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Anemia Resource Review

The Anemia Resource Review is a selection of materials that will help you keep on top of research and developments related to strengthening multisectoral approaches to preventing and controlling anemia. To see materials from earlier editions, or to view resources from across SPRING's technical areas, visit the Resource Review.

Websites to Watch
Places to keep checking for the information you need

UNSCN’s mandate is to promote cooperation among U.N. agencies and partner organizations in support of community, national, regional, and international efforts to end all forms of malnutrition in this generation. The UNSCN website hosts working groups and numerous materials related to nutrition.

The WHO website’s section on nutrition contains guidance materials for the adoption of evidence-informed policies and programs, research and databases on country- and global-level trends in nutrition, and more.

The National Institute of Child Health and Human Development (NICHD), collaborating with food and nutrition partners, created the BOND Program to meet the growing need for discovery, development, and implementation of reliable and valid biomarkers to assess nutrient exposure, status, function, and effect. The project aims to harmonize the decision-making processes around what biomarkers are best for use in support of research, program development and evaluation, and generation of evidence-based policy.

USAID is a global leader in large-scale implementation of integrated treatment programs for neglected tropical diseases (NTDs). The NTD Program depends on key partnerships and currently supports 25 countries and regional programs in Africa and the Americas to reach treatment targets and to monitor and evaluate the programs to document achievement of control and elimination goals.

Links to presentations, proceedings, and other meeting materials

The Scaling Up Nutrition Movement

The Scaling Up Nutrition (SUN) Movement has grown rapidly and now includes the countries that are home to half the world’s malnourished children. Over the years, the SUN Movement Secretariat has organized annual meetings of key participants from SUN countries and the networks that support them. This year’s meeting, the Global Gathering of the SUN Movement, will take place during the days leading up to the Second International Conference on Nutrition (ICN2) and aims to contribute to the outcomes of ICN2 through shared country experiences and approaches to scaling up nutrition. About 300 participants are expected to attend this meeting from November 16-18, 2014 at the World Food Programme offices in Rome.

Food and Agriculture Organization and the World Health Organization

This year’s Second International Conference on Nutrition (ICN2) will be held at Food and Agriculture Organization (FAO) Headquarters in Rome from November 19-21, 2014. ICN2 is an inclusive, inter-governmental meeting on nutrition jointly organized by the FAO and the World Health Organization (WHO), in cooperation with the High Level Task Force on the Global Food Security Crisis (HLTF), IFAD, IFPRI, UNESCO, UNICEF, World Bank, WFP, and the WTO. The conference will review progress made towards improving nutrition since 1992 and propose a flexible policy framework to address current and future nutrition challenges and identify priorities for enhanced international cooperation for improving nutrition.

Reports, Tools, and Other Related Materials
A diverse collection of programmatic materials and news

PMNCH, WHO, World Bank, and AHPSR. (2014). Success Factors for Women’s and Children’s Health: Policy and programme highlights from 10 fast-track countries. Geneva: WHO.

This report focuses on ten low- and middle-income “fast-track” countries that have made significant progress in their efforts to save the lives of women and children. In these countries, the Ministry of Health, together with national and international development partners, reviewed and discussed the evidence on factors contributing to accelerated progress towards MDGs 4 and 5. The report includes a case example of an anemia intervention in China.

African Union Commission, NEPAD Planning and Coordinating Agency, UN Economic Commission for Africa, and UN World Food Programme. The Cost of Hunger in Africa: Social and Economic Impact of Child Undernutrition in Egypt, Ethiopia, Swaziland and Uganda. Report. Addis Ababa: UNECA, 2014.

The Cost of Hunger in Africa study demonstrates that child nutrition can be a determinant factor in achieving Africa's transformation agenda. The report highlights that undernourished children are more likely to experience cases of anemia. It also includes discussion of the broader social and economic costs of undernutrition.

"Integrated Anemia Prevention and Control Toolkit | K4Health." Toolkits by K4Health. September 23, 2014.

