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The global prevalence of anaemia in 2011

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THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

WHO Library Cataloguing-in-Publication Data The global prevalence of anaemia in 2011. 1.Anaemia – epidemiology. 2.Anaemia – statistics and numerical data. 3.Prevalence. 4.Child, Preschool. 5.Infant. 6.Adolescent. 7.Women. I.World Health Organization. ISBN 978 92 4 156496 0 (NLM classification: WH 155)

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Design and layout: Elysium Printed by the WHO Document Production Services, Geneva, Switzerland Suggested citation WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.

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CONTENTS

ACKNOWLEDGEMENTS iv SCOPE AND PURPOSE 1 BACKGROUND 1 METHODS 1 Identification of data sources for blood haemoglobin concentration and anaemia hrough a systematic review; accessing and extracting data; and systematically assessing the population representativeness of data Adjustment of data on blood haemoglobin concentrations for altitude and smoking Application of a statistical model to estimate trends in the distribution of blood haemoglobin concentrations and their uncertainties 2

2 2

RESULTS 3 Population coverage The proportion of the population and number of individuals with anaemia Classification of countries by degree of public health significance of anaemia, based on blood haemoglobin concentration The prevalence of anaemia attributed to iron deficiency 3 4 4 5

DISCUSSION 5 CONCLUSIONS REFERENCES ANNEX 1. WHO MEMBER STATES GROUPED BY REGION, AS OF JANUARY 2011 ANNEX 2. RESULTS BY UNITED NATIONS REGION, AS OF 2011 ANNEX 3. NATIONAL ESTIMATES OF ANAEMIA FOR THE YEAR 2011 6 7 15 17 19

iii

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Acknowledgements Juan Pablo Peña-Rosas, Lisa Rogers and Gretchen A Stevens oversaw the preparation of this report. The World Health Organization (WHO) acknowledges the technical contributions of Marianella Anzola, Camila Chaparro and Luz Maria De-Regil in the drafting and revision of this document. We would also like to thank Florence Rusciano for her support in the preparation of the maps presented in this document. These estimates of the prevalence of anaemia were produced by the Nutrition Impact Model Study Group (NIMS) for Anaemia, a collaboration between WHO and Imperial College London, United Kingdom of Great Britain and Northern Ireland (UK). The study was supported by the Bill & Melinda Gates Foundation and the Medical Research Council of the UK. WHO would like to thank (in alphabetical order): Zulfiqar A Bhutta, Francesco Branca, Luz Maria De-Regil, Majid Ezzati, Mariel M Finucaine, Seth R Flaxman, Christopher J Paciorek, Juan Pablo Peña-Rosas and Gretchen A Stevens for the technical input in the preparation of the estimates. WHO also wishes to thank the many individuals, institutions, governments and nongovernmental and international agencies for providing data for the Micronutrients Database in the WHO Vitamin and Mineral Nutrition Information System (VMNIS), which was developed by the Department of Nutrition for Health and Development and is currently being maintained by the Evidence and Programme Guidance Unit.

Financial support WHO thanks the Micronutrient Malnutrition Prevention and Control (IMMPaCt) Program, United States Centers for Disease Control and Prevention and the Micronutrient Initiative for providing financial support for maintaining the VMNIS Micronutrients Database. WHO gratefully acknowledges the financial support of the Bill & Melinda Gates Foundation and the United States Agency for International Development (USAID) for its work in nutrition.

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Scope and purpose This document describes estimates of the prevalence of anaemia for the year 2011 in preschool-age children (6–59 months) and women of reproductive age (15–49 years), by pregnancy status, and by regions of the United Nations and World Health Organization (WHO), as well as by country. This report is based on analyses previously published (1) to estimate trends (from 1995 to 2011) in the distribution of blood haemoglobin concentrations and the prevalence of anaemia in these same population groups. This document may serve as a resource for estimating the baseline prevalence of anaemia in women of reproductive age, in working towards achieving the second global nutrition target 2025, a 50% reduction of anaemia in women of reproductive age (2), as outlined in the Comprehensive implementation plan on maternal, infant and young child nutrition and endorsed by the Sixty-fifth World Health Assembly, in resolution WHA65.6(3) .

Background Anaemia, defined as a low blood haemoglobin concentration, has been shown to be a public health problem that affects low-, middle- and high-income countries and has significant adverse health consequences, as well as adverse impacts on social and economic development (1, 4–6). Although the most reliable indicator of anaemia at the population level is blood haemoglobin concentration, measurements of this concentration alone do not determine the cause of anaemia. Anaemia may result from a number of causes, with the most significant contributor being iron deficiency.1 Approximately 50% of cases of anaemia are considered to be due to iron deficiency, but the proportion probably varies among population groups and in different areas, according to the local conditions (1, 7, 8). Other causes of anaemia include other micronutrient deficiencies (e.g. folate, riboflavin, vitamins A and B12), acute and chronic infections (e.g. malaria, cancer, tuberculosis and HIV), and inherited or acquired disorders that affect haemoglobin synthesis, red blood cell production or red blood cell survival (e.g. haemoglobinopathies) (9, 10). Anaemia resulting from iron deficiency adversely affects cognitive and motor development, causes fatigue and low productivity (8, 9, 11) and, when it occurs in pregnancy, may be associated with low birth weight and increased risk of maternal and perinatal mortality (12, 13). In developing regions, maternal and neonatal mortality were responsible for 3.0 million deaths in 2013 and are important contributors to overall global mortality (14, 15). It has been further estimated that 90 000 deaths in both sexes and all age groups are due to iron deficiency anaemia alone (16). Any strategy implemented to prevent or treat anaemia should be tailored to local conditions, taking into account the specific etiology and prevalence of anaemia in a given setting and population group.

Methods The study design, data sources and statistical modelling methods on which this report is based have been presented in detail elsewhere (1). The methods were designed to assess trends in the distribution of blood haemoglobin concentrations between 1995 and 2011, using a statistical model (described 1 Iron deficiency anaemia and anaemia are often used synonymously and the prevalence of anaemia has often been used as a proxy for iron deficiency anaemia. However, it is important to realize that not all anaemia is caused by iron deficiency.

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below in “Application of a statistical model to estimate trends in the distribution of blood haemoglobin concentrations and their uncertainties”); however, only the estimates from 2011 are presented here. Briefly, the analysis included three steps, described under the subheadings that follow.

Identification of data sources for blood haemoglobin concentration and anaemia through a systematic review; accessing and extracting data; and systematically assessing the population representativeness of data A PubMed search was carried out for relevant search terms related to anaemia, haemoglobin and iron status, searching for studies published after 1 January 1990. In addition to indexed articles, many reports of national and international agencies were identified and accessed through requests to each corresponding organization. Data that were representative of the population level, or representative of at least three regions within the country, were included. Data mainly came from the Micronutrients Database of the WHO Vitamin and Mineral Information System (VMNIS), which summarizes data on the micronutrient status of populations, collected from the scientific literature and through collaborators, including WHO regional and country offices, United Nations organizations, ministries of health, research and academic institutions, and nongovernmental organizations. In some cases, anonymized individual-level data were obtained from multi-country surveys, including demographic and health surveys, multiple indicator cluster surveys, reproductive health surveys and malaria indicator surveys. Data sources were included if: • • • • • • blood haemoglobin concentration was measured; the study reported anaemia or mean blood haemoglobin concentration for preschool-age children or women of reproductive age; a probabilistic sampling method was used; the sample size was at least 100; data were collected after 1990; data were from the 190 countries designated for the original analysis.

Details on the selection of data sources are available as web appendices for the original publication (1,17); however, this document only presents data for 185 Member States of WHO (see Annexes 1 and 3).

Adjustment of data on blood haemoglobin concentrations for altitude and smoking Total and severe anaemia were defined according to WHO thresholds for blood haemoglobin concentration for individuals living at sea level (18). High altitude and smoking both increase haemoglobin concentration (18), so, where applicable, data that had been adjusted for altitude and smoking status were used whenever possible. Biologically implausible haemoglobin values (<25 g/L or >200 g/L) were excluded.

Application of a statistical model to estimate trends in the distribution of blood haemoglobin concentrations and their uncertainties A Bayesian hierarchical mixture model (1) was used to estimate trends in the distribution of blood haemoglobin concentrations for children and for women of reproductive age by pregnancy status. Briefly, the model calculates estimates for each country and year, informed by data from that country and year themselves, if available, and by data from other years in the same country and in other countries with data for similar time periods, especially countries in the same region. The model borrows data to a greater extent when data are non-existent or weakly informative, and to a lesser degree for data-rich countries and regions. The resulting estimates are also informed by covariates that help predict blood haemoglobin concentrations (e.g. maternal education, prevalence of sickle-cell disorders, mean weightfor-age z-score for children). The uncertainty ranges (credibility intervals)1 reflect the major sources of 1

As a Bayesian statistical model was used, 95% credibility intervals were calculated. These are analogous to confidence intervals, which are used in frequentist statistics.

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uncertainty, including sampling error, non-sampling error due to issues in sample design/measurement, and uncertainty from making estimates for countries and years without data. All analyses were done separately for children and women of reproductive age. Estimates were made for: preschool-age children (6–59 months),1 women of reproductive age (15–49 years), and pregnant women (15–49 years) and nonpregnant women (15–49 years) separately. Data from male and female children were pooled. The time frame for the estimates presented in the original analyses (1) was 1995−2011. The complete population distributions of blood haemoglobin concentrations for every country and year were estimated, which allowed calculation of the relevant summary statistics. For example, from the population distributions, the mean population blood haemoglobin concentration and the total number of individuals affected by, and the population prevalence of, severe anaemia for each country and year were calculated. Distributions for regions were calculated as population-weighted averages of the constituent countries. The prevalence of haemoglobin values below the WHO-recommended population-specific haemoglobin threshold concentration in blood was used to classify countries by the level of significance of the public health problem (18). Although esimates for each year (1995 to 2011) have been generated, the current report only presents estimates for the year 2011. An additional analysis was carried out to estimate the prevalence of anaemia that may be attributed to iron deficiency. In this analysis, the attribution of iron deficiency to the prevalence of anaemia was calculated as the population that would not be anaemic if iron supplements were given. Meta-analyses of the effect of iron supplementation on mean blood haemoglobin concentration in children aged 0–59 months and pregnant women and non-pregnant women aged 12–50 years were used to estimate the percentage of anaemia that could be eliminated by increased iron intake (19–21).

Results Population coverage The analysis performed (1) included 257 surveys conducted between 1990 and 2012, of which 232 (90%) were nationally representative sources. Two-hundred and five sources (80%) had data on women and 224 (87%) had data on children. Of the 194 WHO Member States, estimates of the prevalence of anaemia were not made for nine countries because covariate data were not available. Of the remaining 185 countries, 95 (51%) and 101 (55%) had at least one data source for children and women, respectively, covering 82—85% of the global population of children and women. Data were most sparse in the WHO European Region. In contrast, all countries in the WHO South-East Asia Region had at least one data source, as did 78% of countries in the African Region. Data for non-pregnant women and pregnant women were summed and weighted by the prevalence of pregnancy, to generate one value for all women of reproductive age. Although data for non-pregnant women and all women of reproductive age are very similar, they are shown for all three groups of women separately in the tables. The population covered by survey data at the regional and global level was calculated by summing the population (number of children and women) in countries with survey data and dividing by the total population in all countries in that region or globally. The proportion of the population covered by surveys, by WHO region, was over 90% in the African, South-East Asia and Western Pacific Regions and was lowest (18—23%) in the European Region (see Table 1). Annex 2 presents the results by United Nations region.

The proportion of the population and number of individuals with anaemia The 2011 estimates suggest anaemia affects around 800 million children and women (see Table 2). 1

Estimates were made for children aged 6–59 months because few household surveys measure anaemia in children under 6 months of age. However, the estimate was applied to the entire population of children aged less than 5 years; thus, the number of children affected is for the age range 0–59 months.

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Globally, the mean blood haemoglobin concentration was 111 g/L (95% credibility interval1 [CI]: 110—113) in children, 126 g/L (95% CI: 124—128) in non-pregnant women, and 114 g/L (95% CI: 112—116) in pregnant women (see Table 2), indicating that, on average, all population groups were above the threshold for mild anaemia (110 g/L for children and pregnant women and 120 g/L for non-pregnant women). In 2011, the highest prevalence of anaemia was in children (42.6%, 95% CI: 37—47), and the lowest prevalence was in non-pregnant women (29.0%, 95% CI: 23.9—34.8). In addition, the global prevalence of anaemia for pregnant women was 38.2% (95% CI: 33.5—42.6) and for all women of reproductive age was 29.4% (95% CI: 24.5—35.0). Severe anaemia is associated with substantially worse mortality and cognitive and functional outcomes; in 2011, its prevalence in children and women ranged from 0.9% to 1.5%. Haemoglobin concentrations in pregnant women were lower than in non-pregnant women. However, as the threshold for defining anaemia is lower for pregnant women, the prevalences of anaemia in pregnant and non-pregnant women were only about nine percentage points apart. These prevalences translate to 273.2 million (95% CI: 241.8—303.7) children, 496.3 million (95% CI: 409.3—595.1) non-pregnant women, and 32.4 million (95% CI: 28.4—36.2) pregnant women, giving a total of 528.7 million (95% CI: 440.3—629.4) women of reproductive age with anaemia worldwide in 2011. Of these, 9.6 million (95% CI: 6.9—14.4) children, 19.4 million (95% CI: 12.7—29.4) non-pregnant women and 0.8 million (95% CI: 0.5—1.1) pregnant women had severe anaemia, giving a total of 20.2 million (95% CI: 13.3—30.5) women of reproductive age. Mean blood haemoglobin concentrations and prevalences of anaemia varied substantially across regions and countries. In 2011, the WHO South-East Asia, Eastern Mediterranean and African Regions had the lowest mean blood haemoglobin concentrations and the highest prevalences of anaemia across population groups (see Table 2). Children in these three regions had a mean blood haemoglobin concentration between 104 and 109 g/L (i.e. below the threshold for mild anaemia), with more than half of children in the South-East Asia and African Regions (53.8% or more) classified as having anaemia; severe anaemia was highest in the African Region, with 3.6% of children affected. While women in these regions had higher blood haemoglobin levels than children, the mean blood haemoglobin concentration was also lowest for all women in the same three regions. The prevalence of anaemia was 37.7% to 41.5% for non-pregnant women and 38.9% to 48.7% for pregnant women in these regions. The countries with the lowest blood haemoglobin levels and highest prevalences of anaemia were in the WHO African Region (see Annex 3); this reflects the high prevalence of factors affecting anaemia in this region, such as malaria, sickle cell and thalassaemias. Children in the African Region represented the highest proportion of individuals affected with anaemia, at 62.3% (95% CI: 59.6—64.8), while the greatest number of children and women with anaemia resided in the South-East Asia Region, including 96.7 million (95% CI: 71.7—115.0) children and 202.0 million (95% CI: 141.8—254.3) women of reproductive age (see Table 2) in 2011. The Eastern Mediterranean Region had the next highest anaemia burden for children, accounting for 35.7 million (95% CI: 29.7—41.9) children with anaemia, and the Western Pacific Region had the next highest anaemia burden for women, accounting for 96.2 million (95% CI: 53.5—175.3) women with anaemia in 2011.

