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Abstract Background Capillary-blood based surveys suggest that anaemia is rampant in India. However, these estimates may be inflated as capillary blood haemoglobin (Hb) is an underestimate of its true value. The main cause of anaemia is thought to be iron deficiency (ID), but there are no large-scale surveys to confirm this. Methods A community-based (urban, slum and rural) cross-sectional survey was conducted in eight states across India, to estimate anaemia and ID prevalence from venous blood Hb and plasma ferritin (corrected for inflammation), in adolescents, adults, and elderly of both sexes. Results Anaemia prevalence was 44%, 41% and 45% in adolescent girls, adult and elderly women respectively compared to 24%, 21% and 37% in adolescent boys, adult, and elderly men respectively. The overall prevalence varied widely by state, ranging from 12% in Meghalaya to 70% in Assam. Mild anaemia was predominant, at about 50% of overall anaemia prevalence. ID-associated anaemia (IDA) was less than a third of the overall anaemia prevalence, and varied among age and sex groups, only approaching 45% in adolescent girls. IDA was much lower in mild anaemia. Thus, the major proportion of anaemia in all groups was associated with ‘unknown causes’. Conclusions Anaemia prevalence, when measured by venous blood Hb, was substantially lower than earlier capillary blood-based estimates and was predominantly mild. The prevalence of ID associated anaemia was also much lower than anticipated. The major associated aetiology was that of unknown causes, which needs further investigation. These results have policy implications for anaemia prevention and correction.
Kurpad et al. (Wed,) studied this question.