorter pregnancies etc; impaired physical and cognitive development in children, increased risk of disease and death in children, lower immune parameters, increased risk of maternal mortality and decreased work capacity in adults which leads to decreased and poor human productivity because iron is crucial to energy for day to day activities and mental functioning. The consequences of iron deficiency anaemia are severe and long lasting, especially in children, and it is important to say that when it occurs during age 0-1 years and in the formative years of life, it has long term effects on the cognitive and intellectual performance of the child and results in lack in attention, memory and verbal fluency, while often being irreversible. It is a life threatening problem that needs to be significantly reduced to the barest minimum if not totally eradicated. As such, it can be prevented with adequate diet and intake of iron-rich foods such as green leafy vegetables, beans, red meat, poultry etc., but in the treatment of Iron deficiency anaemia, diet alone is not usually adequate.

Furthermore, prevention of iron deficiency before and during pregnancy through adequate dietary iron intake and iron supplementation is another way to primarily and effectively prevent iron deficiency anaemia. Only when iron deficiency anaemiais seen as critical and preventable, can its spread be addressed significantly, and its consequences curtailed so as to have the needed productivity and better quality of life.

• Amodu is a postgraduate student of the University of Ibadan