Classification of countries by degree of public health significance of anaemia, based on blood haemoglobin concentration The level of the public health problem across countries is illustrated by maps for children and women of reproductive age in Figs. 1 and 2. Additional maps may also be customized and downloaded, using the WHO Global targets tracking tool (22). The tracking tool was designed to allow users to explore various scenarios that take into account different rates of progress for the six global nutrition targets for improving maternal, infant and young child nutrition (3), including a 50% reduction of anaemia in women of reproductive age (2). There are no countries for which country-level estimates were generated where anaemia is not at least a mild public health problem (i.e. the prevalence of anaemia is at least 5%) in children and women (see Table 3). Anaemia is a moderate-to-severe public health problem for pregnant women in all but two of the countries analysed. For children and women, the majority of WHO Member States (141 to 182, 1

As a Bayesian statistical model was used, 95% credibility intervals were calculated. These are analogous to confidence intervals, which are used in frequentist statistics.

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depending on the population group) have a moderate-to-severe public health problem with anaemia.

The prevalence of anaemia attributed to iron deficiency Available meta-analyses suggest that iron supplementation would increase the mean blood haemoglobin concentration by 8.0 g/L (95% CI: 5.0—11.0) in children, 10.2 g/L (95% CI: 6.1—14.2) in pregnant women and 8.6 g/L (95% CI: 3.9—13.4) in non-pregnant women (19—21). Applying these shifts to estimated blood haemoglobin concentrations indicates that about 42% of anaemia in children would be amenable to iron supplementation and about 50% of anaemia in women could be eliminated by iron supplementation (see Table 4).

Discussion The estimates presented in this document are based on data available in the Micronutrients Database of the WHO VMNIS (23). Analyses were performed in a consistent manner for children and women, and by pregnancy status, with reporting of uncertainty (1). Overall, a high proportion of countries had nationally representative survey data available for the three population groups most vulnerable to anaemia: preschool-age children (6–59 months), pregnant women (15–49 years of age) and non-pregnant women (15–49 years of age). Unfortunately, despite the extensive data search, data for blood haemoglobin concentrations are still limited, compared to other nutritional indicators such as child anthropometry (1, 24); this was especially true in the high-income countries of the WHO European Region. As a result, the estimates may not capture the full variation across countries and regions, tending to “shrink” towards global means when data are sparse (1). Additionally, it was not possible to incorporate into the analyses some potentially important predictors of blood haemoglobin concentration, especially dietary iron and iron supplementation, because of limited data. At this time, other population groups, such as adolescents, the elderly and men, have been excluded, also because of limited data. These additional population groups may account for around 45% of all cases of anaemia (25). Despite the relatively limited data available, the proportion of the population covered by at least one anaemia survey conducted between 1995 and 2011 is relatively high (greater than 80%) for all population groups globally. Regionally, the WHO African, South-East Asia and Western Pacific Regions had very high coverage, with over 90% of the population covered by anaemia survey data for children and women, while the WHO European Region had only 18–23% of the population covered by survey data. For the year 2011, it is estimated that roughly 43% of children, 38% of pregnant women, and 29% of nonpregnant women and 29% of all women of reproductive age have anaemia globally, corresponding to 273 million children, 496 million non-pregnant women and 32 million pregnant women. Previous estimates of anaemia were published jointly by the WHO Department of Nutrition for Health and Development and the United States Centers for Disease Control and Prevention in 2008 for the years 1993–2005 (25). Different methodology was used in generating the estimates but the results were consistent. However, because different methodology was used, the estimates should not be compared to infer trends in the prevalence of anaemia. Correcting anaemia requires an integrated approach based on identifying and addressing the contributing factors. Low blood haemoglobin concentrations may be caused by genetic traits like sickle cell and thalassaemias; inadequate bioavailable dietary iron, folic acid and/or vitamin B12 ; malaria, schistosomiasis, hookworm, or human immunodeficiency virus (HIV) infections; and some noncommunicable diseases (8, 9, 18, 26–29). The analysis conducted to better understand the prevalence of anaemia attributed to iron deficiency estimates that the proportion of all anaemia amenable to iron was around 50% in women and

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42% in children, but higher for severe anaemia (over 50% for children and non-pregnant women and over 60% for pregnant women) and in regions where there are fewer other causes of anaemia (e.g. in the WHO Region of the Americas and European Region). The proportion was lowest where other factors contribute to anaemia, for example, <45% in non-pregnant women in different parts of the WHO African and SouthEast Asia Regions. Iron deficiency anaemia should ideally be addressed through dietary diversification and improved access to foods that have high levels of bioavailable iron, including animal products. Daily or intermittent iron supplementation, alone or together with folic acid and other micronutrients, can be used for high-risk groups (children, pregnant women and women of reproductive age), to improve iron intakes (7, 30–33). However, supplementation programmes need to address challenges that have limited their effectiveness, such as poor attendance at antenatal clinics, insufficient doses for supplementation, or insufficient emphasis on behavioural aspects of using supplements on a regular basis (34). Other foodbased approaches, such as fortification of staple foods and condiments, can also be used to improve iron intake in the general population (35, 36). Fortification of wheat flour with iron and other vitamins and minerals is currently mandated in 80 countries but the extent of coverage varies (37). Given that it is estimated that at least half of anaemia cases will have causes other than iron deficiency, current strategies to control anaemia may need to be re-evaluated to ensure that the various factors contributing to anaemia have been identified and addressed properly in an integrated manner. In malariaendemic regions, malaria control can reduce anaemia and severe anaemia by over a quarter and by 60%, respectively (27). The role of malaria in the etiology of anaemia is probably greatest in the WHO African Region, the region with the lowest mean blood haemoglobin concentration among children for 2011, and the region with the most countries with high rates of Plasmodium falciparum parasite infection (38). In malaria-endemic regions, iron supplementation should be integrated with prevention and treatment of malaria (30–33, 39), which can together have synergistically beneficial effects on haemoglobin status. Preventive interventions, including insecticide-treated bednets and intermittent preventive treatment, also improve blood haemoglobin concentrations in children and pregnant women living in malariaendemic areas (9, 27). Sickle cell traits and thalassaemias may have a more important role in parts of the WHO African, Eastern Mediterranean and South-East Asia Regions (40, 41). There is also an increased need for improved water and sanitation and deworming in populations affected by hookworms and schistosomiasis; these populations typically live in rural tropical regions with poor sanitation facilities, especially in areas of Asia and Africa (28, 42).

Conclusions Reducing anaemia is recognized as an important component of the health of women and children, and the second global nutrition target for 2025 calls for a 50% reduction of anaemia in women of reproductive age (2). In low-income countries, the prevalence of anaemia remains high and is an area of priority. If the current trends are maintained (1), there is a probability of less than 25% in all regions of reaching the global target of reducing the prevalence of anaemia by 50% in women of reproductive age. To make a significant impact, it is likely that a combination of key programmes that address the determinants of low blood haemoglobin concentrations will be required. These strategies should be tailored to local conditions, taking into account the specific etiology and prevalence of anaemia in a given setting and population group (9, 10), and should be built into the primary health-care system and existing programmes.

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the UN Inter-agency Group for Child Mortality Estimation. New York: United Nations Children’s Fund; 2014 (http://www.data.unicef.org/fckimages/uploads/1410869227_Child_Mortality_ Report_2014.pdf, accessed 7 May 2015). 15. World Health Organization, United Nations Children’s Fund, United Nations Population Fund, The World Bank, United Nations Population Division. Trends in maternal mortality: 1990 to 2010. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Geneva: World Health Organization; 2014 (http://apps.who.int/iris/bitstre am/10665/112682/2/9789241507226_eng.pdf?ua=1; accessed 7 May 2015). Global health estimates 2014 summary tables: deaths by cause, age and sex, by WHO region, 2000–2012. Geneva: World Health Organization; 2014 (http://www.who.int/healthinfo/global_ burden_disease/estimates/en/index1.html, accessed 25 March 2015). Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F et al. 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. Lancet Glob Health. 2013;1:web appendices (http://www. thelancet.com/cms/attachment/2019279915/2039454081/mmc1.pdf, accessed 7 May 2015). Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011 (http:// www.who.int/vmnis/indicators/haemoglobin/en/index.html, accessed 7 May 2015). De-Regil LM, Jefferds ME, Sylvetsky AC, Dowswell T. Intermittent iron supplementation for improving nutrition and development in children under 12 years of age. Cochrane Database Syst Rev. 2011;(12):CD009085. doi:10.1002/14651858.CD009085.pub2. Fernández-Gaxiola AC, De-Regil LM. Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women. Cochrane Database Syst Rev. 2011;(12):CD009218. doi:10.1002/14651858.CD009218.pub2. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW; Nutrition Impact Model Study Group (anaemia). Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:f3443. doi:10.1136/bmj.f3443. World Health Organization. Global targets tracking tool (http://www.who.int/nutrition/ trackingtool/en/, accessed 7 May 2015). World Health Organization. Vitamin and Mineral Information System (VMNIS) Micronutrients database (http://www.who.int/vmnis/database/en/, accessed 19 May 2015). World Health Organization. Global database on child growth and nutrition (http://www.who.int/ nutgrowthdb/en/, accessed 19 May 2015). World Health Organization, Centers for Disease Control and Prevention. Worldwide prevalence of anaemia 1993–2005: WHO Global Database on Anaemia. Geneva: World Health Organization; 2008 (http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf, accessed 7 May 2015). Crompton DWT, Montresor A, Nesheim MC, Savioli L, editors. Controlling disease due to helminth infections. Geneva: World Health Organization, 2003 (http://apps.who.int/iris/bitstre am/10665/42707/1/9241562390.pdf?ua=1, accessed 7 May 2015). Korenromp EL, Armstrong-Schellenberg JR, Williams BG, Nahlen BL, Snow RW. Impact of malaria control on childhood anaemia in Africa – a quantitative review. Trop Med Int Health. 2004;9:1050–65. Smith JL, Brooker S. Impact of hookworm infection and deworming on anaemia in non-pregnant populations: a systematic review. Trop Med Int Health. 2010;15:776–95. doi: 10.1111/j.13653156.2010.02542.x.

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31.

32.

33.

34.

35.

36.

37. 38.

39.

40. 41.

42.

43.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table 1. Number of countries and percentage of population covered by surveys of anaemia prevalence (national or subnational), by WHO region All women of reproductive age (15–49 years) Countries 36 Coverage (%) 91.1

WHO region African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global a

Number of countries in regiona 46

Children aged 6–59 months Countries 35 Coverage (%) 93.7

Non-pregnant women aged 15–49 years Countries 36 Coverage (%) 90.8

Pregnant women aged 15–49 years Countries 35 Coverage (%) 93.9

86.0

64.3

65.8

64.4

11 51

9 12

96.8 22.7

11 13

100.0 18.4

10 11

97.8 21.7

11 13

100.0 18.6

77.2

81.1

69.2

80.9

90.3

96.7

95.1

96.6

185

85.0

101

81.3

83.2

101

81.5

Table 2. Global and WHO regional mean blood haemoglobin concentration and prevalence of anaemia by population group for 2011 Mean (95% CI) blood haemoglobin concentration (g/L) Percentage (95% CI) of population with severe anaemiac Number (95%CI) of people with severe anaemia (millions)b

WHO region

Percentage (95% CI) of population with anaemiaa

Number (95% CI) of people with anaemia (millions)b

Children aged 6–59 months African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global 104 (103 to 105) 119 (117 to 121) 107 (104 to 112) 119 (115 to 122) 109 (106 to 112) 120 (114 to 125) 111 (110 to 113) 62.3 (59.6 to 64.8)c 22.3 (17.7 to 27.9) 53.8 (39.9 to 63.9) 22.9 (14.9 to 32.8) 48.6 (40.4 to 57.0) 21.9 (12.0 to 36.9) 42.6 (37.7 to 47.4) 84.5 (81.0 to 87.9)c 17.1 (13.5 to 21.3) 96.7 (71.7 to 115.0) 12.7 (8.2 to 18.1) 35.8 (29.7 to 41.9) 25.7 (14.2 to 43.4) 273.2 (241.8 to 303.7) 3.6 (2.9 to 4.4) 0.2 (0.1 to 0.5) 1.5 (0.4 to 3.7) 0.3 (0.1 to 0.8) 2.0 (1.0 to 3.1) 0.2 (0.0 to 0.6) 1.5 (1.0 to 2.2) 4.9 (4.0 to 6.0) 0.18 (0.1 to 0.4) 2.7 (0.8 to 6.6) 0.2 (0.0 to 0.5) 1.5 (0.7 to 2.3) 0.2 (0.0 to 0.7) 9.6 (6.9 to 14.1)

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table 2. Global and WHO regional mean blood haemoglobin concentration and prevalence of anaemia by population group for 2011, continued Mean (95% CI) blood haemoglobin concentration (g/L) Percentage (95% CI) of population with severe anaemiac Number (95%CI) of people with severe anaemia (millions)b

WHO region

Percentage (95% CI) of population with anaemiaa

Number (95% CI) of people with anaemia (millions)b

Non-pregnant women aged 15–49 years African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global 124 (121 to 126) 131 (128 to 134) 121 (117 to 126) 128 (126 to 130) 123 (120 to 126) 129 (124 to 134) 126 (124 to 128) 37.8 (31.8 to 43.7) 16.5 (12.2 to 23.7) 41.5 (28.7 to 52.6) 22.5 (16.4 to 30.1) 37.7 (30.7 to 45.6) 19.8 (10.9 to 36.6) 29.0 (23.9 to 34.8) 69.9 (58.8 to 80.7) 38.1 (28.1 to 54.7) 190.6 (131.7 to 241.3) 48.4 (35.2 to 64.7) 55.2 (44.9 to 66.8) 92.6 (50.8 to 170.9) 496.3 (409.3 to 595.1) 1.8 (1.3 to 2.7) 0.5 (0.3 to 1.1) 1.9 (0.7 to 3.8) 0.6 (0.3 to 1.2) 1.8 (1.1 to 2.6) 0.5 (0.2 to 1.3) 1.1 (0.7 to 1.7) 3.3 (2.4 to 5.1) 1.3 (0.7 to 2.6) 8.6 (3.4 to 17.5) 1.3 (0.7 to 2.6) 2.6 (1.6 to 3.8) 2.2 (0.8 to 6.0) 19.4 (12.7 to 29.4)

Pregnant women aged 15–49 years African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global 111 (110 to 114) 119 (116 to 122) 110 (106 to 114) 118 (115 to 121) 113 (111 to 116) 119 (114 to 124) 114 (112 to 116) 46.3 (40.6 to 51.0) 24.9 (19.0 to 32.5) 48.7 (36.1 to 58.9) 25.8 (19.8 to 33.6) 38.9 (32.7 to 46.3) 24.3 (15.1 to 37.7) 38.2 (33.5 to 42.6) 9.2 (8.13 to 10.1) 2.4 (1.8 to 3.1) 11.5 (8.5 to 13.9) 1.8 (1.4 to 2.3) 3.9 (3.3 to 4.6) 3.6 (2.2 to 5.5) 32.4 (28.41 to 36.2) 1.5 (1.0 to 2.3) 0.3 (0.1 to 0.6) 1.1 (0.5 to 2.2) 0.3 (0.1 to 0.6) 1.1 (0.6 to 1.6) 0.4 (0.1 to 0.9) 0.9 (0.6 to 1.3) 0.3 (0.2 to 0.5) 0.0 (0.0 to 0.1) 0.3 (0.1 to 0.5) 0.0 (0.0 to 0.0) 0.1 (0.1 to 0.2) 0.1 (0.0 to 0.1) 0.8 (0.5 to 1.1)

