Transcript Iron Deficiency in Sri Lanka Dr. Renuka Jayatissa (M.B.B.S., M.Sc, M.D.) Nutrition Specialist, UNICEF.

Iron Deficiency in Sri Lanka
Dr. Renuka Jayatissa (M.B.B.S., M.Sc, M.D.)
Nutrition Specialist, UNICEF
Major micronutrient deficiencies in Sri Lanka
1.Vitamin A
2.Iodine
3.Iron
Vitamin A Deficiency
Bitot’s spot
Blindness
Supplementation with vitamin A capsules since year 2000
Iodine Deficiency
Goitre
Fortification of salt with
Iodine since 1995 and
elimination of IDD
Successful programme of
public and private
partnership
Renuka/SL/2014
Anaemia and Iron deficiency
Renuka/SL/2014
Trends in the prevalence of anaemia among
under five children
(Source: MRI 1973, 1996, 2001, DHS 2006 & MRI 2009, 2012)
80
70
70
Anaemia
60
50
45
40
30
29.9
30.6
20
25.4
15.1
10
0
1973
Renuka/SL/2014
1996
2001
2006
2009
2012
Not much improvement since 2001. Only 0.6% reduction per year.
Trends in the prevalence of Anaemia in
Sri Lanka
(Source: Mudalige and Nestel, 1996, MRI-1970, 1989, 1998, 2001, 2009, 2012 & DHS 2006
Reduction of anaemia in all age groups over 39 years. Still around 20% of the population has anaemia.
When the prevalence of anaemia is >5% it will be considered as a public health problem by WHO.
Renuka/SL/2014
Millions of anaemic children, adolescent
girls and women in Sri Lanka
 Iron is critical for the early
development of a child because it
improves learning ability, physical
coordination, and emotional
development. Irreversible damages.
Renuka/SL/2014
Prevalence of Anaemia in different sectors
and age groups in Sri Lanka
(Source: Medical Research Institute 1996, 2001, 2009)
High in urban sector among children and high in plantation sector among adult female
Renuka/SL/2014
Prevalence of anaemia in children aged 6-59 months of age by
District IN 2012
Kegalle
Galle
Hambantota
Matara
Rathnapura
Matale
Nuwara Eliya
Ampara
Mullative
Kalutara
Sri Lanka
Batticalo
Mannar
Gampaha
Badulla
Kurunegala
Anuradhapura
Kandy
Colombo
Vauvniya
Jaffna
Puttalam
Polonnaruwa
Trincomalle
Monaragala
Killinochchi
0.0%
4.9%
5.0%
8.9%
9.7%
10.0%
11.1%
12.9%
13.3%
13.6%
14.3%
14.7%
15.1%
15.3%
15.4%
15.8%
15.9%
16.0%
16.2%
16.9%
17.1%
18.1%
18.6%
20.3%
21.5%
23.1%
10.0%
15.0%
20.0%
25.6%
26.9%
25.0%
30.0%
Renuka/SL/2014
Anaemia in Women 15-49 years of age by Districts in 2009
Source- MRI 2009
Percentage
Renuka/SL/2014
Causes of anaemia – 6-59 months children in 2012
%
5%
5%
Iron Deficiency
Haemoglobinopathies
48%
30%
Abnormal red cell indices
Infections
Unkown
12%
Renuka/SL/2014
Prevalence of Iron deficiency (serum ferritin <12µg) in
children aged 6-59 months by District (n=5741)
Mullative
Kegalle
Batticaloe
Trincomalee
Kalutara
Mannar
Kurunegala
Vavuniya
Nuwaraeliya
Amapara
Polonnaruwa
Badulla
Jaffna
Ratnapura
Sri Lanka
Monaragala
Kandy
Killinochchi
Hambanthota
Colombo
Gampaha
Anuradhapura
Galle
Matara
Puttulum
Matale
19.1 21.6
22.8
23.5
0
10
20
27.7
29.5
29.7
29.7
30.3
30.7
30.8
31
31
31.1
32.3
30
34.1
34.2
34.4
35.4
36.2
36.4
37.7
38.4
40
42
43.2
45.4
50
Renuka/SL/2014
Causes of Anaemia in adults
Population group
No
Anaemia ID
Free trade zone female
garment workers in 2004
652
44.7%
66.6%
Adult female (20-39 years)
in central province in 2005
863
27.7%
41.4%
Source: MRI 2004, 2005
It estimates that major cause of anaemia is iron deficiency
Renuka/SL/2014
Iron deficiency (serum ferritin <12µg) among
children age 6-59 months, by wealth quintile (MRI
2012)
40
35
30
30.3
32.1
32.4
33.7
33.2
32.3
25
20
%
15
10
5
0
Poorest
Renuka/SL/2014
Poor
Middle
Rich
Richest
National
Not much variation between wealth quintiles
.
Why Should Fighting Iron Deficiency Anemia be
a National Priority?
 For each US $1 spent on an iron supplementation program
for pregnant women, there is a US $24 return in increased
lifelong wages and decreased disability,
 For each US $1 spent on iron fortification of food there is a
US $84 return in increased productivity and decreased
disability of the consumer,
 Work output in many occupations can increase 10 to 30%
when workers are given iron supplementation,
 Prevention and treatment of iron deficiency and
anemia can raise national productivity by 20%.
Thank you