Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021
William M. Gardner, Christian Razo, Theresa A. McHugh, Hailey Hagins, Victor M. Vilchis-Tella, Conor Hennessy, Heather Jean Taylor, Nandita Perumal, Kia Fuller, Kelly Cercy, Leo Zoeckler, Catherine S Chen, Stephen S Lim, Amirali Aali, Kalkidan Hassen Abate, Sherief Abd‐Elsalam, Ame Mehadi Abdurehman, Getachew Abebe, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Girma Beressa Aboye, Yonas Derso Abtew, Manfred Accrombessi, Denberu Eshetie Adane Adane, Tigist Demssew Adane, Isaac Yeboah Addo, Miracle Ayomikun Adesina, Daniel A Adeyinka, Qorinah Estiningtyas Sakilah Adnani, Muhammad U. Afzal, Saira Afzal, Rina Agustina, Bright Opoku Ahinkorah, Aqeel Ahmad, Sajjad Ahmad, Sepideh Ahmadi, Ayman Ahmed, Tarik A. Rashid, Wajeeha Aiman, Marjan Ajami, Hossein Akbarialiabad, Fares Alahdab, Ziyad Al‐Aly, Nazmul Alam, Astawus Alemayehu, Robert Kaba Alhassan, Muhammad Ashar Ali, Sami Almustanyir, Rajaa Al‐Raddadi, Rami H. Al‐Rifai, Khalid A Altirkawi, Saba Alvand, Nelson Alvis‐Guzmán, Yasser Sami Amer, Edward Kwabena Ameyaw, Hubert Amu, Tadele Fentabil Anagaw, Robert Ancuceanu, Ali Arash Anoushirvani, Maxwell Hubert Antwi, Davood Anvari, Jalal Arabloo, Aleksandr Y. Aravkin, Hany Ariffin, Timur Aripov, Asrat Arja, Michael B. Arndt, Judie Arulappan, Raphael Taiwo Aruleba, Tahira Ashraf, Melash Belachew Asresie, Seyyed Shamsadin Athari, Daniel Atlaw, Avinash Aujayeb, Andargie Abate Awoke, Mamaru Ayenew Awoke, Sina Azadnajafabad, Mohammadreza Azangou‐Khyavy, B B Darshan, Alaa Badawi, Ashish Badiye, Nayereh Baghcheghi, Nasser Bagheri, Sara Bagherieh, Atif Amin Baig, Maciej Banach, Palash Chandra Banik, Abere Tilahun Bantie, Ronald D. Barr, Amadou Barrow, Azadeh Bashiri, Saurav Basu, Abdul‐Monim Batiha, Tahmina Begum, Melaku Ashagrie Belete, Luı́s Belo, Isabela M. Benseñor, Alemshet Yirga Berhie, Akshaya Srikanth Bhagavathula
Abstract
BACKGROUND: Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. METHODS: We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. FINDINGS: In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9-24·7), corresponding to 1·92 billion (1·89-1·95) prevalent cases, compared with a prevalence of 28·2% (27·8-28·5) and 1·50 billion (1·48-1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1-75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1-612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2-123·7]), and other neglected tropical diseases (36·3 [24·4-52·8]), collectively accounting for 84·7% (84·1-85·2) of anaemia YLDs. INTERPRETATION: Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. FUNDING: Bill & Melinda Gates Foundation.