All women of reproductive age (15–49 years) African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global 123 (120 to 125) 131 (128 to 133) 121 (117 to 125) 128 (125 to 130) 122 (120 to 125) 129 (124 to 134) 125 (124 to 127) 38.6 (32.9 to 44.2) 16.8 (12.6 to 23.8) 41.9 (29.4 to 52.7) 22.6 (16.6 to 29.9) 37.8 (31.0 to 45.5) 19.9 (11.1 to 36.3) 29.4 (24.5 to 35.0) 79.1 (67.3 to 90.5) 40.5 (30.2 to 57.3) 202.0 (141.8 to 254.3) 50.2 (36.8 to 66.5) 59.1 (48.4 to 71.2) 96.2 (53.5 to 175.3) 528.7 (440.3 to 629.4) 1.8 (1.3 to 2.7) 0.5 (0.3 to 1.1) 1.8 (0.7 to 3.8) 0.6 (0.3 to 1.2) 1.8 (1.1 to 2.5) 0.5 (0.2 to 1.3) 3.6 (2.6 to 5.5) 1.3 (0.7 to 2.7) 8.9 (3.5 to 18.1) 1.4 (0.7 to 2.7) 2.7 (1.7 to 3.9) 2.3 (0.8 to 6.1)

1.1 (0.7 to 1.7) 20.2 (13.3 to 30.5)

CI: credibility interval. a Anaemia is defined as blood haemoglobin concentration <110 g/L for children and pregnant women and <120 g/L for nonpregnant women. b Estimates of the number of children affected correspond to the age range 0–59 months. c Severe anaemia is defined as blood haemoglobin concentration <70 g/L for children and pregnant women and <80 g/L for non-pregnant women.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table 3. Number of countriesa categorized by public health significance of anaemia, 2011 Non-pregnant women (15-49 years) 0 44 109 32 All women of reproductive age (15–49 years) 0 42 110 33

Category of public health problemb None Mild Moderate Severe a

Children (6–59 months) 0 32 84 69

Pregnant women (15–49 years) 0 2 146 37

Excludes WHO Member States of Cook Islands (Western Pacific Region), Monaco (European Region), Nauru (Western Pacific Region), Niue (Western Pacific Region), Palau (Western Pacific Region), Saint Kitts and Nevis (Region of the Americas), San Marino (European Region) and Tuvalu (Western Pacific Region). Former Sudan is included in lieu of Sudan and South Sudan, consistent with the situation from 1 January to 9 July 2011. The prevalence of anaemia as a public health problem is categorized as follows: <5%, no public health problem; 5–19.9%, mild public health problem; 20–39.9%, moderate public health problem; ≥40%, severe public health problem.

Table 4. Estimated percentage (95% CI) of anaemiaa that is amendable to iron supplementation

WHO region African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Global

Children (6–59 months) 32 (30 to 34) 56 (48 to 63) 41 (34 to 54) 54 (44 to 65) 38 (33 to 43) 64 (46 to 73) 42 (38 to 46)

Non-pregnant women (15–49 years) 41 (36 to 46) 55 (44 to 62) 45 (35 to 53) 55 (46 to 61) 45 (39 to 50) 59 (44 to 70) 49 (43 to 53)

Pregnant women (15–49 years) 44 (42 to 47) 60 (52 to 68) 47 (42 to 54) 62 (54 to 71) 49 (46 to 54) 61 (49 to 72) 50 (47 to 53)

CI: credibility interval. a Anaemia is defined as blood haemoglobin concentration <110 g/L for children and pregnant women and <120 g/L for nonpregnant women.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Fig.1. Global estimates of the prevalence of anaemia in infants and children aged 6–59 months, 2011

Percentage (%) <20.0 20.0–39.9 40.0–59.9 ≥60.0 No estimate Not applicable 0 850 1,700 3,400 Kilometers

Fig.2. Global estimates of the prevalence of anaemia in women of reproductive age, 15–49 years, 2011 a. Prevalence of anaemia, all women aged 15–49 years, 2011

Percentage (%) <20.0 20.0–39.9 40.0–59.9 ≥60.0 No estimate Not applicable 0 850 1,700 3,400 Kilometers

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

b. Prevalence of anaemia, pregnant women aged 15–49 years, 2011

Percentage (%) <20.0 20.0–39.9 40.0–59.9 ≥60.0 No estimate Not applicable 0 850 1,700 3,400 Kilometers

c. Prevalence of anaemia, non-pregnant women aged 15–49 years, 2011

Percentage (%) <20.0 20.0–39.9 40.0–59.9 ≥60.0 No estimate Not applicable 0 850 1,700 3,400 Kilometers

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Annex 1. WHO Member States grouped by region, as of 2011 Table A1.1. WHO Member States grouped by WHO region

WHO region African Region

WHO Member States, as of 1 January 2011 Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis,b Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, United States of America, Uruguay, Venezuela (Bolivarian Republic of)

Region of the Americas

Eastern Mediterranean Afghanistan, Bahrain, Djibouti, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Kuwait, Lebanon, Libya, Region Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, former Sudan a, Syrian Arab Republic, Tunisia, United Arab Emirates, Yemen European Region Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Monaco,b Montenegro, Netherlands, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, San Marino,b Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, the former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, United Kingdom of Great Britain and Northern Ireland, Uzbekistan

South-East Asia Region Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste Western Pacific Region Australia, Brunei Darussalam, Cambodia, China, Cook Islands,b Fiji, Japan, Kiribati, Lao People’s Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated States of), Mongolia, Nauru,b New Zealand, Niue,b Palau,b Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Tuvalu,b Vanuatu, Viet Nam a b

Former Sudan is included in lieu of Sudan and South Sudan, consistent with the situation from 1 January to 9 July 2011. Estimates were not made for these WHO Member States because covariate data were not available.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A1.2. WHO Member States grouped by United Nations region and subregion (43) United Nations region and subregion Africa Eastern Africa Middle Africa Northern Africa Southern Africa Western Africa Americas Latin America and the Caribbean Caribbean Central America South America Northern America Asia Central Asia Eastern Asia Southern Asia South-Eastern Asia Western Asia Europe Eastern Europe Northern Europe Southern Europe Western Europe Oceania Australia and New Zealand Melanesia Micronesia Polynesia a b

WHO Member States, as of 1 January 2011

Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Rwanda, Seychelles, Somalia, Uganda, United Republic of Tanzania, Zambia, Zimbabwe Angola, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Sao Tome and Principe Algeria, Egypt, Libya, Morocco, former Sudan,a Tunisia Botswana, Lesotho, Namibia, South Africa, Swaziland Benin, Burkina Faso, Cabo Verde, Côte d’Ivoire, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Togo

Antigua and Barbuda, Bahamas, Barbados, Cuba, Dominica, Dominican Republic, Grenada, Haiti, Jamaica, Saint Kitts and Nevis,b Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama Argentina, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay, Venezuela (Bolivarian Republic of) Canada, United States of America

Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan China, Democratic People’s Republic of Korea, Japan, Mongolia, Republic of Korea Afghanistan, Bangladesh, Bhutan, India, Iran (Islamic Republic of), Maldives, Nepal, Pakistan, Sri Lanka Brunei Darussalam, Cambodia, Indonesia, Lao People’s Democratic Republic, Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste, Viet Nam Armenia, Azerbaijan, Bahrain, Georgia, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Turkey, United Arab Emirates, Yemen

Belarus, Bulgaria, Czech Republic, Hungary, Poland, Republic of Moldova, Romania, Russian Federation, Slovakia, Ukraine Denmark, Estonia, Finland, Iceland, Ireland, Latvia, Lithuania, Norway, Sweden, United Kingdom of Great Britain and Northern Ireland Albania, Andorra, Bosnia and Herzegovina, Croatia, Greece, Italy, Malta, Montenegro, Portugal, San Marino,b Serbia, Slovenia, Spain, the former Yugoslav Republic of Macedonia Austria, Belgium, France, Germany, Luxembourg, Monaco,b Netherlands, Switzerland

Australia, New Zealand Fiji, Papua New Guinea, Solomon Islands, Vanuatu Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru,b Palau,b Cook Islands,b Niue,b Samoa, Tonga, Tuvalub

Former Sudan is included in lieu of Sudan and South Sudan, consistent with the situation from 1 January to 9 July 2011 Estimates were not made for these WHO Member States because covariate data were not available.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Annex 2. Results by United Nations region, as of 2011 Table A2.1. Number of countries and percentage of population covered by surveys of anaemia prevalence (national or subnational), by United Nations region All women of reproductive age (15–49 years) Countries 41 36 14 5 5 101 Coverage (%) 92.0 94.7 64.4 10.9 16.2 81.5

United Nations region Africa Asia Americas Europe Oceania Global a

Number of countries in regiona 53 47 34 40 11 185

Children aged 6–59 months Countries 40 30 15 5 5 95 Coverage (%) 94.0 89.6 86.0 12.3 5.4 85.0

Non-pregnant women aged 15–49 years Countries 41 36 14 5 5 101

Pregnant women aged 15–49 years Coverage (%) 94.2 89.5 65.8 11.9 15.2 83.2

Coverage (%) Countries 91.8 94.7 64.3 10.9 16.3 81.3 40 32 13 4 5 94

Excludes WHO Member States of Cook Islands (Oceania), Monaco (Europe), Nauru (Oceania), Niue (Oceania), Palau (Oceania), Saint Kitts and Nevis (Americas), San Marino (Europe), Tuvalu (Oceania). Former Sudan is included in lieu of Sudan and South Sudan, consistent with the situation from 1 January to 9 July 2011.

Table A2.2. Global and United Nations regional mean blood haemoglobin concentration and prevalence of anaemia by population group for 2011 Mean (95%CI) blood haemoglobin concentration (g/L)

United Nations region

Percentage (95% CI) of population with anaemiaa

Number (95% CI) of people with anaemia (millions)b

Percentage (95% CI) of population with severe anaemiac

Number (95% CI) of people with severe anaemia (millions)b

Children aged 6–59 months Africa Latin America and the Caribbean Northern America Asia Europe Oceania Global 105 (103 to 106) 117 (114 to 120) 124 (122 to125) 112 (109 to 115) 120 (116 to 123) 117 (112 to 122) 111 (110 to 113) 60.2 (57.0 to 63.1) 29.1 (22.5 to 36.9) 7.0 (4.9 to 12.3) 42.0 (34.1 to 49.9) 19.3 (10.9 to 30.7) 26.2 (14.5 to 41.6) 42.6 (37.7 to 47.4) 95.0 (90.0 to 99.6) 15.5 (12.0 to 19.6) 1.6 (1.2 to 2.9) 3.3 (2.7 to 4.0) 0.3 (0.2 to 0.7) 0.0 (0.0 to 0.2) 5.2 (4.2 to 6.3) 0.2 (0.1 to 0.4) 0.0 (0.0 to 0.0) 4.1 (1.8 to 8.2) 0.1 (0.0 to 0.3) 0.0 (0.0 to 0.0) 9.6 (6.9 to 14.1)

152.2 (123.5 to 180.9) 1.1 (0.5 to 2.3) 7.8 (4.4 to 12.4) 0.8 (0.4 to 1.3) 0.2 (0.0 to 0.8) 0.3 (0.0 to 1.3)

273.2 (241.8 to 303.7) 1.5 (1.0 to 2.2)

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A2.2. Global and United Nations regional mean blood haemoglobin concentration and prevalence of anaemia by population group for 2011, continued Mean (95%CI) blood haemoglobin concentration (g/L)

United Nations region

Percentage (95% CI) of population with anaemiaa

Number (95% CI) of people with anaemia (millions)b

Percentage (95% CI) of population with severe anaemiac

Number (95% CI) of people with severe anaemia (millions)b

Non-pregnant women aged 15–49 years Africa Latin America and the Caribbean Northern America Asia Europe Oceania Global 124 (122 to 126) 131 (127 to 134) 132 (130 to 134) 125 (122 to 128) 129 (126 to 131) 129 (123 to 133) 126 (124 to 128) 36.9 (31.5 to 42.6) 18.7 (12.7 to 29.4) 12.2 (9.1 to 17.0) 31.6 (24.1 to 40.5) 19.9 (13.5 to 28.4) 19.5 (11.5 to 35.6) 29.0 (23.9 to 34.8) 85.1 (72.6 to 98.1) 28.7 (19.4 to 45.0) 9.6 (7.2 to 13.4) 1.6 (1.2 to 2.4) 0.7 (0.3 to 1.6) 0.2 (0.1 to 0.5) 3.8 (2.8 to 5.6) 1.1 (0.5 to 2.4) 0.2 (0.7 to 0.4) 13.4 (7.3 to 23.1) 0.9 (0.4 to 2.01) 0.1 (0.0 to 0.2) 19.4 (12.7 to 29.4)

337.0 (257.4 to 432.4) 1.3 (0.7 to 2.2) 34.5 (23.4 to 49.1) 1.7 (1.0 to 3.0) 0.5 (0.2 to 1.2) 0.8 (0.2 to 2.0)

496.3 (409.3 to 595.1) 1.1 (0.7 to 1.7)

Pregnant women aged 15–49 years Africa Latin America and the Caribbean Northern America Asia Europe Oceania Global 112 (110 to 114) 118 (114 to 123) 121 (119 to 125) 113 (111 to 116) 118 (115 to 122) 117 (112 to 122) 114 (112 to 116) 44.6 (39.3 to 49.0) 28.3 (20.1 to 38.6) 17.1 (11.8 to 21.8) 39.3 (31.8 to 46.5) 24.5 (17.8 to 33.8) 29.0 (18.4 to 42.8) 38.2 (33.5 to 42.6) 10.2 (9.0 to 11.2) 1.9 (1.4 to 2.6) 0.5 (0.3 to 0.6) 18.5 (15.0 to 21.9) 1.2 (0.9 to 1.7) 0.1 (0.1 to 0.2) 32.4 (28.4 to 36.2) 1.4 (0.9 to 2.1) 0.4 (0.2 to 0.9) 0.1 (0.0 to 0.2) 0.9 (0.5 to 1.5) 0.2 (0.1 to 0.6) 0.6 (0.1 to 1.5) 0.8 (0.6 to 1.2) 0.3 (0.2 to 0.51) 0.0 (0.0 to 0.1) 0.0 (0.0 to 0.0) 0.4 (0.2 to 0.7) 0.0 (0.0 to 0.0) 0.0 (0.0 to 0.0) 0.8 (0.5 to 1.1)

All women of reproductive age (15–49 years) Africa Latin America and the Caribbean Northern America Asia Europe Oceania Global 123 (121 to 125) 130 (126 to 134) 131 (130 to 133) 124 (122 to 127) 129 (126 to 131) 128 (123 to 132) 125 (124 to 127) 37.6 (32.4 to 43.0) 19.1 (13.1 to 29.4) 12.4 (9.3 to 17.1) 31.9 (24.6 to 40.6) 20.1 (13.8 to 28.3) 20.0 (12.0 to 35.5) 29.4 (24.5 to 35.0) 95.3 (82.1 to 108.0) 30.6 (20.9 to 46.9) 10.1 (7.6 to 14.0) 1.6 (1.2 to 2.4) 0.7 (0.3 to 1.6) 0.2 (0.1 to 0.5) 4.1 (3.0 to 6.0) 1.1 (0.5 to 2.5) 0.2 (0.1 to 0.4) 13.8 (7.5 to 23.7) 0.9 (0.4 to 2.0) 0.1 (0.0 to 0.2) 20.2 (13.3 to 30.5)

355.5 (274.5 to 452.8) 1.2 (0.7 to 2.1) 35.7 (24.6 to 50.4) 1.8 (1.1 to 3.2) 0.5 (0.2 to 1.1) 0.8 (0.2 to 1.9)

528.7 (440.3 to 629.4) 1.1 (0.7 to 1.7)

