Prevalence of iron deficiency and anemia among healthy women of reproductive age in Bhaktapur, Nepal

Objective: To determine the prevalence of anemia and iron status as assessed by biochemical markers and to explore the associations between markers of iron status and iron intake. Study area and population: Five hundred healthy women of reproductive age from the Bhaktapur district of Nepal were included in the study. Methods: A cluster sampling procedure was applied for this cross-sectional study. Women without any ongoing infection aged 13-35 years were selected randomly from the population. We measured the plasma concentration of hemoglobin (Hb), ferritin and transferrin receptors. Dietary information was obtained by a food frequency questionnaire and two 24-h dietary recalls. Results: The prevalence of anemia ( Hb concentration < 12 g/dl) was 12% (n = 58). The prevalence of depleted iron stores ( plasma ferritin < 15 mg/l) was 20% ( n 98) whereas the prevalence of iron deficiency anemia ( anemia, depleted iron stores with elevated transferrin receptor i.e. > 1.54 mg/l) was 6% ( n 30). Seven percent ( n 35) of women were having iron-deficient erythropoiesis ( depleted iron stores and elevated transferrin receptor but normal Hb). Out of the 58 anemic women, 41 (71%) and 31 (53%) were also having elevated plasma transferrin receptor and depleted iron stores, respectively. Fifty-four percent of the women ate less than the recommended average intake of iron. The main foods contributing to dietary iron were rice, wheat flour and green and dry vegetables. Conclusions: The prevalence of anemia in our study was substantially lower than the national figure for non-pregnant women. Only about half of the women with anemia were also having depleted iron stores, suggesting that other causes of anemia may be prevalent in this population.