Haematology Division, Regional Medical Research Centre, N.E. Region (Indian Council of Medical Research), Dibrugarh, India.
Trop Med Int Health. 2019 Jul;24(7):829-838. doi: 10.1111/tmi.13240. Epub 2019 May 6.
To assess temporal trends in the occurrence of severe anaemia in India over the past decade, encompassing every state and union territory.
For the period 2008-09 to 2017-18, annual estimates (%) of severe anaemia (haemoglobin < 7 g/dl) for India were derived from Health Management Information System datasets, along with 95% confidence intervals (CIs) to construct temporal trends. Differential patterns in the distribution of severe anaemia by geography, epidemiological transition level and socio-demographic index values were also investigated.
Severe anaemia occurred in 3.29% (95% CI: 3.28-3.30%) of all haemoglobin determinations in India in 2017-18, which was less than a third of the number in 2008-09. This decline (overall 7.8% or 0.78% per year) over the past decade was consistent (χ = 1 557 296, P < 0.001). Distribution of severe anaemia was heterogeneous between states and union territories (in 2017-18), ranged from < 1% (in Kerala and Lakshadweep) to > 8% (in Telangana). Significant variations were observed according to geographical region (highest in Central zone), epidemiological transition level (highest at higher middle epidemiological transition level) and socio-demographic index (highest at middle socio-demographic index). Severe anaemia burden between rural and urban areas also differed significantly.
Although the prevalence of severe anaemia has decreased in India over the last decade, it remains substantial and differs widely with respect to geography, epidemiological transition level, and socio-economic conditions. A detailed assessment of the various aetiologies and documentation of their spatial epidemiology is desirable to understand their relative contribution to the severe anaemia burden and to design appropriate interventions.
评估过去十年中印度严重贫血的发生时间趋势，涵盖每个邦和联邦属地。
2008-09 年至 2017-18 年期间，从健康管理信息系统数据集中得出印度每年严重贫血（血红蛋白<7 g/dl）的估计百分比（%），并构建时间趋势，同时构建 95%置信区间（CI）。还调查了严重贫血在地理、流行病学转变水平和社会人口指数值方面的分布差异模式。
2017-18 年，印度所有血红蛋白测定中严重贫血发生率为 3.29%（95%CI：3.28-3.30%），不到 2008-09 年的三分之一。过去十年中，这一下降（总体 7.8%或每年 0.78%）是一致的（χ²=1 557 296，P<0.001）。2017-18 年，各邦和联邦属地之间严重贫血的分布不均（<1%（喀拉拉邦和拉克沙群岛）至>8%（特伦甘纳邦））。根据地理位置（中央区最高）、流行病学转变水平（中高流行病学转变水平最高）和社会人口指数（中高社会人口指数最高）观察到显著差异。城乡地区严重贫血负担也存在显著差异。
尽管过去十年中印度严重贫血的患病率有所下降，但仍相当高，并且在地理、流行病学转变水平和社会经济条件方面存在很大差异。详细评估各种病因及其空间流行病学记录，有助于了解其对严重贫血负担的相对贡献，并设计适当的干预措施。