CI: credibility interval. a Anaemia is defined as blood haemoglobin concentration <110 g/L for children and pregnant women and <120 g/L for non-pregnant women. b Estimates of the number of children affected correspond to the age range 0–59 months. c Severe anaemia is defined as blood haemoglobin concentration <70 g/L for children and pregnant women and <80 g/L for non-pregnant women.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Annex 3. National estimates of anaemia for the year 2011 Table A3.1. Country estimates for children aged 6–59 months Percentage of children with blood haemoglobin concentration <110 g/L Estimate 44 22 95% CI 20 to 69 10 to 37 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 1.8 0.1 95% CI 0.2 to 6.4 0.0 to 0.3

Mean blood haemoglobin concentration (g/L) Country Afghanistan Albania Estimate 111 119 95% CI 102 to 121 113 to 123

Level of public health significancea Severe Moderate

Algeria Andorra Angola

116 122 109

105 to 124 113 to 126 105 to 112

32 14 52

10 to 65 5 to 36 43 to 63

0.4 0.1 0.9

0.0 to 2.4 0.0 to 0.8 0.4 to 2.0

Moderate Mild Severe

Antigua and Barbuda Argentina Armenia

113 120 115

103 to 122 112 to 125 106 to 122

38 21 34

15 to 67 7 to 42 15 to 59

0.9 0.2 0.8

0.1 to 4.6 0.0 to 1.0 0.1 to 3.7

Moderate Moderate Moderate

Australia Austria Azerbaijan

121 122 114

113 to 126 113 to 127 107 to 121

15 14 35

5 to 35 5 to 37 16 to 57

0.1 0.2 0.3

0.0 to 0.6 0.0 to 1.4 0.1 to 1.1

Mild Mild Moderate

Bahamas (the) Bahrain Bangladesh

115 116 107

105 to 123 106 to 124 102 to 112

33 32 56

11 to 62 10 to 63 40 to 70

0.5 0.2 1.1

0.0 to 2.6 0.0 to 0.9 0.3 to 3.4

Moderate Moderate Severe

Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of)

114 118 122 114 103 107 107

104 to 122 108 to 125 114 to 127 105 to 123 99 to 105 98 to 119 102 to 113

37 25 13 35 65 55 56

14 to 66 7 to 55 5 to 35 13 to 65 58 to 74 24 to 78 38 to 68

0.7 0.2 0.1 0.6 3.9 2.3 1.7

0.0 to 3.2 0.0 to 1.2 0.0 to 0.9 0.0 to 2.9 2.3 to 6.0 0.2 to 7.7 0.4 to 4.1

Moderate Moderate Mild Moderate Severe Severe Severe

Bosnia and Herzegovina Botswana Brazil

117 112 118

106 to 125 103 to 121 111 to 124

28 43 24

8 to 60 16 to 69 8 to 46

0.3 0.7 0.2

0.0 to 1.6 0.1 to 3.4 0.0 to 1.3

Moderate Severe Moderate

Brunei Darussalam Bulgaria Burkina Faso Burundi

120 117 91 110

112 to 125 107 to 124 89 to 95 106 to 113

18 27 86 47

5 to 40 8 to 57 82 to 89 37 to 59

0.1 0.2 12.3 0.9

0.0 to 0.4 0.0 to 1.0

Mild Moderate

8.6 to 14.6 Severe 0.3 to 2.3 Severe

Cabo Verde

104

94 to 115

31 to 80

3.7

0.4 to 10.6 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.1. Country estimates for children aged 6–59 months, continued Percentage of children with blood haemoglobin concentration <110 g/L Estimate 55 63 95% CI 46 to 64 56 to 70 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 0.9 2.6 95% CI 0.4 to 1.8 1.3 to 4.3

Mean blood haemoglobin concentration (g/L) Country Cambodia Cameroon Estimate 107 104 95% CI 105 to 110 101 to 107

Level of public health significancea Severe Severe

Canada Central African Republic (the) Chad

122 100 99

113 to 127 92 to 108 90 to 108

14 72 74

5 to 36 52 to 84 53 to 87

0.2 5.0 6.0

0.0 to 1.4

Mild

0.9 to 11.5 Severe 0.9 to 13.6 Severe

Chile China Colombia

119 121 121

110 to 125 113 to 129 115 to 126

21 19 28

6 to 49 6 to 38 19 to 38

0.3 0.1 0.2

0.0 to 2.2 0.0 to 0.7 0.1 to 0.7

Moderate Mild Moderate

Comoros (the) Congo (the) Costa Rica Côte d’Ivoire

108 104 115 100

98 to 117 103 to 106 107 to 122 97 to 102

51 65 33 75

26 to 75 60 to 70 14 to 57 70 to 78

2.5 1.2 0.4 4.1

0.2 to 9.0 0.6 to 2.2 0.0 to 1.9 2.2 to 6.4

Severe Severe Moderate Severe

Croatia Cuba Cyprus Czech Republic (the) Democratic People’s Republic of Korea (the) Democratic Republic of the Congo (the) Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt El Salvador Equatorial Guinea

117 115 120 117 114 102

107 to 124 105 to 123 109 to 125 107 to 124 105 to 122 98 to 108

27 34 19 27 34 67

8 to 58 13 to 62 5 to 48 8 to 57 14 to 61 53 to 76

0.2 0.5 0.4 0.2 0.5 3.4

0.0 to 1.3 0.0 to 2.8 0.0 to 3.3 0.0 to 1.2 0.0 to 2.8 1.2 to 6.9

Moderate Moderate Mild Moderate Moderate Severe

122 111 114 115 112 111 116 103

113 to 127 102 to 120 104 to 122 105 to 123 104 to 120 104 to 120 112 to 120 99 to 107

14 43 37 33 40 45 30 66

5 to 36 18 to 70 15 to 65 12 to 63 18 to 67 21 to 67 19 to 41 54 to 75

0.2 1.5 0.5 0.5 0.4 0.3 0.2 3.3

0.0 to 1.3 0.1 to 6.1 0.0 to 2.8 0.0 to 2.7 0.0 to 2.3 0.1 to 0.9 0.0 to 0.6 1.0 to 7.2

Mild Severe Moderate Moderate Severe Severe Moderate Severe

Eritrea Estonia Ethiopia Fiji

105 118 108 115

94 to 114 107 to 125 105 to 111 107 to 123

59 26 50 32

34 to 79 8 to 57 41 to 59 12 to 56

3.5 0.3 2.9 0.2

0.4 to 10.9 Severe 0.0 to 1.5 1.3 to 4.6 0.0 to 1.3

Moderate Severe Moderate

Finland France

122 122

113 to 128 113 to 127

14 14

5 to 37 5 to 37

0.2 0.2

0.0 to 1.8 0.0 to 1.0

Mild Mild

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.1. Country estimates for children aged 6–59 months, continued Percentage of children with blood haemoglobin concentration <110 g/L Estimate 60 65 95% CI 52 to 67 38 to 83 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 2.0 5.1 95% CI 0.9 to 3.8

Mean blood haemoglobin concentration (g/L) Country Gabon Gambia (the) Estimate 105 102 95% CI 102 to 108 93 to 113

Level of public health significancea Severe

0.6 to 11.9 Severe

Georgia Germany Ghana

118 122 98

107 to 125 113 to 127 93 to 102

26 14 76

8 to 59 5 to 36 66 to 83

0.4 0.2 6.5

0.0 to 2.1 0.0 to 1.5

Moderate Mild

2.5 to 11.1 Severe

Greece Grenada Guatemala Guinea

121 113 110 98

112 to 127 103 to 121 107 to 114 95 to 101

15 40 47 76

5 to 39 16 to 68 34 to 58 70 to 80

0.2 0.7 0.6 6.2

0.0 to 1.4 0.1 to 3.8 0.2 to 1.4 3.5 to 8.6

Mild Severe Severe Severe

Guinea-Bissau Guyana Haiti Honduras

100 112 106 113

91 to 109 106 to 118 104 to 109 106 to 119

71 41 62 39

47 to 86 24 to 61 52 to 67 21 to 60

5.5 0.6 1.0 0.4

0.7 to 12.8 Severe 0.1 to 2.1 0.5 to 1.9 0.1 to 1.5 Severe Severe Moderate

Hungary Iceland India Indonesia Iran (Islamic Republic of)

117 122 106 114 116

107 to 124 113 to 128 101 to 112 111 to 119 106 to 123

27 14 59 32 32

8 to 58 5 to 39 40 to 72 21 to 44 10 to 61

0.2 0.2 1.8 0.3 0.3

0.0 to 1.2 0.0 to 1.5 0.4 to 4.9 0.1 to 1.1 0.0 to 1.1

Moderate Mild Severe Moderate Moderate

Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya

115 122 121 122 116 121 116 116 109

104 to 124 113 to 128 113 to 126 113 to 127 106 to 124 113 to 126 111 to 120 107 to 124 105 to 112

36 14 15 14 32 15 31 30 46

10 to 69 5 to 38 5 to 36 5 to 36 11 to 61 5 to 39 19 to 45 9 to 59 40 to 56

0.5 0.3 0.1 0.2 0.6 0.1 0.1 0.5 2.0

0.0 to 2.3 0.0 to 2.0 0.0 to 0.5 0.0 to 1.2 0.1 to 2.9 0.0 to 1.0 0.1 to 0.3 0.0 to 2.4 0.9 to 3.9

Moderate Mild Mild Mild Moderate Mild Moderate Moderate Severe

Kiribati Kuwait Kyrgyzstan Lao People’s Democratic Republic (the)

113 118 114 112

105 to 121 107 to 124 105 to 123 104 to 120

37 26 36 42

16 to 63 7 to 59 12 to 65 19 to 66

0.2 0.2 0.6 0.8

0.0 to 1.3 0.0 to 0.9 0.0 to 2.5 0.1 to 3.2

Moderate Moderate Moderate Severe

Latvia

118

108 to 125

8 to 54

0.3

0.0 to 1.6

Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.1. Country estimates for children aged 6–59 months, continued Percentage of children with blood haemoglobin concentration <110 g/L Estimate 24 48 72 95% CI 7 to 53 36 to 61 64 to 76 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 0.2 1.2 3.0 95% CI 0.0 to 0.9 0.4 to 2.6 1.3 to 5.1

Mean blood haemoglobin concentration (g/L) Country Lebanon Lesotho Liberia Estimate 118 109 101 95% CI 109 to 124 105 to 113 99 to 104

Level of public health significancea Moderate Severe Severe

Libya Lithuania Luxembourg Madagascar Malawi

116 118 122 109 103

105 to 125 107 to 125 113 to 128 107 to 112 100 to 105

30 26 13 50 66

8 to 64 8 to 58 5 to 37 41 to 57 59 to 71

0.3 0.3 0.2 0.4 3.8

0.0 to 1.4 0.0 to 1.5 0.0 to 1.0 0.2 to 0.8 2.2 to 5.9

Moderate Moderate Mild Severe Severe

Malaysia Maldives Mali

115 115 95

108 to 122 107 to 122 91 to 99

32 30 80

14 to 53 13 to 56 73 to 85

0.1 0.4 9.5

0.0 to 0.7 0.0 to 1.8

Moderate Moderate

5.6 to 12.6 Severe

Malta Marshall Islands (the)

122 115

113 to 126 107 to 123

14 33

5 to 35 11 to 58

0.1 0.2

0.0 to 0.6 0.0 to 0.9

Mild Moderate

Mauritania Mauritius Mexico Micronesia (Federated States of) Mongolia

100 110 118 114 119

90 to 110 99 to 119 113 to 123 106 to 122 110 to 129

71 44 26 34 26

47 to 86 21 to 72 16 to 39 14 to 60 9 to 52

5.5 2.3 0.2 0.2 0.3

0.7 to 13.6 Severe 0.1 to 8.5 0.0 to 0.6 0.0 to 1.4 0.0 to 1.4

Severe Moderate Moderate Moderate

Montenegro Morocco Mozambique

117 115 102

106 to 124 105 to 124 100 to 105

27 35 66

8 to 60 12 to 66 58 to 72

0.2 0.4 3.7

0.0 to 1.1 0.0 to 2.1 2.1 to 5.5

Moderate Moderate Severe

Myanmar Namibia Nepal

112 109 109

104 to 120 102 to 119 103 to 114

40 49 51

19 to 67 23 to 72 34 to 68

0.7 1.1 0.9

0.0 to 3.9 0.1 to 4.5 0.2 to 3.1

Severe Severe Severe

Netherlands (the) New Zealand Nicaragua Niger (the) Nigeria

122 121 120 99 100

112 to 128 113 to 126 110 to 126 96 to 101 97 to 104

14 15 19 76 71

5 to 40 5 to 37 6 to 49 72 to 80 64 to 77

0.2 0.1 0.4 4.5 4.8

0.0 to 1.1 0.0 to 0.7 0.0 to 1.9 2.6 to 7.4 2.4 to 7.6

Mild Mild Mild Severe Severe

Norway Oman Pakistan

122 113 104

113 to 127 105 to 121 100 to 108

14 41 61

5 to 38 18 to 63 51 to 69

0.2 0.3 4.2

0.0 to 1.7 0.0 to 1.5 1.3 to 6.8

Mild Severe Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.1. Country estimates for children aged 6–59 months, continued Percentage of children with blood haemoglobin concentration <110 g/L Estimate 32 95% CI 13 to 55 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 0.3 95% CI 0.0 to 1.4

Mean blood haemoglobin concentration (g/L) Country Panama Estimate 115 95% CI 108 to 122

Level of public health significancea Moderate

Papua New Guinea Paraguay Peru Philippines (the)

111 117 115 114

103 to 120 106 to 125 113 to 116 108 to 120

44 27 33 35

19 to 71 8 to 60 28 to 39 19 to 54

0.6 0.5 0.4 0.2

0.0 to 3.1 0.0 to 3.1 0.2 to 0.6 0.0 to 0.8

Severe Moderate Moderate Moderate

Poland Portugal Qatar Republic of Korea (the) Republic of Moldova (the)

118 122 117 121 116

107 to 125 113 to 128 109 to 124 114 to 126 109 to 123

26 14 26 15 29

8 to 58 5 to 41 8 to 52 5 to 33 10 to 52

0.2 0.2 0.2 0.1 0.1

0.0 to 1.4 0.0 to 1.2 0.0 to 0.9 0.0 to 0.5 0.0 to 0.5

Moderate Mild Moderate Mild Moderate

Romania Russian Federation (the) Rwanda

117 118 113

107 to 124 108 to 125 110 to 116

27 26 38

8 to 59 8 to 56 30 to 46

0.2 0.3 0.4

0.0 to 1.2 0.0 to 1.5 0.2 to 1.1

Moderate Moderate Moderate

Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe

112 113 115 106

103 to 122 104 to 121 107 to 123 103 to 110

41 38 32 59

17 to 70 16 to 65 11 to 59 46 to 69

0.9 0.7 0.3 0.8

0.1 to 4.1 0.1 to 3.4 0.0 to 1.6 0.2 to 2.9

Severe Moderate Moderate Severe

Saudi Arabia Senegal Serbia

113 97 118

103 to 123 94 to 99 108 to 124

39 79 26

13 to 69 75 to 82 8 to 54

0.5 6.5 0.2

0.0 to 2.4 4.2 to 9.2 0.0 to 1.1

Moderate Severe Moderate

Seychelles Sierra Leone

113 100

103 to 120 97 to 104

37 74

17 to 64 66 to 79

1.2 3.8

0.1 to 6.2 1.6 to 7.3

Moderate Severe

Singapore Slovakia Slovenia Solomon Islands Somalia South Africa

119 117 117 112 106 112

113 to 125 106 to 125 107 to 125 103 to 122 102 to 111 104 to 120

19 27 27 40 57 41

5 to 39 8 to 60 8 to 59 15 to 69 43 to 68 19 to 64

0.0 0.3 0.3 0.4 2.8 0.7

0.0 to 0.3 0.0 to 1.5 0.0 to 1.5 0.0 to 2.6 1.1 to 5.4 0.1 to 2.9

Mild Moderate Moderate Severe Severe Severe

Spain Sri Lanka Sudan (former)b

122 113 105

113 to 127 107 to 120 94 to 114

14 36 59

5 to 36 19 to 56 33 to 79

0.2 0.2 3.6

0.0 to 1.1 0.0 to 1.1

Mild Moderate

0.2 to 11.1 Severe

Suriname

113

104 to 121

16 to 67

0.4

0.0 to 2.1

Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.1. Country estimates for children aged 6–59 months, continued Percentage of children with blood haemoglobin concentration <110 g/L Estimate 44 95% CI 24 to 65 Percentage of children with blood haemoglobin concentration <70 g/L Estimate 1.0 95% CI 0.2 to 3.2

