Prevalence of anemia in Brazilian adults and elderly

This is a cross-sectional study consisted of 8,060 subjects aged over 18 years old in all Brazilian states. We used data from laboratory tests of the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS). The following indicators obtained by erythrogram were used: hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW). Reference values of the World Health Organization (WHO) were used to determine anemia, which considers hemoglobin levels below 13.0 g/dL for men and less than 12.0 g/dL for women. Sociodemographic information was obtained by interview.

Results:

The prevalence of anemia among Brazilian adults and elderly was 9.9%. Higher prevalence of anemia and more severe cases were found among women, elderly, people with low schooling, black skin color and residents of the North and Northeast regions. Normocytic normochromic anemia was the most common type of anemia (56.0%).

Conclusion:

The anemia prevalence found in the study was in agreement with the literature. It must be stressed that higher anemia prevalence was found in disadvantaged and older population. Considering the increase of the population over 60 years of age, interventions to prevent and treat anemia among adults and elderly is imperative in the health service network.

Keywords:
Anemia; Nutritional anemias; Risk factors; Adult; Aged

	Total (n = 8,060)				Males (n = 3,353)				Females (n = 4,707)
	%	95%CI		p	%	95%CI		p	%	95%CI		p
Total	9.86	9.07	10.71		7.18	6.13	8.40		12.25	11.11	13.48	< 0.001
Age range (years)				< 0.001				< 0.001				< 0.001
18 to 29	8.08	6.58	9.89		4.73	3.01	7.36		11.43	9.16	14.17
30 to 44	9.33	8.03	10.80		4.79	3.50	6.53		13.26	11.22	15.60
45 to 59	8.64	7.15	10.40		7.85	5.64	10.84		9.35	7.50	11.60
60 to 74	12.00	10.04	14.29		10.85	8.13	14.34		12.92	10.27	16.13
75 old or older	24.33	19.50	29.92		26.71	19.10	36.01		22.68	16.76	29.62
Education				< 0.001				0.001				0.079
Illiterate or incomplete elementary education	11.91	10.67	13.28		9.85	8.19	11.81		13.81	12.05	15.79
Complete elementary or incomplete high school education	10.18	8.01	12.86		7.64	4.75	12.07		12.72	9.81	16.35
Complete high school education or higher	8.03	6.95	9.26		4.64	3.39	6.33		10.85	9.25	12.68
Skin color				< 0.001				< 0.001				0.001
White	8.04	6.96	9.26		5.26	3.99	6.89		10.43	8.83	12.28
Black	17.13	13.48	21.52		17.03	11.26	24.92		17.21	13.10	22.28
Brown	10.47	9.40	11.64		7.26	6.01	8.75		13.46	11.83	15.27
Other	4.19	2.11	8.18		1.39	0.21	8.43		6.08	2.82	12.59
Region				< 0.001				< 0.001				< 0.001
North	11.59	10.19	13.16		8.33	6.54	10.56		14.64	12.61	16.93
Northeast	13.62	12.36	14.98		11.21	9.48	13.21		15.73	13.98	17.65
Southeast	9.09	7.68	10.73		6.10	4.33	8.54		11.73	9.71	14.11
South	6.80	5.33	8.64		4.35	2.55	7.31		9.01	6.92	11.65
Midwest	6.40	4.90	8.31		4.79	2.88	7.87		7.87	5.80	10.58

	Moderate to severe anemia (n = 191)			Mild anemia (n = 714)			Normal (n = 7,155)
	%	95%CI		%	95%CI		%	95%CI
Total (n = 8.060)	1.91	1.57	2.31	7.95	7.24	8.74	90.14	89.29	90.93
Gender
Male	0.88	0.52	1.49	6.31	5.34	7.43	92.82	91.60	93.87
Female	2.76	2.25	3.38	9.38	8.36	10.52	87.86	86.62	89.01
Age range (years)
18 to 29	2.04	1.32	3.15	6.04	4.77	7.62	91.92	90.11	93.42
30 to 44	1.34	0.96	1.87	7.99	6.76	9.41	90.67	89.20	91.97
45 to 59	1.40	0.86	2.27	7.24	5.87	8.89	91.36	89.60	92.85
60 to 74	2.56	1.70	3.83	9.45	7.71	11.53	88.00	85.71	89.96
75 old or older	5.92	3.74	9.24	18.42	14.10	23.69	75.67	70.08	80.50
Education
Illiterate and incomplete elementar education	2.22	1.70	2.90	9.69	8.57	10.94	88.09	86.72	89.33
Complete elementar and incomplete high school education	2.04	1.22	3.39	8.14	6.18	10.67	89.82	87.14	91.99
Complete high school and higher	1.59	1.15	2.21	6.44	5.47	7.56	91.97	90.74	93.05
Skin color
White	1.42	1.05	1.93	6.61	5.62	7.77	91.96	90.74	93.04
Black	3.46	1.94	6.09	13.67	10.39	17.77	82.87	78.48	86.52
Brown	2.15	1.65	2.81	8.31	7.38	9.35	89.53	88.36	90.60
Other	0.30	0.04	2.14	3.89	1.90	7.83	95.81	91.83	97.89
Region
North	3.36	2.61	4.33	8.23	7.05	9.58	88.41	86.84	89.81
Northeast	2.42	1.91	3.06	11.20	10.04	12.47	86.38	85.02	87.64
Southeast	1.74	1.17	2.59	7.35	6.08	8.86	90.91	89.27	92.32
South	1.53	0.95	2.45	5.27	3.95	6.99	93.20	91.36	94.68
Midwest	0.69	0.33	1.46	5.71	4.29	7.56	93.60	91.69	95.10

Hematimetric rates	Reduced			Normal			Increased
Hematimetric rates	%	95%CI		%	95%CI		%	95%CI
Total (n = 905)
MCV	23.17	19.49	27.32	66.63	62.35	70.66	10.19	8.12	12.71
MCH	32.13	28.18	36.37	65.61	61.30	69.68	2.26	1.12	4.50
RDW	0.00	0.00	0.00	24.53	20.87	28.59	75.47	71.41	79.13
Male (n = 279)
MCV	18.00	12.01	26.09	67.91	59.79	75.07	14.09	9.89	19.70
MCH	25.74	19.05	33.79	71.20	62.89	78.30	3.06	0.94	9.49
RDW	0.00	0.00	0.00	22.03	16.04	29.46	77.97	70.54	83.96
Female (n = 626)
MCV	25.88	21.46	30.85	65.97	60.92	70.68	8.15	6.08	10.85
MCH	35.48	30.75	40.51	62.69	57.61	67.50	1.83	0.81	4.12
RDW	0.00	0.00	0.00	25.83	21.42	30.80	74.17	69.20	78.58

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

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[1] Corresponding author: Ísis Eloah Machado. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte, MG, Brazil. E-mail: isiseloah@gmail.com