Anemia remains a public health problem in Rwanda, affecting 38% of young children and 17% of women of reproductive age (DHS 2010). The importance of iron deficiency (ID) as a cause of anemia in Rwanda is not known. We aimed to estimate the prevalence of ID and iron deficiency anemia (IDA) among young children and women in two provinces of Rwanda.
We conducted a cluster randomized survey, selecting 408 predominantly rural households each in the Northern and Southern provinces of Rwanda in 2010. Anemia was defined as hemoglobin (Hb) <110 g/L in children and <120 g/L in non-pregnant women after correction for altitude. We defined ID as: (1) serum transferrin receptor (TfR) >8.3 mg/L or 2) serum ferritin (SF) <12 µg/L in children and <15 µg/L in non-pregnant women after correction for inflammation.
The prevalence of anemia was 30.9% (95%CI: 26.4-35.8) in children (n=577) and 11.2% (95%CI: 8.4-14.7) in women (n=595). The prevalence of ID in children was 3.1% (95%CI: 1.8-5.1) as defined by high TfR and 5.9% (95%CI: 4.0-8.4) as defined by low SF. Similarly, 3.0% (95%CI: 1.8-4.8) of women had high TfR and 4.8% (95%CI: 3.2-7.2) had low SF. The prevalence of IDA (low SF with concurrent anemia) ranged from 1.4% (95%CI: 0.5-3.6) among women in the North to 5.6% (95%CI: 3.1-10.0) among children in the South.
Iron deficiency is likely not an important contributor to anemia in the Northern and Southern provinces of Rwanda. This warrants further investigation into other causes of anemia.