Mean blood haemoglobin concentration (g/L) Country Swaziland Estimate 111 95% CI 104 to 118

Level of public health significancea Severe

Sweden Switzerland Syrian Arab Republic (the) Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste

122 122 114 117 116 119 111

113 to 128 112 to 127 104 to 123 112 to 122 107 to 123 116 to 123 107 to 115

13 14 37 27 29 22 45

5 to 36 5 to 39 12 to 68 16 to 41 11 to 55 15 to 31 33 to 58

0.2 0.2 0.5 0.5 0.5 0.1 0.2

0.0 to 1.7 0.0 to 1.3 0.0 to 2.6 0.1 to 1.5 0.0 to 2.7 0.0 to 0.4 0.1 to 0.6

Mild Mild Moderate Moderate Moderate Moderate Severe

Togo Tonga Trinidad and Tobago Tunisia

101 113 113 117

92 to 108 105 to 122 103 to 122 106 to 125

71 36 39 29

50 to 84 14 to 64 14 to 69 9 to 61

4.6 0.4 1.0 0.3

0.7 to 11.9 Severe 0.0 to 2.8 0.1 to 4.8 0.0 to 1.5

Moderate Moderate Moderate

Turkey Turkmenistan Uganda

117 116 106

105 to 125 106 to 124 103 to 109

30 32 56

9 to 64 11 to 60 48 to 65

0.4 0.4 3.0

0.0 to 1.8 0.0 to 1.7 1.6 to 4.9

Moderate Moderate Severe

Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United Republic of Tanzania (the) United States of America (the)

117 116 122 105 124

107 to 125 106 to 124 114 to 126 103 to 108 122 to 125

27 29 13 61 6

8 to 56 9 to 60 5 to 33 52 to 68 5 to 12

0.2 0.2 0.1 1.5 0.0

0.0 to 1.3 0.0 to 0.8 0.0 to 0.9 0.7 to 2.8 0.0 to 0.1

Moderate Moderate Mild Severe Mild

Uruguay Uzbekistan Vanuatu

118 113 113

108 to 125 104 to 124 107 to 119

24 43 38

6 to 55 15 to 70 22 to 57

0.3 0.6 0.2

0.0 to 2.4 0.1 to 2.3 0.0 to 0.7

Moderate Severe Moderate

Venezuela (Bolivarian Republic of) Viet Nam

115 115

106 to 123 108 to 122

32 31

12 to 59 13 to 54

0.3 0.4

0.0 to 1.4 0.0 to 1.8

Moderate Moderate

Yemen Zambia Zimbabwe

106 105 106

100 to 116 102 to 109 103 to 109

59 58 59

29 to 75 49 to 66 49 to 67

0.9 2.9 1.3

0.1 to 4.7 1.1 to 4.9 0.5 to 2.6

Severe Severe Severe

CI: credibility interval. Countries in italics do not have national or subnational data on the prevalence of anaemia. a Based on proportion with blood haemoglobin concentration <110 g/L. b Estimates are for former Sudan, consistent with the situation from 1 January to 6 July 2011.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 31 22 95% CI 14 to 54 12 to 36 Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 1.8 0.6 95% CI

Mean blood haemoglobin concentration (g/L) Country Afghanistan Albania Estimate 125 128 95% CI 117 to 133 124 to 131

Level of public health significancea

0.3 to 4.8 Moderate 0.2 to 1.3 Moderate

Algeria Andorra Angola

125 130 121

116 to 133 122 to 135 116 to 128

33 17 44

13 to 56 8 to 39 26 to 58

1.3 0.5 1.1

0.2 to 4.4 Moderate 0.0 to 1.7 Mild 0.3 to 2.6 Severe

Antigua and Barbuda Argentina Armenia

128 131 127

119 to 136 124 to 138 120 to 133

25 15 26

10 to 50 6 to 34 12 to 48

1.0 0.5 0.7

0.1 to 3.5 Moderate 0.0 to 2.2 Mild 0.1 to 2.2 Moderate

Australia Austria Azerbaijan

129 129 124

121 to 135 121 to 135 118 to 130

17 18 33

8 to 42 9 to 42 17 to 51

0.5 0.6 1.2

0.0 to 1.9 Mild 0.1 to 2.5 Mild 0.3 to 3.0 Moderate

Bahamas (the) Bahrain Bangladesh

129 123 122

119 to 137 116 to 131 119 to 124

23 38 43

9 to 50 16 to 59 35 to 50

0.7 0.9 0.7

0.1 to 2.5 Moderate 0.1 to 2.9 Moderate 0.3 to 1.3 Severe

Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of)

129 128 129 130 120 121 126

120 to 137 120 to 134 121 to 135 120 to 138 116 to 126 112 to 129 120 to 131

23 22 18 21 48 44 32

9 to 49 9 to 49 8 to 45 8 to 46 32 to 59 21 to 63 18 to 47

0.9 0.5 0.5 0.8 1.4 2.2 1.1

0.1 to 3.2 Moderate 0.0 to 2.1 Moderate 0.0 to 2.1 Mild 0.1 to 2.9 Moderate 0.8 to 2.2 Severe 0.4 to 8.1 Severe 0.4 to 2.1 Moderate

Bosnia and Herzegovina Botswana

127 127

119 to 134 118 to 135

24 28

10 to 49 12 to 51

0.8 1.5

0.1 to 3.1 Moderate 0.2 to 4.3 Moderate

Brazil Brunei Darussalam

130 128

120 to 139 121 to 132

19 20

6 to 47 10 to 43

0.8 0.7

0.1 to 3.1 Mild 0.1 to 2.5 Moderate

Bulgaria Burkina Faso Burundi

127 119 131

120 to 133 116 to 123 127 to 135

24 48 20

10 to 48 38 to 58 13 to 30

0.6 2.4 0.7

0.1 to 2.5 Moderate 1.5 to 3.6 Severe 0.3 to 1.5 Moderate

Cabo Verde Cambodia Cameroon

124 121 122

115 to 132 119 to 125 120 to 125

38 43 41

15 to 58 33 to 51 33 to 48

1.1 1.0 1.5

0.2 to 3.7 Moderate 0.5 to 1.7 Severe 0.9 to 2.3 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years, continued Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 95% CI Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 95% CI

Mean blood haemoglobin concentration (g/L) Country Estimate 95% CI

Level of public health significancea

Canada Central African Republic (the)

130 120

123 to 135 114 to 128

16 45

8 to 39 25 to 62

0.4 1.9

0.0 to 1.7 Mild 0.4 to 4.9 Severe

Chad Chile China Colombia

120 133 129 130

112 to 129 126 to 140 123 to 135 124 to 136

46 12 19 19

22 to 66 5 to 28 8 to 41 9 to 37

2.4 0.3 0.3 0.5

0.5 to 6.4 Severe 0.0 to 1.4 Mild 0.0 to 1.3 Mild 0.1 to 1.5 Mild

Comoros (the) Congo (the) Costa Rica Côte d’Ivoire

127 119 130 120

117 to 136 116 to 124 122 to 136 116 to 125

30 50 19 48

12 to 54 34 to 60 8 to 42 34 to 59

1.4 1.1 0.8 1.5

0.2 to 4.1 Moderate 0.7 to 1.7 Severe 0.1 to 3.2 Mild 0.8 to 2.4 Severe

Croatia Cuba Cyprus Czech Republic (the) Democratic People’s Republic of Korea (the) Democratic Republic of the Congo (the)

127 129 126 128 127 119

120 to 134 120 to 136 116 to 131 120 to 134 121 to 133 113 to 125

24 23 28 22 25 49

10 to 49 9 to 49 11 to 56 9 to 47 11 to 46 32 to 64

0.7 0.8 0.9 0.5 0.6 2.5

0.1 to 2.7 Moderate 0.1 to 2.8 Moderate 0.1 to 2.8 Moderate 0.0 to 2.1 Moderate 0.0 to 2.2 Moderate 1.1 to 4.8 Severe

Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt

129 129 128 128 128 124

121 to 135 119 to 138 118 to 136 118 to 136 119 to 136 118 to 131

18 27 25 26 24 35

8 to 43 9 to 52 10 to 53 10 to 52 9 to 50 16 to 53

0.5 1.0 0.9 1.0 0.9 0.7

0.0 to 2.0 Mild 0.1 to 3.6 Moderate 0.1 to 3.3 Moderate 0.1 to 3.3 Moderate 0.1 to 3.1 Moderate 0.2 to 1.9 Moderate

El Salvador Equatorial Guinea

129 121

120 to 137 115 to 127

23 45

9 to 48 26 to 61

0.9 1.9

0.1 to 3.4 Moderate 1.0 to 3.1 Severe

Eritrea Estonia Ethiopia Fiji

126 128 132 125

116 to 136 120 to 134 129 to 135 122 to 129

33 24 19 26

12 to 56 10 to 49 14 to 26 18 to 36

1.7 0.6 1.1 2.7

0.3 to 5.3 Moderate 0.1 to 2.7 Moderate 0.6 to 1.9 Mild 0.7 to 5.4 Moderate

Finland France Gabon

130 129 118

121 to 136 121 to 134 113 to 125

17 19 50

8 to 42 9 to 43 30 to 65

0.5 0.6 2.1

0.0 to 2.1 Mild 0.1 to 2.3 Mild 0.9 to 3.2 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years, continued Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 44 28 95% CI 22 to 64 13 to 47 Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 1.8 0.8 95% CI

Mean blood haemoglobin concentration (g/L) Country Gambia (the) Georgia Estimate 121 127 95% CI 113 to 130 120 to 132

Level of public health significancea

0.3 to 4.6 Severe 0.2 to 2.4 Moderate

Germany Ghana

129 116

121 to 135 111 to 121

18 56

8 to 42 42 to 67

0.6 3.6

0.0 to 2.5 Mild 1.1 to 7.8 Severe

Greece Grenada Guatemala Guinea

128 128 129 120

120 to 133 118 to 136 120 to 136 116 to 125

20 26 25 47

9 to 45 10 to 52 11 to 47 32 to 59

0.7 1.1 1.3 2.1

0.1 to 2.5 Moderate 0.1 to 3.6 Moderate 0.2 to 4.5 Moderate 1.4 to 3.0 Severe

Guinea-Bissau Guyana Haiti Honduras

121 124 124 132

113 to 130 120 to 128 118 to 130 125 to 138

44 34 36 18

21 to 65 23 to 46 23 to 52 8 to 37

2.1 1.5 2.4 0.7

0.4 to 6.3 Severe 0.7 to 2.8 Moderate 1.6 to 3.5 Moderate 0.1 to 2.0 Mild

Hungary Iceland India Indonesia Iran (Islamic Republic of)

128 130 119 128 127

120 to 134 122 to 136 113 to 125 123 to 131 120 to 133

23 17 48 22 28

10 to 48 8 to 40 29 to 63 12 to 37 12 to 49

0.6 0.4 2.5 0.6 0.8

0.1 to 2.6 Moderate 0.0 to 2.0 Mild 0.8 to 5.4 Severe 0.1 to 1.6 Moderate 0.1 to 2.6 Moderate

Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya

126 130 130 129 128 127 126 126 132

117 to 135 122 to 136 122 to 134 121 to 134 119 to 136 122 to 131 123 to 130 119 to 133 117 to 142

31 17 17 19 24 22 29 30 24

12 to 56 8 to 40 8 to 41 9 to 43 9 to 51 13 to 36 20 to 37 13 to 51 5 to 56

1.2 0.5 0.4 0.7 0.9 1.1 0.5 0.9 1.6

0.2 to 4.0 Moderate 0.1 to 2.3 Mild 0.0 to 1.7 Mild 0.1 to 2.5 Mild 0.1 to 3.1 Moderate 0.3 to 2.9 Moderate 0.2 to 0.9 Moderate 0.1 to 3.1 Moderate 0.4 to 3.9 Moderate

Kiribati Kuwait Kyrgyzstan Lao People’s Democratic Republic (the)

129 129 125 125

120 to 135 121 to 136 118 to 132 119 to 130

20 22 33 31

8 to 46 9 to 43 15 to 52 15 to 50

0.7 0.6 1.2 1.3

0.0 to 2.9 Moderate 0.1 to 2.1 Moderate 0.2 to 3.7 Moderate 0.3 to 3.7 Moderate

Latvia

128

120 to 134

9 to 50

0.6

0.1 to 2.6 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years, continued Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 28 27 49 95% CI 12 to 49 17 to 39 27 to 64 Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 0.7 1.5 1.9 95% CI

Mean blood haemoglobin concentration (g/L) Country Lebanon Lesotho Liberia Estimate 127 128 119 95% CI 119 to 133 123 to 133 113 to 127

Level of public health significancea

0.1 to 2.6 Moderate 0.7 to 2.6 Moderate 0.4 to 4.7 Severe

Libya Lithuania Luxembourg Madagascar Malawi

127 128 130 126 128

118 to 135 120 to 134 122 to 135 121 to 131 124 to 132

28 23 17 32 28

11 to 53 9 to 49 8 to 40 19 to 45 19 to 37

0.9 0.6 0.5 0.9 1.3

0.1 to 3.4 Moderate 0.0 to 2.3 Moderate 0.0 to 2.0 Mild 0.3 to 1.8 Moderate 0.7 to 2.2 Moderate

Malaysia Maldives Mali

129 124 117

121 to 134 119 to 128 112 to 122

20 37 56

9 to 45 20 to 52 39 to 67

0.5 0.6 2.9

0.0 to 1.8 Moderate 0.1 to 1.9 Moderate 1.2 to 5.4 Severe

Malta Marshall Islands (the) Mauritania Mauritius Mexico Micronesia (Federated States of) Mongolia

130 129 123 130 134 129 132

122 to 135 121 to 136 115 to 133 120 to 139 129 to 139 122 to 135 122 to 140

17 20 38 23 14 18 20

8 to 40 8 to 45 15 to 60 7 to 51 8 to 24 8 to 39 6 to 44

0.4 0.6 1.4 0.6 0.5 0.7 0.8

0.0 to 1.8 Mild 0.0 to 3.0 Moderate 0.2 to 4.6 Moderate 0.1 to 2.6 Moderate 0.2 to 1.2 Mild 0.0 to 3.3 Mild 0.1 to 2.7 Moderate

