It is generally assumed that, on average, around 50% of the cases of anaemiaare due to iron deficiency, as opposed to malaria (which causes anaemia becausethe malaria parasite destroys erythrocytes), the presence of infection or othernutrient deficiencies. However, the proportion is probably higher in infants andpreschool-aged children than in older children or women (75), and is likely tovary by location. Although anaemia usually occurs when iron stores are depleted,the prevalence of iron deficiency will often be substantially higher than theprevalence of iron-deficiency anaemia. However, in iron-deficient populationswith endemic malaria, the prevalence of anaemia will be greater than, or similarto, the prevalence of iron deficiency (75). Furthermore, the use of serum ferritin as an indicator of iron status may well overestimatethe prevalence of irondeficiency in malaria endemic areas; this is because serum ferritin levels are elevated by the presence of infections such as malaria (Table 3.1), and also thereason why, traditionally, the cut-off level that defined iron deficiency in individuals with malaria was higher (<30µg/l) than that used for individuals freefrom infection (<15µg/l).
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