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. 2016 Jul;19(10):1862-74.
doi: 10.1017/S1368980015003651. Epub 2016 Jan 28.

Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron

Sabuktagin Rahman  1 , Tahmeed Ahmed  1 , Ahmed Shafiqur Rahman  1 , Nurul Alam  2 , Am Shamsir Ahmed  1 , Santhia Ireen  1 , Ireen Akhter Chowdhury  3 , Fatima Parveen Chowdhury  4 , Sm Mustafizur Rahman  5
Affiliations

Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron

Sabuktagin Rahman et al. Public Health Nutr. 2016 Jul.

Abstract

Objective: Using data from the national micronutrients survey 2011-2012, the present study explored the determinants of Fe status and Hb levels in Bangladesh with a particular focus on groundwater Fe.

Design: Cross-sectional study conducted at the nationwide scale. Settings The survey was conducted in 150 clusters, fifty in each of the three strata of rural, urban and slum.

Subjects: Three population groups: pre-school age children (6-59 months; PSAC), school age children (6-14 years; SAC) and non-pregnant non-lactating women (15-49 years; NPNLW).

Results: National prevalence of Fe deficiency was 10·7 %, 7·1 % and 3·9-9·5 % in PSAC, NPNLW and SAC, respectively. Prevalence of anaemia was 33·1 % (PSAC), 26·0 % (NPNLW) and 17·1-19·1 % (SAC). Multivariate regression analyses showed that the area with 'predominantly high groundwater Fe' was a determinant of higher serum ferritin levels in NPNLW (standardized β=0·19; P=0·03), SAC (standardized β=0·22; P=0·01) and PSAC (standardized β=0·20; P=0·03). This area also determined higher levels of Hb in PSAC (standardized β=0·14; P=0·01).

Conclusions: National prevalence of Fe deficiency in Bangladesh is low, contrary to the widely held assumption. High Fe level in groundwater is associated with higher Fe status (all populations) and higher Hb level (PSAC).

Keywords: Anaemia; Bangladesh; Groundwater; Iron.

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Figures

Fig. 1
Fig. 1
(colour online) Iron concentration in groundwater in Bangladesh: British Geological Survey 2001( 8 ). According to the 2001 British Geological Survey, either side of the Brahmaputra basin, south of the Ganges basin and north-eastern haor regions (low plains with water mass) are predominantly high groundwater iron areas (denoted by shades of red), while the Barind and Madhupur tracts are the areas (denoted by shades of blue) with predominantly low iron in groundwater
Fig. 2
Fig. 2
Prevalence of drinking tube well water (i.e. groundwater; formula image) and of iron deficiency (formula image) by area of residence among pre-school age children (PSAC; 6–59 months old) in Bangladesh, 2011–2012. An inverse trend of usage of tube well water for drinking is seen in PSAC from rural, urban and slum areas. A progressive rise in drinking of tube well water with an associated decreasing prevalence of Fe deficiency is seen from slum through urban to rural areas
See this image and copyright information in PMC

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