Montenegro Morocco Mozambique Myanmar

128 125 122 125

119 to 134 117 to 133 116 to 129 118 to 132

24 33 44 30

10 to 49 14 to 54 27 to 58 13 to 51

0.7 1.5 2.6 1.0

0.1 to 2.5 Moderate 0.2 to 4.7 Moderate 1.4 to 3.7 Severe 0.1 to 3.1 Moderate

Namibia Nepal

126 125

115 to 135 122 to 127

33 36

12 to 59 28 to 44

1.7 0.8

0.3 to 5.3 Moderate 0.4 to 1.4 Moderate

Netherlands (the) New Zealand Nicaragua Niger (the) Nigeria

129 131 133 121 119

121 to 135 125 to 137 127 to 139 116 to 126 110 to 130

18 14 12 45 47

8 to 42 7 to 32 6 to 27 30 to 58 21 to 71

0.5 0.4 0.6 2.1 2.2

0.1 to 2.2 Mild 0.0 to 1.4 Mild 0.1 to 2.1 Mild 1.4 to 3.2 Severe 0.5 to 7.2 Severe

Norway Oman

130 124

122 to 135 117 to 130

17 35

8 to 41 17 to 55

0.5 1.1

0.0 to 2.1 Mild 0.2 to 3.4 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years, continued Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 51 25 95% CI 43 to 59 10 to 47 Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 3.5 0.7 95% CI

Mean blood haemoglobin concentration (g/L) Country Pakistan Panama Estimate 117 128 95% CI 115 to 120 120 to 135

Level of public health significancea

1.5 to 5.0 Severe 0.1 to 2.2 Moderate

Papua New Guinea Paraguay Peru Philippines (the)

126 130 130 127

116 to 133 121 to 139 128 to 133 119 to 132

29 19 18 25

11 to 54 6 to 45 15 to 23 12 to 45

1.8 0.8 0.6 1.7

0.2 to 6.2 Moderate 0.1 to 3.0 Mild 0.4 to 0.8 Mild 0.2 to 5.5 Moderate

Poland Portugal Qatar Republic of Korea (the) Republic of Moldova (the)

128 129 127 128 127

120 to 134 121 to 135 118 to 134 125 to 130 120 to 132

23 19 28 19 26

9 to 48 8 to 44 11 to 53 13 to 28 12 to 46

0.6 0.7 0.7 0.4 0.6

0.1 to 2.5 Moderate 0.1 to 2.7 Mild 0.1 to 2.5 Moderate 0.2 to 0.9 Mild 0.1 to 1.8 Moderate

Romania Russian Federation (the) Rwanda

127 129 133

119 to 134 120 to 135 130 to 136

24 21 17

10 to 49 9 to 46 12 to 25

0.7 0.5 0.5

0.1 to 2.4 Moderate 0.0 to 1.9 Moderate 0.2 to 0.9 Mild

Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe

127 128 130 122

117 to 136 119 to 136 123 to 136 117 to 127

26 25 17 42

10 to 53 9 to 51 8 to 39 27 to 55

1.2 1.0 0.6 1.2

0.2 to 4.1 Moderate 0.1 to 3.3 Moderate 0.0 to 2.7 Mild 0.5 to 2.4 Severe

Saudi Arabia Senegal Serbia

122 116 127

112 to 130 113 to 118 120 to 134

40 57 25

17 to 66 50 to 63 11 to 47

1.4 3.5 0.8

0.2 to 4.3 Severe 2.3 to 5.1 Severe 0.1 to 3.2 Moderate

Seychelles Sierra Leone

130 120

121 to 139 115 to 126

21 45

7 to 47 30 to 60

0.5 1.7

0.1 to 2.0 Moderate 0.8 to 3.2 Severe

Singapore Slovakia Slovenia Solomon Islands Somalia South Africa

128 128 128 127 121 128

118 to 132 119 to 134 119 to 134 118 to 135 116 to 127 120 to 136

22 23 24 25 42 27

10 to 51 9 to 50 10 to 50 10 to 51 28 to 55 12 to 48

0.7 0.6 0.7 1.3 2.7 1.1

0.1 to 2.7 Moderate 0.1 to 2.5 Moderate 0.1 to 2.7 Moderate 0.1 to 5.1 Moderate 1.0 to 5.8 Severe 0.2 to 3.3 Moderate

Spain Sri Lanka

129 127

121 to 135 120 to 132

18 26

8 to 42 12 to 46

0.6 0.7

0.1 to 2.1 Mild 0.1 to 2.3 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.2. Country estimates for non-pregnant women aged 15–49 years, continued Percentage of nonpregnant women with blood haemoglobin concentration <120 g/L Estimate 31 95% CI 13 to 53 Percentage of nonpregnant women with blood haemoglobin concentration <80 g/L Estimate 1.1 95% CI

Mean blood haemoglobin concentration (g/L) Country Sudan (former)b Estimate 126 95% CI 118 to 135

Level of public health significancea

0.2 to 3.7 Moderate

Suriname Swaziland

128 128

119 to 137 120 to 135

25 28

9 to 50 13 to 48

1.0 1.0

0.1 to 3.5 Moderate 0.3 to 2.5 Moderate

Sweden Switzerland Syrian Arab Republic (the) Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste

130 129 126 128 127 129 128

122 to 135 121 to 134 117 to 134 123 to 133 115 to 132 126 to 133 124 to 132

18 19 31 24 24 19 22

8 to 42 9 to 45 11 to 56 15 to 39 10 to 58 13 to 27 14 to 34

0.5 0.6 1.1 0.9 0.9 0.3 0.7

0.0 to 2.1 Mild 0.1 to 2.4 Mild 0.1 to 3.8 Moderate 0.3 to 2.0 Moderate 0.1 to 3.5 Moderate 0.1 to 0.9 Mild 0.3 to 1.6 Moderate

Togo Tonga Trinidad and Tobago Tunisia

118 130 128 127

109 to 127 121 to 137 119 to 136 118 to 134

52 18 25 28

28 to 75 7 to 43 9 to 51 11 to 52

2.5 0.6 1.2 1.0

0.6 to 6.5 Severe 0.0 to 2.9 Mild 0.1 to 4.3 Moderate 0.1 to 3.2 Moderate

Turkey Turkmenistan Uganda

127 125 129

118 to 135 116 to 133 125 to 132

29 32 26

10 to 54 13 to 57 19 to 34

1.0 1.2 1.1

0.1 to 3.6 Moderate 0.2 to 3.8 Moderate 0.6 to 1.8 Moderate

Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United Republic of Tanzania (the) United States of America (the)

128 127 130 123 132

120 to 134 119 to 135 126 to 134 120 to 127 130 to 134

23 26 14 38 12

9 to 49 10 to 51 8 to 28 28 to 47 9 to 16

0.6 0.6 0.2 2.0 0.2

0.0 to 2.3 Moderate 0.1 to 2.3 Moderate 0.0 to 0.8 Mild 1.1 to 3.1 Moderate 0.1 to 0.5 Mild

Uruguay Uzbekistan Vanuatu

131 119 129

121 to 139 112 to 129 123 to 133

17 53 21

6 to 43 20 to 68 10 to 40

0.6 1.2 0.2

0.0 to 2.3 Mild 0.2 to 3.3 Severe 0.0 to 1.2 Moderate

Venezuela (Bolivarian Republic of) Viet Nam

129 131

120 to 137 127 to 135

22 14

8 to 47 9 to 24

0.7 0.4

0.1 to 2.7 Moderate 0.1 to 1.3 Mild

Yemen Zambia Zimbabwe

123 127 128

112 to 133 120 to 135 124 to 132

38 28 28

16 to 63 12 to 48 20 to 38

2.3 1.2 1.6

0.3 to 7.0 Moderate 0.2 to 3.4 Moderate 0.9 to 2.5 Moderate

CI: credibility interval. Countries in italics do not have national or subnational data on the prevalence of anaemia. a Based on proportion with blood haemoglobin concentration <120 g/L. b Estimates are for former Sudan, consistent with the situation from 1 January to 6 July 2011.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 95% CI Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 95% CI

Mean blood haemoglobin concentration (g/L) Country Estimate 95% CI

Level of public health significancea

Afghanistan Albania

111 119

104 to 119 115 to 124

44 22

24 to 66 14 to 32

1.2 0.3

0.3 to 3.2 Severe 0.0 to 0.9 Moderate

Algeria Andorra Angola

116 118 111

107 to 125 111 to 126 105 to 117

31 24 47

15 to 57 11 to 45 29 to 63

0.4 0.2 1.1

0.1 to 1.6 Moderate 0.0 to 0.8 Moderate 0.3 to 2.6 Severe

Antigua and Barbuda Argentina Armenia

118 118 118

108 to 127 108 to 129 110 to 125

29 28 28

11 to 57 10 to 55 14 to 50

0.4 0.4 0.3

0.1 to 1.5 Moderate 0.0 to 1.5 Moderate 0.0 to 0.9 Moderate

Australia Austria Azerbaijan

118 118 116

111 to 126 111 to 125 110 to 123

25 25 31

11 to 47 13 to 45 18 to 48

0.2 0.3 0.4

0.0 to 0.9 Moderate 0.0 to 1.1 Moderate 0.1 to 1.1 Moderate

Bahamas (the) Bahrain Bangladesh

118 115 110

108 to 127 107 to 123 107 to 113

29 34 48

12 to 55 17 to 59 37 to 58

0.3 0.3 0.5

0.0 to 1.1 Moderate 0.0 to 1.1 Moderate 0.2 to 1.0 Severe

Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of)

119 119 118 119 105 110 114

109 to 128 110 to 127 112 to 125 110 to 128 102 to 108 104 to 118 109 to 120

28 24 24 27 63 46 38

11 to 54 10 to 49 12 to 45 11 to 51 53 to 71 25 to 67 24 to 54

0.4 0.3 0.2 0.3 1.7 1.2 0.4

0.1 to 1.4 Moderate 0.0 to 1.0 Moderate 0.0 to 0.8 Moderate 0.0 to 1.2 Moderate 1.0 to 2.9 Severe 0.2 to 4.2 Severe 0.2 to 0.9 Moderate

Bosnia and Herzegovina Botswana Brazil Brunei Darussalam

118 118 116 117

109 to 127 108 to 128 106 to 128 109 to 124

27 32 32 28

11 to 52 13 to 57 11 to 62 15 to 52

0.4 0.5 0.5 0.3

0.0 to 1.8 Moderate 0.1 to 1.5 Moderate 0.0 to 2.1 Moderate 0.0 to 1.2 Moderate

Bulgaria Burkina Faso Burundi

118 107 118

110 to 126 104 to 110 112 to 122

26 58 30

12 to 50 49 to 65 21 to 45

0.3 2.2 0.7

0.0 to 1.3 Moderate 1.3 to 3.5 Severe 0.3 to 1.6 Moderate

Cabo Verde Cambodia Cameroon

113 109 110

105 to 122 106 to 112 107 to 113

42 51 49

21 to 65 41 to 61 41 to 58

1.1 0.8 1.0

0.2 to 3.4 Severe 0.4 to 1.6 Severe 0.5 to 1.8 Severe

Canada

119

112 to 126

11 to 42

0.2

0.0 to 0.7 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years, continued Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 51 95% CI 31 to 67 Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 1.7 95% CI

Mean blood haemoglobin concentration (g/L) Country Central African Republic (the) Estimate 109 95% CI 104 to 117

Level of public health significancea

0.4 to 4.2 Severe

Chad Chile China Colombia

109 120 120 118

103 to 118 109 to 131 113 to 127 111 to 124

51 25 22 30

29 to 69 6 to 54 10 to 40 16 to 48

2.0 0.3 0.2 0.3

0.5 to 5.0 Severe 0.0 to 1.1 Moderate 0.0 to 0.9 Moderate 0.1 to 0.8 Moderate

Comoros (the) Congo (the) Costa Rica Côte d’Ivoire

116 107 120 107

107 to 125 104 to 110 110 to 129 103 to 113

35 59 26 57

18 to 58 49 to 69 10 to 51 41 to 69

1.1 1.0 0.4 1.3

0.2 to 3.3 Moderate 0.5 to 1.8 Severe 0.0 to 1.4 Moderate 0.6 to 2.6 Severe

Croatia Cuba Cyprus Czech Republic (the) Democratic People’s Republic of Korea (the) Democratic Republic of the Congo (the)

118 118 116 119 118 110

110 to 126 109 to 127 107 to 121 111 to 126 111 to 124 105 to 116

26 28 31 24 27 49

12 to 50 11 to 52 18 to 57 11 to 46 14 to 47 34 to 63

0.4 0.3 0.3 0.3 0.4 1.9

0.0 to 1.4 Moderate 0.1 to 1.2 Moderate 0.0 to 1.3 Moderate 0.0 to 1.2 Moderate 0.1 to 1.5 Moderate 0.7 to 3.8 Severe

Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt

118 117 117 117 118 116

111 to 125 108 to 128 107 to 126 108 to 126 109 to 127 110 to 122

24 32 32 32 29 30

12 to 45 14 to 55 12 to 59 14 to 58 12 to 54 18 to 48

0.2 0.8 0.4 0.4 0.4 0.3

0.0 to 1.0 Moderate 0.1 to 2.8 Moderate 0.1 to 1.3 Moderate 0.1 to 1.3 Moderate 0.1 to 1.3 Moderate 0.1 to 0.7 Moderate

El Salvador Equatorial Guinea

118 108

109 to 128 104 to 114

28 53

12 to 52 38 to 67

0.4 1.8

0.1 to 1.4 Moderate 0.8 to 3.3 Severe

Eritrea Estonia Ethiopia Fiji

115 118 121 115

106 to 124 110 to 126 117 to 124 107 to 123

36 26 23 35

19 to 59 12 to 49 18 to 31 18 to 58

1.4 0.3 1.1 1.6

0.2 to 4.0 Moderate 0.0 to 1.5 Moderate 0.5 to 1.9 Moderate 0.2 to 4.3 Moderate

Finland France Gabon Gambia (the)

118 118 106 108

111 to 126 111 to 124 102 to 113 102 to 117

24 25 60 56

11 to 46 13 to 47 42 to 71 29 to 72

0.2 0.2 2.1 1.6

0.0 to 1.0 Moderate 0.0 to 1.1 Moderate 0.7 to 8.3 Severe 0.5 to 3.9 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years, continued Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 25 95% CI 13 to 43 Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 0.3 95% CI

Mean blood haemoglobin concentration (g/L) Country Georgia Estimate 119 95% CI 112 to 125

Level of public health significancea

0.1 to 0.9 Moderate

Germany Ghana

118 105

111 to 125 102 to 109

24 62

12 to 45 51 to 70

0.2 2.8

0.0 to 1.0 Moderate 0.9 to 5.8 Severe

Greece Grenada Guatemala Guinea

117 117 117 106

109 to 124 108 to 126 109 to 126 103 to 109

27 31 30 61

15 to 51 13 to 56 15 to 54 52 to 68

0.3 0.5 0.6 2.0

0.0 to 1.2 Moderate 0.1 to 1.6 Moderate 0.1 to 1.9 Moderate 1.1 to 3.2 Severe

Guinea-Bissau Guyana Haiti Honduras

110 117 111 121

103 to 118 112 to 121 107 to 116 114 to 127

49 30 48 22

27 to 68 21 to 42 35 to 59 10 to 38

1.9 0.6 1.2 0.2

0.4 to 5.0 Severe 0.2 to 1.3 Moderate 0.6 to 2.2 Severe 0.0 to 0.7 Moderate

Hungary Iceland India Indonesia Iran (Islamic Republic of)

