Anaemia in Bangladesh: a review of prevalence and aetiology.

OBJECTIVE : This paper provides a comprehensive review of the changes in the prevalence and the extent of anaemia among different population groups in Bangladesh up to the present time. The report also focuses on various factors in the aetiology of anaemia in the country. DESIGN AND SETTING : All the available data have been examined in detail, including data from national nutrition surveys, as well as small studies in different population groups. RESULTS : Over the past three decades a number of studies including four national nutrition surveys (1962/64; 1975/76; 1981/82 and 1995/96) have been carried out to investigate the prevalence of anaemia among different population groups in Bangladesh, and have demonstrated a significant public health problem. Since the 1975/76 survey the average national prevalence of anaemia has not fallen; in 1995/96, 74% were anaemic (64% in urban areas and 77% in rural areas). However, age-specific comparisons suggest that the rates have fallen in most groups except adult men: in preschool children in rural areas it has decreased by about 30%, but the current level (53%) still falls within internationally agreed high risk levels. Among the rural population, the prevalence of anaemia is 43% in adolescent girls, 45% in non-pregnant women and 49% in pregnant women. The rates in the urban population are slightly lower compared with rural areas, but are high enough to pose a considerable problem. It appears that severe anaemia in the Bangladeshi population is less frequent, possibly present among only 2-3% of the population. The data on the aetiology of anaemia reveal that iron deficiency may be a substantial cause of anaemia in the Bangladeshi population. Other dietary factors in addition to parasitic infestations may also precipitate the high prevalence of anaemia. CONCLUSIONS : While the overall prevalence of anaemia among the Bangladeshi population is still very high, the rates of severe anaemia are almost non-existent. A large proportion of anaemia can be attributed to iron deficiency. There is a need for a comprehensive strategy for the prevention and control of anaemia in Bangladesh.