Global Technical Services, Nutrition International, Ottawa, Ontario, Canada.
Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ann N Y Acad Sci. 2023 Nov;1529(1):42-60. doi: 10.1111/nyas.15062. Epub 2023 Sep 8.
Anemia remains a major public health problem, especially in low- and middle-income countries. The World Health Organization recommends several interventions to prevent and manage anemia in vulnerable population groups, including young children, menstruating adolescent girls and women, and pregnant and postpartum women. Daily iron supplementation reduces the risk of anemia in infants, children, and pregnant women, and intermittent iron supplementation reduces anemia risk in menstruating girls and women. Micronutrient powders reduce the risk of anemia in children. Fortifying wheat flour with iron reduces the risk of anemia in the overall population, whereas the effect of fortifying maize flour and rice is still uncertain. Regarding non-nutrition-related interventions, malaria treatment and deworming have been reported to decrease anemia prevalence. Promising interventions to prevent anemia include vitamin A supplementation, multiple micronutrient supplementation for pregnant women, small-quantity lipid-based supplements, and fortification of salt with iodine and iron. Future research could address the efficacy and safety of different iron supplementation formulations, identify the most bioavailable form of iron for fortification, examine adherence to supplementation regimens and fortification standards, and investigate the effectiveness of integrating micronutrient, helminth, and malaria control programs.
贫血仍然是一个主要的公共卫生问题,特别是在低收入和中等收入国家。世界卫生组织建议采取几项干预措施,以预防和管理脆弱人群组(包括幼儿、经期少女和妇女以及孕妇和产后妇女)的贫血。每日补铁可降低婴儿、儿童和孕妇患贫血的风险,间歇性补铁可降低经期少女和妇女患贫血的风险。微量营养素粉末可降低儿童患贫血的风险。用铁强化小麦面粉可降低整个人群患贫血的风险,而用铁强化玉米粉和大米的效果仍不确定。关于非营养相关的干预措施,据报道,疟疾治疗和驱虫可降低贫血的流行率。预防贫血的有前景的干预措施包括维生素 A 补充、孕妇多种微量营养素补充、小剂量脂质补充剂以及用碘和铁强化盐。未来的研究可以解决不同铁补充剂配方的疗效和安全性、确定最适合强化的铁的生物利用形式、检查补充方案和强化标准的依从性,并研究将微量营养素、寄生虫和疟疾控制方案相结合的有效性。