118 119 108 117 118

110 to 127 111 to 126 104 to 113 109 to 123 111 to 125

25 23 54 30 26

11 to 49 11 to 46 37 to 67 17 to 51 13 to 46

0.3 0.2 1.3 0.5 0.2

0.0 to 1.4 Moderate 0.0 to 0.9 Moderate 0.5 to 2.8 Severe 0.1 to 1.5 Moderate 0.0 to 0.8 Moderate

Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya

117 118 119 118 118 116 118 118 117

108 to 126 111 to 126 111 to 126 110 to 124 108 to 127 109 to 121 115 to 121 111 to 125 107 to 131

31 24 24 26 30 31 27 27 36

14 to 56 12 to 46 11 to 47 14 to 48 12 to 55 19 to 52 19 to 37 14 to 48 11 to 62

0.4 0.2 0.2 0.3 0.4 0.5 0.2 0.3 1.2

0.1 to 1.3 Moderate 0.0 to 1.0 Moderate 0.0 to 0.8 Moderate 0.0 to 1.0 Moderate 0.1 to 1.3 Moderate 0.1 to 1.6 Moderate 0.1 to 0.4 Moderate 0.0 to 1.1 Moderate 0.3 to 3.0 Moderate

Kiribati Kuwait Kyrgyzstan Lao People’s Democratic Republic (the)

118 120 117 114

107 to 128 111 to 128 110 to 124 107 to 120

29 25 30 36

10 to 57 10 to 48 16 to 50 21 to 57

0.5 0.2 0.4 1.0

0.0 to 1.8 Moderate 0.0 to 0.7 Moderate 0.1 to 1.3 Moderate 0.2 to 2.7 Moderate

Latvia Lebanon

118 118

110 to 127 110 to 125

25 27

11 to 49 13 to 49

0.3 0.2

0.0 to 1.3 Moderate 0.0 to 0.9 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years, continued Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 31 53 95% CI 21 to 43 33 to 69 Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 0.5 1.7 95% CI

Mean blood haemoglobin concentration (g/L) Country Lesotho Liberia Estimate 117 108 95% CI 113 to 122 103 to 116

Level of public health significancea

0.2 to 1.0 Moderate 0.4 to 4.1 Severe

Libya Lithuania Luxembourg Madagascar Malawi

118 119 118 116 115

109 to 127 110 to 127 111 to 125 111 to 121 111 to 119

28 25 24 33 37

12 to 54 11 to 49 12 to 45 24 to 45 28 to 47

0.3 0.3 0.2 0.9 0.9

0.0 to 1.1 Moderate 0.0 to 1.3 Moderate 0.0 to 1.0 Moderate 0.3 to 1.8 Moderate 0.4 to 1.6 Moderate

Malaysia Maldives Mali

118 113 105

109 to 127 105 to 119 102 to 110

27 39 61

10 to 52 21 to 63 48 to 70

0.4 0.6 2.5

0.0 to 1.3 Moderate 0.1 to 1.8 Moderate 1.0 to 4.7 Severe

Malta Marshall Islands (the) Mauritania Mauritius Mexico Micronesia (Federated States of) Mongolia

118 118 112 117 121 119 120

112 to 125 108 to 128 104 to 122 109 to 127 117 to 126 108 to 130 110 to 130

24 28 44 30 21 27 25

12 to 43 9 to 57 22 to 66 14 to 53 13 to 31 8 to 56 9 to 50

0.2 0.4 1.3 0.6 0.2 0.5 0.3

0.0 to 0.7 Moderate 0.0 to 1.7 Moderate 0.3 to 3.8 Severe 0.1 to 2.1 Moderate 0.1 to 0.5 Moderate 0.0 to 2.1 Moderate 0.0 to 1.1 Moderate

Montenegro Morocco Mozambique

118 116 110

110 to 126 109 to 124 106 to 114

26 32 48

11 to 51 17 to 53 37 to 59

0.3 0.5 1.9

0.0 to 1.4 Moderate 0.1 to 1.7 Moderate 0.9 to 3.1 Severe

Myanmar Namibia Nepal

115 116 111

108 to 122 106 to 126 108 to 115

33 34 44

18 to 56 14 to 61 33 to 56

0.7 0.6 0.6

0.1 to 2.3 Moderate 0.1 to 1.9 Moderate 0.3 to 1.3 Severe

Netherlands (the) New Zealand Nicaragua Niger (the) Nigeria

118 119 124 107 107

111 to 125 112 to 126 113 to 133 104 to 110 102 to 116

25 23 20 57 58

12 to 46 11 to 44 6 to 44 48 to 66 36 to 71

0.2 0.2 0.3 2.0 1.6

0.0 to 1.0 Moderate 0.0 to 0.6 Moderate 0.0 to 1.0 Moderate 1.2 to 3.5 Severe 0.4 to 5.4 Severe

Norway Oman Pakistan

119 115 109

111 to 126 108 to 122 106 to 112

24 34 50

11 to 47 18 to 57 41 to 58

0.2 0.4 2.1

0.0 to 0.9 Moderate 0.1 to 1.3 Moderate 0.9 to 3.3 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years, continued Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 28 95% CI 13 to 49 Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 0.3 95% CI

Mean blood haemoglobin concentration (g/L) Country Panama Estimate 118 95% CI 110 to 126

Level of public health significancea

0.1 to 1.0 Moderate

Papua New Guinea Paraguay Peru Philippines (the)

114 117 120 116

105 to 124 106 to 128 118 to 123 109 to 123

37 31 23 32

16 to 63 12 to 61 18 to 29 18 to 51

1.1 0.5 0.2 1.2

0.1 to 3.7 Moderate 0.0 to 2.1 Moderate 0.1 to 0.4 Moderate 0.2 to 4.0 Moderate

Poland Portugal Qatar Republic of Korea (the) Republic of Moldova (the)

118 118 118 117 117

110 to 127 110 to 125 109 to 126 114 to 120 111 to 124

25 26 28 25 28

11 to 49 13 to 47 12 to 53 19 to 34 16 to 45

0.3 0.3 0.2 0.1 0.3

0.0 to 1.3 Moderate 0.0 to 1.2 Moderate 0.0 to 0.8 Moderate 0.0 to 0.5 Moderate 0.0 to 1.0 Moderate

Romania Russian Federation (the) Rwanda

118 119 122

110 to 126 111 to 128 119 to 125

26 23 19

11 to 50 8 to 46 14 to 26

0.4 0.2 0.4

0.0 to 1.4 Moderate 0.0 to 1.1 Moderate 0.2 to 0.9 Mild

Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe

117 117 119 111

108 to 126 108 to 127 109 to 129 106 to 116

32 30 26 47

14 to 57 13 to 55 8 to 53 34 to 61

0.5 0.4 0.4 1.0

0.1 to 1.8 Moderate 0.1 to 1.4 Moderate 0.0 to 1.8 Moderate 0.4 to 2.1 Severe

Saudi Arabia Senegal Serbia

113 104 118

105 to 122 103 to 107 110 to 125

40 63 27

19 to 66 56 to 69 13 to 50

0.4 2.7 0.4

0.1 to 1.6 Severe 1.6 to 3.9 Severe 0.0 to 1.7 Moderate

Seychelles Sierra Leone

120 112

110 to 130 106 to 118

26 45

9 to 50 31 to 61

0.4 1.4

0.1 to 1.6 Moderate 0.5 to 2.8 Severe

Singapore Slovakia Slovenia Solomon Islands Somalia South Africa

117 118 118 116 111 118

108 to 124 110 to 127 110 to 126 106 to 126 106 to 116 109 to 127

28 25 25 33 45 30

14 to 54 10 to 49 11 to 48 13 to 60 32 to 60 13 to 54

0.3 0.3 0.3 0.8 2.0 0.3

0.0 to 1.1 Moderate 0.0 to 1.4 Moderate 0.0 to 1.4 Moderate 0.1 to 3.2 Moderate 0.7 to 4.4 Severe 0.1 to 1.1 Moderate

Spain Sri Lanka Sudan (former)b

118 118 116

111 to 125 112 to 124 108 to 124

25 25 34

12 to 47 15 to 42 18 to 56

0.2 0.4 1.0

0.0 to 0.9 Moderate 0.0 to 1.5 Moderate 0.2 to 2.8 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.3. Country estimates for pregnant women aged 15–49 years, continued Percentage of pregnant women with blood haemoglobin concentration <110 g/L Estimate 95% CI Percentage of pregnant women with blood haemoglobin concentration <70 g/L Estimate 95% CI

Mean blood haemoglobin concentration (g/L) Country Estimate 95% CI

Level of public health significancea

Suriname Swaziland

117 118

108 to 127 111 to 126

31 31

13 to 56 17 to 50

0.4 0.4

0.1 to 1.5 Moderate 0.1 to 1.0 Moderate

Sweden Switzerland Syrian Arab Republic Tajikistan Thailand

118 118 117 118 117

111 to 125 110 to 124 108 to 126 110 to 124 104 to 126

24 26 30 28 30

13 to 44 13 to 48 13 to 56 15 to 49 12 to 66

0.2 0.3 0.4 0.3 0.6

0.0 to 1.0 Moderate 0.0 to 1.1 Moderate 0.1 to 1.3 Moderate 0.1 to 1.0 Moderate 0.1 to 2.0 Moderate

The former Yugoslav Republic of Macedonia Timor-Leste

118 119

111 to 124 115 to 123

26 24

14 to 47 16 to 35

0.2 0.6

0.0 to 0.7 Moderate 0.2 to 1.4 Moderate

Togo Tonga Trinidad and Tobago Tunisia

107 120 118 118

102 to 114 108 to 130 108 to 127 109 to 126

58 26 30 29

37 to 72 7 to 57 12 to 56 12 to 54

1.9 0.4 0.5 0.3

0.5 to 4.7 Severe 0.0 to 1.7 Moderate 0.1 to 1.8 Moderate 0.1 to 1.2 Moderate

Turkey Turkmenistan Uganda

118 117 116

109 to 127 108 to 125 112 to 120

28 29 34

12 to 53 13 to 54 27 to 45

0.3 0.4 1.1

0.0 to 1.2 Moderate 0.1 to 1.2 Moderate 0.5 to 2.0 Moderate

Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United Republic of Tanzania (the) United States of America (the)

119 119 118 109 121

111 to 127 110 to 127 113 to 123 106 to 113 119 to 125

24 26 23 51 17

10 to 47 11 to 51 15 to 38 40 to 59 11 to 21

0.3 0.2 0.1 1.8 0.0

0.0 to 1.1 Moderate 0.0 to 0.8 Moderate 0.0 to 0.4 Moderate 1.0 to 2.9 Severe 0.0 to 0.2 Mild

Uruguay Uzbekistan Vanuatu

118 114 118

107 to 129 106 to 121 111 to 125

29 35 27

9 to 58 19 to 61 13 to 47

0.4 0.4 0.2

0.0 to 1.7 Moderate 0.1 to 1.1 Moderate 0.0 to 1.0 Moderate

Venezuela (Bolivarian Republic of) Viet Nam

119 120

109 to 128 114 to 126

27 23

11 to 52 12 to 39

0.3 0.4

0.0 to 1.1 Moderate 0.1 to 1.4 Moderate

Yemen Zambia Zimbabwe

115 116 116

106 to 124 108 to 124 112 to 120

36 36 34

17 to 62 19 to 56 25 to 46

0.8 1.0 0.5

0.1 to 2.7 Moderate 0.2 to 2.8 Moderate 0.2 to 1.0 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years) Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 33 22 95% CI 16 to 54 12 to 36 Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 1.7 0.5 95% CI

Mean blood haemoglobin concentration (g/L) Country Afghanistan Albania Estimate 124 128 95% CI 116 to 131 123 to 131

Level of public health significancea

0.3 to 4.6 Moderate 0.2 to 1.3 Moderate

Algeria Andorra Angola

125 129 120

116 to 132 122 to 135 115 to 126

33 17 45

14 to 55 8 to 39 28 to 58

1.3 0.5 1.1

0.2 to 4.3 Moderate 0.0 to 1.7 Mild 0.3 to 2.6 Severe

Antigua and Barbuda Argentina Armenia

128 130 127

119 to 135 123 to 138 120 to 133

25 16 26

10 to 50 7 to 34 12 to 47

1.0 0.5 0.7

0.1 to 3.4 Moderate 0.0 to 2.1 Mild 0.1 to 2.2 Moderate

Australia Austria Azerbaijan

129 129 124

121 to 135 121 to 134 118 to 129

17 19 33

8 to 41 9 to 42 17 to 50

0.5 0.6 1.1

0.0 to 1.8 Mild 0.1 to 2.4 Mild 0.3 to 2.9 Moderate

Bahamas (the) Bahrain Bangladesh

129 123 121

119 to 136 115 to 131 119 to 124

23 38 43

9 to 50 16 to 58 35 to 50

0.7 0.9 0.7

0.1 to 2.4 Moderate 0.1 to 2.8 Moderate 0.3 to 1.3 Severe

Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of)

129 128 129 129 118 120 125

119 to 137 119 to 134 120 to 134 120 to 137 115 to 124 112 to 128 119 to 130

23 22 18 22 50 44 32

9 to 48 9 to 48 8 to 45 8 to 46 35 to 60 22 to 63 19 to 47

0.9 0.5 0.5 0.8 1.4 2.2 1.0

0.1 to 3.1 Moderate 0.0 to 2.0 Moderate 0.0 to 2.1 Mild 0.1 to 2.8 Moderate 0.9 to 2.2 Severe 0.4 to 7.9 Severe 0.4 to 2.0 Moderate

Bosnia and Herzegovina Botswana

127 127

119 to 134 118 to 135

24 29

10 to 49 12 to 50

0.8 1.4

0.1 to 3.0 Moderate 0.2 to 4.1 Moderate

Brazil Brunei Darussalam

129 128

120 to 138 120 to 132

20 20

7 to 47 10 to 42

0.8 0.7

0.1 to 3.0 Moderate 0.1 to 2.4 Moderate

Bulgaria Burkina Faso Burundi

127 118 130

120 to 133 114 to 121 126 to 134

24 50 21

10 to 47 40 to 58 14 to 31

0.6 2.4 0.7

0.1 to 2.4 Moderate 1.5 to 3.5 Severe 0.3 to 1.5 Moderate

Cabo Verde Cambodia Cameroon

123 121 121

115 to 132 118 to 124 118 to 124

38 44 42

16 to 58 34 to 51 34 to 49

1.1 1.0 1.4

0.2 to 3.7 Moderate 0.5 to 1.7 Severe 0.9 to 2.2 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years), continued Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 95% CI Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 95% CI

Mean blood haemoglobin concentration (g/L) Country Estimate 95% CI

Level of public health significancea

Canada Central African Republic (the)

130 119

122 to 135 113 to 127

17 46

8 to 38 26 to 62

0.4 1.9

0.0 to 1.6 Mild 0.4 to 4.9 Severe

Chad Chile China Colombia

119 132 129 130

111 to 127 126 to 139 122 to 135 123 to 136

47 12 20 19

25 to 65 5 to 28 8 to 41 10 to 37

2.3 0.3 0.3 0.5

0.5 to 6.2 Severe 0.0 to 1.4 Mild 0.0 to 1.3 Moderate 0.1 to 1.5 Mild

Comoros (the) Congo Costa Rica Côte d’Ivoire Croatia Cuba Cyprus

126 118 130 119 127 128 125

116 to 134 115 to 123 122 to 136 115 to 123 120 to 133 119 to 136 116 to 131

31 51 19 49 25 23 28

13 to 54 36 to 60 8 to 42 36 to 59 10 to 48 9 to 49 11 to 55

1.4 1.1 0.8 1.5 0.7 0.8 0.8

0.2 to 4.0 Moderate 0.7 to 1.7 Severe 0.1 to 3.1 Mild 0.8 to 2.4 Severe 0.1 to 2.6 Moderate 0.1 to 2.7 Moderate 0.1 to 2.7 Moderate

