Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Cote d'Ivoire

Background: Iron deficiency is highly prevalent in most developing countrie s. However, its detection is often obscured by infections and inflammatory disorders that are common in the same populations. Objective: The aim of this study was to estimate the prevalence of iron def iciency with or without concurrent anemia in different population groups fr om Me d'Ivoire and to evaluate the influence of infectious and inflammatory disorders on iron-status indexes. Design: Blood samples from 1573 children, women, and men were analyzed for hemoglobin, serum ferritin, zinc protoporphyrin, and serum transferrin rece ptor. C-reactive protein was used as the indicator of inflammation or infec tion, and samples were screened for malarial parasites and hemoglobinopathi es. Iron deficiency was defined as 2 of 3 iron-status indexes outside the c utoff values, and iron deficiency anemia (IDA) was defined as iron deficien cy with concurrent anemia. Pearson's correlation coefficients were used to evaluate the influence. of malaria and inflammation on iron-status indexes. Results: The prevalence of iron deficiency was 41-63% in the women and chil dren and 13% in the men, whereas the prevalence of IDA was 20-39% in the wo men and children and 4% in the men. The detection of iron deficiency and ID A was obscured by the high prevalence of inflammatory disorders. Conclusions: Iron deficiency and IDA are highly prevalent in the women and children in Cote d'Ivoire. Iron deficiency was detected in approximate to 5 0% of anemic women and children, which indicates that hemoglobin alone is n ot a good indicator of iron status when inflammatory disorders are highly p revalent. The serum transferrin receptor is the most useful single indicato r of iron deficiency because it was the only iron-status index unaffected b y malaria or inflammation.