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Risk factors for iron deficiency anaemia in preschool children in northern Ethiopia

  • AA Adish (a1) (a2), SA Esrey (a1) (a3) (a4), TW Gyorkos (a4) (a5) and T Johns (a1)
  • DOI:
  • Published online: 01 January 2007

To determine risk factors for anaemia in preschool children.


A cross-sectional study.


Tigray province, northern Ethiopia.


2080 of 2373 children aged 6–60 months provided blood to assess anaemia.


Anaemia was highly prevalent (42%) and constituted an important nutritional problem in the region. In a sub-sample of 230 anaemic children, 56% had a low red blood cell (RBC) count, and 43% had a serum ferritin of less than 12 μg l−1 indicating that the anaemia was largely due to iron deficiency. Unlike other regions in developing countries, hookworm (0.4%) and malaria (0.0%) were rare and contributed little to the anaemia. Even though their diet lacked variety, the amount of iron consumed through cereal-based staple foods was adequate. However, the iron in these foods was not readily available and their diets were probably high in iron absorption inhibitors and low in enhancers. Dietary factors associated with anaemia included frequent consumption of inhibitors, such as fenugreek and coffee, and poor health in the child such as diarrhoea and stunting.


Underlying causes of anaemia were lack of safe water and inadequate human waste management, maternal illiteracy and mother being ill, and having no food reserves. The root cause of these factors was poverty. The optimal control strategy for iron deficiency anaemia should have a holistic approach which includes the alleviation of poverty, the empowerment of women and the provision of a safe environment.

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3M Gebre-medhin , A Kilander , B Bahlquist , E Wuhib . Rarity of anaemia of pregnancy in Ethiopia. Scand. J. Haematol. 1976; 16: 168–75.

12H Foy , A Kondi . Hookworm in the etiology of tropical iron deficiency anemia. Trans. R. Soc. Trop. Med. Hyg. 1960; 54: 419–33.

27AA Adish , SA Esrey , TW Gyorkos , J Jean-Baptiste , A Rojhani . Effect of consumption of food cooked in iron pots on iron status and growth of young chirldren: randomised trial. Lancet 1999; 353: 712–16.

30AJ Roodenburg . Iron supplementation during pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 1995; 61: 6571.

35M Hamdaoui , A Hedhili , T Doghri , B Tritar . Effect of tea on iron absorption from the typical Tunisian meal ‘couscous’ fed to healthy rats. Ann. Nutr. Metabol. 1994; 38: 226–31.

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