The Integrated Anemia Prevention and Control Toolkit provides an integrated package of services to control the three major causes of anemia and provides background information related to these causes and guidance about implementing programs to address them. In addition, the toolkit discusses maternal and child health programs that contribute to anemia.

"WHO Global Database on Anaemia." WHO. January 1, 2014.

The WHO database on anemia includes data by country on prevalence of anemia and mean hemoglobin concentrations.

"E-Library of Evidence for Nutrition Actions (eLENA)." WHO. January 1, 2014.

eLENA is an online library of evidence-informed guidance that aims to help countries successfully implement and scale-up nutrition interventions. Policymakers and program designers may look to this resource for the latest nutrition guidelines, recommendations, and related information, including journal articles, background materials, and expert commentaries.

UNICEF-CDC. Global Assessment of Home Fortification Interventions, 2011. Geneva: Home Fortification Technical Advisory Group, 2013.

The objective of the Home Fortification Global Assessment was to map the current status of programmatic interventions being implemented and planned around the world in 2011 and to provide basic descriptive information about them. Information was collected on three types of home fortification products: micronutrient powders, lipid-based nutrient supplements, and powdered complementary food supplements in 109 countries. The report includes basic descriptions of program activities, scope, scale, and challenges.

Research Articles
Recent findings from academic and peer-reviewed journals

Spottiswoode, Natasha, Patrick E. Duffy, and Hal Drakesmith. "Iron, Anemia and Hepcidin in Malaria." Frontiers in Pharmacology 5, no. 125 (2014).

Anemia is a major global health problem. The relationship between two of the key causes of anemia – iron and malaria – is complex and incompletely understood. This paper reviewed the current knowledge on the connections between anemia, malaria, iron, and hepcidin.

Dostal, A., J. Baumgartner, N. Riesen, C. Chassard, CM Smuts, MB Zimmermann, and C. Lacroix. "Effects of Iron Supplementation on Dominant Bacterial Groups in the Gut, Faecal SCFA and Gut Inflammation: A Randomised, Placebo-controlled Intervention Trial in South African Children." British Journal of Nutrition 112, no. 4 (2014): 547-56.

An alteration in the gut microbiota can potentially increase the risk of enteropathogenic infections. The authors randomized iron supplementation to South African children and measured whether the iron-group had changes in their bacteria profile, the amount of short-chain fatty acids, and gut inflammation. The authors found that compared to the placebo group, children given iron supplementation did not have significantly different bacterial groups in the gut, fecal short-chain fatty acids concentration, or gut inflammation.

Anand, Tanu, Manju Rahi, Pragya Sharma, and G.k. Ingle. "Issues In Prevention Of Iron Deficiency Anemia In India." Nutrition 30, no. 7-8 (2014): 764-70.

This review examined the current burden of iron deficiency anemia (IDA) in India, its epidemiology, and the various issues regarding its prevention and control. The authors conclude that IDA remains a major health concern that underscores the need to strengthen existing programs. The authors suggest tackling IDA through multifactorial and multisectoral approaches; assertively adopting a lifecycle approach; improving community-level nutrition knowledge; and promptly diagnosing and treating of infections.

Casmo, V., G. Augusto, R. Nala, A. Sabonete, and FA Carvalho-Costa. "The Effect of Hookworm Infection and Urinary Schistosomiasis on Blood Hemoglobin Concentration of Schoolchildren Living in Northern Mozambique." Revista do Instituto de Medicina Tropical de São Paulo 56, no. 3 (2014): 219-24.

This study aimed to assess the association between schistosomiasis and hookworm infection with hemoglobin levels of schoolchildren in northern Mozambique. The authors concluded that hookworm and Schistosoma haematobium infections negatively influenced hemoglobin levels in schoolchildren. Recommendations for future programs include periodic deworming, as well as health education and improvements in sanitary infrastructure.

Knoblauch, AM, MS Winkler, C. Archer, MJ Divall, M. Owuor, RM Yapo, PA Yao, and J. Utzinger. "The Epidemiology of Malaria and Anaemia in the Bonikro Mining Area, Central Côte D'Ivoire." Malaria Journal 13, no. 194 (2014).

