title: Prevalence of anaemia and iron deficiency in Portugal: the EMPIRE study.
abstract: BACKGROUND
  Anaemia and iron deficiency are major public health problems with great implications on quality of life.
  
  
  OBJECTIVE
  To establish the general prevalence of anaemia and iron deficiency in the adult Portuguese population and the prevalence by age, gender and region.
  
  
  METHODS
  This was a population-based, cross-sectional study (EMPIRE study) based on a representative sample of 7980 adults residing in mainland Portugal, which were selected using a random route sampling method. Levels of haemoglobin, ferritin, creatinine and C-reactive protein were measured by Point-of-Care assays; participants also completed a questionnaire about demography and medical history.
  
  
  RESULTS
  The measured prevalence of anaemia was 19.9% (95% confidence interval: 19.0-20.8%); 84% of cases were previously undiagnosed. Anaemia was more prevalent among women (20.8%), young adults (18-34 years) (22.8-30.5%), older adults (21.0%), and pregnant women (54.2%). Anaemia varied across regions: from 15.5% in the Center region to 24.9% in the South. Iron deficiency was also highly prevalent: 16.7% (ferritin <15 ng/mL), 31.9% (<30 ng/mL), 53.3% (<50 ng/mL) and 84.3% (<100 ng/mL). Iron deficiency anaemia represented most anaemia cases: 29.0% (ferritin <15 ng/mL), 54.8% (<30 ng/mL), 75.4% (<50 ng/mL) and 92.5% (<100 ng/mL).
  
  
  CONCLUSIONS
  Anaemia and iron deficiency are highly prevalent in Portugal and largely undiagnosed. Women, young adults and older individuals are more prone to present these conditions and there are marked regional asymmetries. Nationwide strategies for prevention, diagnosis and treatment of these conditions should be implemented.
authors: Anemia Working Group Portugal, Lisbon, Portugal.|Internal Medicine Department, S. Francisco Xavier Hospital/Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.|NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors: C
authors: C
authors: Fonseca
authors: Anemia Working Group Portugal, Lisbon, Portugal.|Internal Medicine Department, S. Francisco Xavier Hospital/Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.|NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors: F
authors: F
authors: Marques
authors: Anemia Working Group Portugal, Lisbon, Portugal.|Imunnohemotherapy (Transfusion Medicine) Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
authors: A
authors: A
authors: Robalo Nunes
authors: Anemia Working Group Portugal, Lisbon, Portugal.|OM Pharma, Lisbon, Portugal.
authors: A
authors: A
authors: Belo
authors: Anemia Working Group Portugal, Lisbon, Portugal.|Hematology Department, Cancer Portuguese Institute, Francisco Gentil - Lisbon, Lisbon, Portugal.
authors: D
authors: D
authors: Brilhante
authors: Anemia Working Group Portugal, Lisbon, Portugal.|Laboratory Medicine Unit, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.|Clinical Pathology (Haematology Laboratory), Cancer Portuguese Institute, Francisco Gentil - Lisbon, Lisbon, Portugal.
authors: J
authors: J
authors: Cortez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D055815:Young Adult
keywords: anaemia; epidemiology; iron deficiency; portugal; prevalence