title: Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron.
abstract: Using data from the national micronutrients survey 2011-2012, the present study explored the determinants of Fe status and Hb levels in Bangladesh with a particular focus on groundwater Fe.
  
  
  
  Cross-sectional study conducted at the nationwide scale. Settings The survey was conducted in 150 clusters, fifty in each of the three strata of rural, urban and slum.
  
  
  
  Three population groups: pre-school age children (6-59 months; PSAC), school age children (6-14 years; SAC) and non-pregnant non-lactating women (15-49 years; NPNLW).
  
  
  
  National prevalence of Fe deficiency was 10·7 %, 7·1 % and 3·9-9·5 % in PSAC, NPNLW and SAC, respectively. Prevalence of anaemia was 33·1 % (PSAC), 26·0 % (NPNLW) and 17·1-19·1 % (SAC). Multivariate regression analyses showed that the area with 'predominantly high groundwater Fe' was a determinant of higher serum ferritin levels in NPNLW (standardized β=0·19; P=0·03), SAC (standardized β=0·22; P=0·01) and PSAC (standardized β=0·20; P=0·03). This area also determined higher levels of Hb in PSAC (standardized β=0·14; P=0·01).
  
  
  
  National prevalence of Fe deficiency in Bangladesh is low, contrary to the widely held assumption. High Fe level in groundwater is associated with higher Fe status (all populations) and higher Hb level (PSAC).
authors.affiliation: 1Nutrition and Clinical Services Division,icddr,b,68 Shaheed Tajuddin Ahmed Sharani,Mohakhali,Dhaka 1212,Bangladesh.
authors.forename: Sabuktagin
authors.initials: S
authors.lastname: Rahman
authors.affiliation: 1Nutrition and Clinical Services Division,icddr,b,68 Shaheed Tajuddin Ahmed Sharani,Mohakhali,Dhaka 1212,Bangladesh.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: 1Nutrition and Clinical Services Division,icddr,b,68 Shaheed Tajuddin Ahmed Sharani,Mohakhali,Dhaka 1212,Bangladesh.
authors.forename: Ahmed Shafiqur
authors.initials: AS
authors.lastname: Rahman
authors.affiliation: 2Health Systems and Population Studies Division,icddr,b,Dhaka,Bangladesh.
authors.forename: Nurul
authors.initials: N
authors.lastname: Alam
authors.affiliation: 1Nutrition and Clinical Services Division,icddr,b,68 Shaheed Tajuddin Ahmed Sharani,Mohakhali,Dhaka 1212,Bangladesh.
authors.forename: Am Shamsir
authors.initials: AS
authors.lastname: Ahmed
authors.affiliation: 1Nutrition and Clinical Services Division,icddr,b,68 Shaheed Tajuddin Ahmed Sharani,Mohakhali,Dhaka 1212,Bangladesh.
authors.forename: Santhia
authors.initials: S
authors.lastname: Ireen
authors.affiliation: 4UNICEF Bangladesh,Dhaka,Bangladesh.
authors.forename: Ireen Akhter
authors.initials: IA
authors.lastname: Chowdhury
authors.affiliation: 5Ayesha Memorial Medical College,Dhaka,Bangladesh.
authors.forename: Fatima Parveen
authors.initials: FP
authors.lastname: Chowdhury
authors.affiliation: 6Institute of Public Health Nutrition,Dhaka,Bangladesh.
authors.forename: Sm Mustafizur
authors.initials: SM
authors.lastname: Rahman
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D060587:Groundwater / Q000737:chemistry*; D006801:Humans; D007223:Infant; D007501:Iron / Q000032:analysis / Q000097:blood*; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D055815:Young Adult
chemical_list: D005293:Ferritins; D007501:Iron
keywords: Anaemia; Bangladesh; Groundwater; Iron
references.citation: Am J Clin Nutr. 2010 Dec;92(6):1406-15
references.pmid: 20962160
references.citation: J Water Health. 2010 Dec;8(4):818-25
references.pmid: 20705991
references.citation: J Nutr. 2011 Dec;141(12):2233-41
references.pmid: 22049292
references.citation: Biometals. 1994 Jan;7(1):75-9
references.pmid: 8118176
references.citation: J Nutr. 2001 Mar;131(3):758-64
references.pmid: 11238756
references.citation: Clin Lab Haematol. 2003 Aug;25(4):227-31
references.pmid: 12890161
references.citation: J Nutr. 2000 Nov;130(11):2691-6
references.pmid: 11053508
references.citation: Am J Clin Nutr. 2000 Nov;72(5):1170-8
references.pmid: 11063445
references.citation: Int J Vitam Nutr Res. 2012 Feb;82(1):5-14
references.pmid: 22811372
references.citation: Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):428-37
references.pmid: 21297038
references.citation: Pediatrics. 2010 Jul;126(1):e140-9
references.pmid: 20547647
references.citation: J Nutr. 2009 Jun;139(6):1179-84
references.pmid: 19403710
references.citation: Annu Rev Nutr. 1981;1:123-47
references.pmid: 6764713
references.citation: J Nutr. 2008 Mar;138(3):581-6
references.pmid: 18287370
references.citation: Asia Pac J Clin Nutr. 2008;17(1):166-77
references.pmid: 18364342
references.citation: Acta Obstet Gynecol Scand. 2011 Jan;90(1):47-56
references.pmid: 21275915
references.citation: Int J Food Sci Nutr. 2013 Mar;64(2):175-84
references.pmid: 22856382
references.citation: J Nutr. 2011 May;141(5):944-9
references.pmid: 21451130
references.citation: Clin Infect Dis. 2002 Sep 1;35(5):618-24
references.pmid: 12173139
references.citation: Blood Transfus. 2007 Nov;5(4):244-5
references.pmid: 19204781
references.citation: Eur J Clin Nutr. 2000 Sep;54(9):678-83
references.pmid: 11002378
references.citation: Environ Sci Technol. 2007 Sep 1;41(17):5960-6
references.pmid: 17937267
references.citation: J Nutr. 2004 Jun;134(6):1295-8
references.pmid: 15173386
references.citation: Asia Pac J Clin Nutr. 2012;21(3):416-24
references.pmid: 22705433
references.citation: Am J Clin Nutr. 2010 Sep;92(3):546-55
references.pmid: 20610634