The authors of this study conducted a cross-sectional survey in seven communities situated in central Côte d'Ivoire and found that malaria and anemia were highly endemic among children aged six to 59 months. A knowledge, attitudes, and practices survey undertaken as part of the study revealed insufficiencies in knowledge of malaria transmission and prevention (i.e., fewer than half of the mothers correctly identified how malaria is transmitted), indicating that intervention campaigns should be accompanied with context-specific information, education, and communication strategies. As the communities surveyed fall within a major mining area, malaria control in this area may serve direct business interests and could provide cooperate social responsibility opportunities for the private sector.

Stevens, Gretchen A, Mariel M Finucane, Luz Maria De-Regil, Christopher J Paciorek, Seth R Flaxman, Francesco Branca, Juan Pablo Peña-Rosas, Zulfiqar A Bhutta, and Majid Ezzati. "Global, Regional, and National Trends in Haemoglobin Concentration and Prevalence of Total and Severe Anaemia in Children and Pregnant and Non-pregnant Women for 1995–2011: A Systematic Analysis of Population-representative Data." The Lancet Global Health 1, no. 1 (2013): E16-25.

The authors obtained data about hemoglobin and anemia for children and women of childbearing age from the population-representative data sources of 107 countries. They found that children's and women's hemoglobin statuses improved in some regions where concentrations had been low in the 1990s, leading to a modest global increase in mean hemoglobin and a reduction in anemia prevalence, from 33% to 29% and 43% to 38% in non-pregnant and pregnant women (respectively), and from 47% to 43% in children. This translates to around 801 million women and children with anemia in 2011.

Kassebaum, NJ, R. Jasrasaria, M. Naghavi, SK Wulf, N. Johns, R. Lozano, M. Regan, D. Weatherall, DP Chou, TP Eisele, R. Flaxman S, L. Pullan R, SJ Brooker, and CJ Murray. "A Systematic Analysis of Global Anemia Burden from 1990 to 2010." Blood 123, no. 5 (2014): 615-24.

Using publicly available data, the authors of this study estimated mild, moderate, and severe anemia from 1990 to 2010 for both sexes and 20 age groups in 187 countries. The authors found that anemia accounted for 8.8% of the total disability from all conditions in 2010, more than major depression (8.18%), chronic respiratory diseases (6.33%), and the totality of injuries (6.29%). Children 5 years and women had the highest burden. Though iron-deficiency anemia was the most common etiology globally, other leading causes of anemia varied widely by geography, age, and sex.

Singla, Daisy R., Sohana Shafique, Stanley H. Zlotkin, and Frances E. Aboud. "A 22-Element Micronutrient Powder Benefits Language but Not Cognition in Bangladeshi Full-Term Low-Birth-Weight Children." Journal of Nutrition, no. 114 (2014).

This article presents a sub-study of low-birth-weight children included in randomized cluster trial of a 22-element micronutrient powder (MNP) nutrition intervention intended to improve linear growth and reduce anemia. In this study, the authors measured the effects of the MNP on mental development. They found that the stunted children who received the MNPs had higher expressive language scores compared to the stunted children in the control group. The authors observed no effect on cognition, consistent with previous studies mentioned in the article.

Ngure, Francis M., Brianna M. Reid, Jean H. Humphrey, Mduduzi N. Mbuya, Gretel Pelto, and Rebecca J. Stoltzfus. "Water, Sanitation, and Hygiene (WASH), Environmental Enteropathy, Nutrition, and Early Child Development: Making the Links." Annals of the New York Academy of Sciences 1308 (2014): 118-28.

The authors of this article reviewed evidence linking WASH, anemia, and child growth, and highlighted pathways through which WASH may affect early child development, primarily through inflammation, stunting, and anemia. They described the role of environmental enteropathy, a prevalent subclinical condition of the gut, as a potential key mediating pathway linking poor hygiene to developmental deficits. The authors proposed the concept of expanding WASH to include behaviors that will interrupt the key fecal-oral vectors of babies’ hands and hand-to-mouth activity and coined it “Baby WASH.”