Czech Republic (the) Democratic People’s Republic of Korea (the) Democratic Republic of the Congo (the)

128 127 118

120 to 134 121 to 133 112 to 124

23 25 49

9 to 46 11 to 46 34 to 64

0.5 0.5 2.4

0.0 to 2.1 Moderate 0.0 to 2.1 Moderate 1.1 to 4.6 Severe

Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt

129 128 128 127 128 124 129 119

121 to 135 118 to 137 118 to 136 118 to 135 119 to 136 118 to 130 119 to 136 115 to 126

18 27 25 26 24 35 23 45

8 to 42 9 to 51 10 to 53 10 to 52 10 to 49 16 to 52 9 to 48 28 to 60

0.5 1.0 0.9 1.0 0.9 0.7 0.9 1.9

0.0 to 2.0 Mild 0.1 to 3.5 Moderate 0.1 to 3.2 Moderate 0.1 to 3.2 Moderate 0.1 to 3.0 Moderate 0.2 to 1.8 Moderate 0.1 to 3.3 Moderate 1.0 to 3.1 Severe

El Salvador Equatorial Guinea

Eritrea Estonia Ethiopia Fiji

125 127 131 125

116 to 134 120 to 134 128 to 134 121 to 128

33 24 19 27

13 to 55 10 to 48 14 to 26 18 to 36

1.7 0.6 1.1 2.6

0. to 5.14 Moderate 0.1 to 2.7 Moderate 0.6 to 1.8 Mild 0.7 to 5.3 Moderate

Finland France

129 129

121 to 135 121 to 134

18 19

8 to 42 9 to 43

0.5 0.6

0.0 to 2.1 Mild 0.1 to 2.3 Mild

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years), continued Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 51 45 28 95% CI 32 to 65 24 to 65 13 to 46 Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 2.1 1.8 0.8 95% CI

Mean blood haemoglobin concentration (g/L) Country Gabon Gambia (the) Georgia Estimate 117 120 126 95% CI 112 to 124 112 to 128 120 to 132

Level of public health significancea

1.2 to 3.2 Severe 0.4 to 4.5 Severe 0.2 to 2.3 Moderate

Germany Ghana

129 115 128

121 to 135 110 to 120 120 to 133

18 56 20

9 to 41 43 to 67 10 to 45

0.6 3.5 0.7

0.0 to 2.5 Mild 1.1 to 7.6 Severe 0.1 to 2.4 Moderate

Greece Grenada Guatemala Guinea

127 128 118

118 to 135 119 to 135 114 to 123

26 26 48

10 to 51 11 to 46 35 to 60

1.1 1.3 2.1

0.1 to 3.5 Moderate 0.2 to 4.3 Moderate 1.4 to 3.0 Severe

Guinea-Bissau Guyana Haiti Honduras

120 124 123 131

112 to 128 120 to 128 117 to 129 124 to 137

45 34 37 18

23 to 65 23 to 45 24 to 52 8 to 36

2.1 1.5 2.4 0.6

0.4 to 6.1 Severe 0.7 to 2.7 Moderate 1.6 to 3.4 Moderate 0.1 to 1.9 Mild

Hungary Iceland India Indonesia Iran (Islamic Republic of)

127 129 118 127 126

120 to 133 122 to 135 113 to 125 123 to 130 119 to 133

24 17 48 23 28

10 to 48 8 to 40 30 to 64 13 to 37 13 to 48

0.6 0.4 2.4 0.6 0.8

0.1 to 2.6 Moderate 0.0 to 3.0 Mild 0.8 to 5.3 Severe 0.2 to 1.5 Moderate 0.1 to 2.6 Moderate

Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya

125 129 129 128 128 127 126 126 131

116 to 134 122 to 135 121 to 134 121 to 134 119 to 136 122 to 130 123 to 129 119 to 132 116 to 141

31 17 17 19 24 22 28 30 25

12 to 54 8 to 40 9 to 40 9 to 43 9 to 51 13 to 37 21 to 37 13 to 50 6 to 57

1.1 0.5 0.4 0.6 0.9 1.1 0.5 0.9 1.6

0.2 to 3.8 Moderate 0.1 to 2.2 Mild 0.0 to 1.7 Mild 0.1 to 2.5 Mild 0.1 to 3.0 Moderate 0.3 to 2.8 Moderate 0.2 to 0.9 Moderate 0.1 to 3.0 Moderate 0.4 to 3.7 Moderate

Kiribati Kuwait Kyrgyzstan

128 129 124

120 to 135 121 to 136 118 to 131

21 22 32

9 to 46 9 to 43 15 to 51

0.7 0.5 1.2

0.0 to 2.9 Moderate 0.1 to 2.0 Moderate 0.2 to 3.6 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years), continued Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 31 95% CI 16 to 50 Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 1.3 95% CI

Mean blood haemoglobin concentration (g/L) Country Lao People’s Democratic Republic (the) Estimate 124 95% CI 118 to 130

Level of public health significancea

0.3 to 3.6 Moderate

Latvia Lebanon Lesotho Liberia

128 126 128 118

119 to 134 119 to 133 123 to 132 112 to 125

24 27 27 49

10 to 49 12 to 48 17 to 39 29 to 64

0.6 0.7 1.4 1.8

0.1 to 2.5 Moderate 0.1 to 2.6 Moderate 0.7 to 2.5 Moderate 0.4 to 4.6 Severe

Libya Lithuania Luxembourg Madagascar Malawi

126 128 129 125 127

117 to 134 120 to 134 122 to 135 120 to 130 123 to 130

28 23 18 32 29

11 to 53 9 to 48 8 to 40 19 to 45 21 to 38

0.9 0.6 0.5 0.9 1.3

0.1 to 3.3 Moderate 0.0 to 2.2 Moderate 0.0 to 2.0 Mild 0.3 to 1.8 Moderate 0.7 to 2.1 Moderate

Malaysia Maldives Mali

128 123 115

121 to 134 119 to 128 111 to 121

21 37 56

9 to 45 21 to 51 42 to 67

0.5 0.6 2.8

0.0 to 1.7 Moderate 0.1 to 1.9 Moderate 1.2 to 5.2 Severe

Malta Marshall Islands (the) Mauritania Mauritius Mexico Micronesia (Federated States of) Mongolia

129 129 122 130 134 129 131

122 to 134 120 to 135 114 to 132 119 to 138 129 to 138 122 to 135 122 to 140

17 20 39 23 14 18 20

8 to 40 8 to 44 17 to 60 8 to 50 8 to 24 9 to 38 7 to 43

0.4 0.6 1.4 0.6 0.5 0.7 0.8

0.0 to 1.8 Mild 0.0 to 2.9 Moderate 0.2 to 4.4 Moderate 0.1 to 2.5 Moderate 0.2 to 1.2 Mild 0.0 to 3.2 Mild 0.1 to 2.7 Moderate

Montenegro Morocco Mozambique Myanmar

127 125 120 125

119 to 133 117 to 132 115 to 127 118 to 131

24 33 44 30

10 to 49 15 to 54 29 to 57 14 to 51

0.6 1.5 2.5 0.9

0.1 to 2.4 Moderate 0.2 to 4.6 Moderate 1.4 to 3.6 Severe 0.1 to 3.0 Moderate

Namibia Nepal

125 124

114 to 135 121 to 127

33 36

13 to 58 28 to 44

1.7 0.8

0.3 to 5.1 Moderate 0.4 to 1.4 Moderate

Netherlands (the) New Zealand Nicaragua Niger (the)

129 130 132 119

121 to 135 124 to 136 126 to 138 115 to 124

18 15 13 47

8 to 42 8 to 32 6 to 27 34 to 58

0.5 0.4 0.6 2.1

0.1 to 2.2 Mild 0.0 to 1.3 Mild 0.1 to 2.1 Mild 1.4 to 3.2 Severe

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years), continued Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 49 95% CI 24 to 71 Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 2.1 95% CI

Mean blood haemoglobin concentration (g/L) Country Nigeria Estimate 118 95% CI 109 to 128

Level of public health significancea

0.5 to 6.9 Severe

Norway Oman Pakistan Panama

129 123 117 128

121 to 135 117 to 130 114 to 120 120 to 135

17 35 51 25

8 to 41 17 to 55 43 to 58 10 to 46

0.5 1.0 3.4 0.6

0.0 to 2.0 Mild 0.2 to 3.3 Moderate 1.5 to 4.8 Severe 0.1 to 2.2 Moderate

Papua New Guinea Paraguay Peru Philippines (the)

125 129 130 126

116 to 132 120 to 138 128 to 132 119 to 131

30 19 18 25

12 to 53 7 to 45 15 to 23 13 to 44

1.8 0.8 0.5 1.6

0.2 to 5.9 Moderate 0.1 to 2.9 Mild 0.4 to 0.8 Mild 0.2 to 5.4 Moderate

Poland Portugal Qatar Republic of Korea (the) Republic of Moldova (the)

128 129 126 128 127

120 to 134 121 to 135 118 to 133 125 to 130 120 to 132

23 19 28 19 26

9 to 48 8 to 44 11 to 52 14 to 28 12 to 46

0.6 0.7 0.7 0.4 0.6

0.1 to 2.4 Moderate 0.1 to 2.7 Mild 0.1 to 2.4 Moderate 0.2 to 0.9 Mild 0.1 to 1.7 Moderate

Romania Russian Federation (the) Rwanda

127 128 132

119 to 133 120 to 135 129 to 135

24 21 17

10 to 49 9 to 46 12 to 24

0.7 0.5 0.5

0.1 to 2.4 Moderate 0.0 to 1.9 Moderate 0.2 to 0.9 Mild

Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe

127 128 129 121

117 to 135 118 to 136 122 to 135 117 to 126

26 25 18 43

11 to 53 10 to 51 8 to 39 28 to 55

1.2 1.0 0.6 1.2

0.2 to 4.0 Moderate 0.1 to 3.3 Moderate 0.0 to 2.6 Mild 0.5 to 2.4 Severe

Saudi Arabia Senegal Serbia

121 115 127

112 to 130 112 to 117 120 to 133

40 57 25

18 to 65 51 to 63 11 to 47

1.4 3.4 0.8

0.2 to 4.1 Severe 2.3 to 5.0 Severe 0.1 to 3.1 Moderate

Seychelles Sierra Leone

130 120

121 to 138 114 to 125

21 45

7 to 46 30 to 59

0.5 1.7

0.1 to 1.9 Moderate 0.8 to 3.1 Severe

Singapore Slovakia Slovenia Solomon Islands

127 128 127 126

118 to 132 119 to 134 119 to 134 118 to 134

22 23 24 25

10 to 51 10 to 50 10 to 50 10 to 50

0.7 0.6 0.6 1.2

0.1 to 2.6 Moderate 0.1 to 2.5 Moderate 0.1 to 2.6 Moderate 0.1 to 4.9 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Table A3.4 Country estimates for all women of reproductive age (15–49 years), continued Percentage of women with anaemia (blood haemoglobin concentration <120 g/L for non-pregnant women and <110 g/L for pregnant women) Estimate 43 28 95% CI 29 to 55 12 to 47 Percentage of women with severe anaemia (blood haemoglobin concentration <80 g/L for non-pregnant women and <70 g/L for pregnant women) Estimate 2.6 1.1 95% CI

Mean blood haemoglobin concentration (g/L) Country Somalia South Africa Estimate 120 127 95% CI 115 to 125 120 to 135

Level of public health significancea

1.0 to 5.5 Severe 0.2 to 3.1 Moderate

Spain Sri Lanka Sudan (former)b

129 126 126

121 to 135 119 to 131 117 to 133

18 26 31

8 to 42 12 to 46 14 to 52

0.6 0.7 1.1

0.1 to 2.1 Mild 0.1 to 2.2 Moderate 0.2 to 3.6 Moderate

Suriname Swaziland

128 127

119 to 136 120 to 134

25 28

10 to 50 14 to 47

1.0 1.0

0.1 to 3.4 Moderate 0.3 to 2.4 Moderate

Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste

129 129 125 127 127 129 127

121 to 135 120 to 134 116 to 133 122 to 132 114 to 132 126 to 133 124 to 131

18 19 31 25 24 19 22

8 to 42 9 to 44 12 to 55 15 to 39 10 to 58 13 to 27 14 to 33

0.5 0.6 1.0 0.9 0.9 0.3 0.7

0.0 to 2.1 Mild 0.1 to 2.3 Mild 0.1 to 3.7 Moderate 0.3 to 1.9 Moderate 0.1 to 3.4 Moderate 0.1 to 0.8 Mild 0.3 to 1.5 Moderate

Togo Tonga Trinidad and Tobago Tunisia

117 129 128 126

108 to 125 120 to 136 118 to 136 118 to 134

53 19 25 28

30 to 74 7 to 43 9 to 51 11 to 52

2.5 0.6 1.2 1.0

0.6 to 6.4 Severe 0.0 to 2.9 Mild 0.1 to 4.2 Moderate 0.1 to 3.1 Moderate

Turkey Turkmenistan Uganda

126 125 127

118 to 135 116 to 132 124 to 130

29 32 27

11 to 53 13 to 56 21 to 35

0.9 1.2 1.1

0.1 to 3.5 Moderate 0.2 to 3.7 Moderate 0.6 to 1.8 Moderate

Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United Republic of Tanzania (the) United States of America (the)

128 127 130 121 132

120 to 134 119 to 134 126 to 134 118 to 125 130 to 134

23 26 15 40 12

9 to 48 11 to 51 9 to 28 30 to 48 9 to 16

0.5 0.6 0.2 2.0 0.2

0.1 to 2.3 Moderate 0.1 to 2.2 Moderate 0.0 to 0.8 Mild 1.1 to 3.1 Severe 0.1 to 0.4 Mild

Uruguay Uzbekistan Vanuatu

130 118 128

121 to 138 112 to 129 122 to 132

17 52 22

6 to 43 21 to 67 10 to 39

0.6 1.1 0.2

0.0 to 2.3 Mild 0.2 to 3.2 Severe 0.0 to 1.1 Moderate

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

Mean blood haemoglobin concentration (g/L) Country Estimate 95% CI

Level of public health significancea

Venezuela (Bolivarian Republic of) Viet Nam

129 131

120 to 136 127 to 135

22 14

9 to 47 10 to 25

0.7 0.4

0.1 to 2.6 Moderate 0.1 to 1.3 Mild

Yemen Zambia Zimbabwe

122 126 127

112 to 132 119 to 133 123 to 131

38 29 28

16 to 62 14 to 48 21 to 38

2.2 1.1 1.5

0.3 to 6.5 Moderate 0.2 to 3.3 Moderate 0.9 to 2.4 Moderate

CI: credibility interval. Countries in italics do not have national or subnational data on the prevalence of anaemia. a Based on proportion of non-pregnant women with blood haemoglobin concentration <120 g/L and pregnant women with blood haemoglobin concentration <110g/L. b Estimates are for former Sudan, consistent with the situation from 1 January to 11 July 2011.

THE GLOBAL PREVALENCE OF ANAEMIA IN 2011

For more information, please contact: Department of Nutrition for Health and Development World Health Organization Avenue Appia 20, CH-1211 Geneva 27, Switzerland Fax: +41 22 791 4156 Email: nutrition@who.int www.who.int/nutrition

Key facts

Organisation World Health Organization (WHO)

Document type Publications

Adoption date June 25, 2015

Source World Health Organization