LOW DIETARY IRON AVAILABILITY IS A MAJOR CAUSE OF ANEMIA - A NUTRITION SURVEY IN THE LINDI DISTRICT OF TANZANIA

A nutrition survey was conducted in the rural Lindi District of Tanzan ia to determine the magnitude of anemia and iron deficiency in differe nt age and sex groups as related to nutritional status, parasitic infe ctions, food iron intake, and socioeconomic factors. In a 30-cluster s ampling design, 660 households were randomly selected and a total of 2 320 subjects aged 6 mo to 65 y were examined. Iron status was assessed by measuring hemoglobin and erythrocyte protoporphyrin in a finger-pr ick sample: 55% of the subjects had anemia and 61% of the anemia was a ssociated with iron deficiency (erythrocyte protoporphyrin > 125 mu mo l/mol heme). Preschool children (aged <5 y) were the most affected; 84 % were anemic (hemoglobin <110 g/L). Fifty percent of the nonanemic pr eschool children and approximate to 90% of all the severely anemic sub jects were iron deficient, Hemoglobin was lower in schoolchildren (age d 5-14 y) and in adolescent and adult males (aged greater than or equa l to 15 y) with a low body mass index. Parasitic infections were only associated with anemia and iron deficiency in schoolchildren and adole scent and adult males, Malaria was associated with anemia (P < 0.001), whereas schistosomiasis was associated with anemia and iron deficienc y (P < 0.001 and P < 0.05, respectively), Hookworm infestation was ass ociated with iron deficiency (P < 0.05) and with anemia (P < 0.01) onl y in adolescents and adults. A mainly cereal-based diet with additiona l legumes and green vegetables was found by in vitro tests to contain high amounts of total iron but of low bioavailability. Estimation of t he amount of iron absorbed confirmed inadequate iron nutrition. Althou gh anemia is a result of a synergism of a variety of causes, iron defi ciency remains the major cause.