title: Epidemiology of iron deficiency anaemia in four European countries: a population-based study in primary care.
abstract: OBJECTIVE
  Iron deficiency anaemia (IDA) is a global public health concern, being responsible for about 800 000 deaths per year worldwide. To date, few studies have investigated the epidemiology of IDA in Europe. This study therefore aimed to assess the incidence rate and determinants of IDA in four European countries.
  
  
  METHODS
  Demographic and clinical information was obtained from four national primary care databases, respectively, for Italy, Belgium, Germany and Spain. IDA-related determinants were estimated using multivariable Cox regression.
  
  
  RESULTS
  The annual incidence rates of IDA ranged between 7.2 and 13.96 per 1000 person-years. The estimates were higher in Spain and Germany. Females, younger and older patients were at greater risk of IDA, as well as those suffering from gastrointestinal diseases, pregnant women and those with history of menometrorrhagia, and aspirin and/or antacids users. A Charlson Index >0 was a significant determinant of IDA in all countries.
  
  
  CONCLUSIONS
  The use of primary care databases allowed us to assess the incidence rate and determinants of IDA in four European countries. Given the crucial role of general practitioners in the diagnosis and management of this condition, our findings may contribute to increase the awareness of IDA among physicians as well as to reduce its occurrence among at-risk patients.
authors.affiliation: Health Search Italian College of General Practitioners and Primary Care, Florence, Italy.|Department of Health Sciences, University of Florence, Florence, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Levi
authors.affiliation: Institute for Liver and Digestive Health, Royal Free Hospital, University College of London, London, UK.
authors.forename: Matteo
authors.initials: M
authors.lastname: Rosselli
authors.affiliation: Health Search Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Simonetti
authors.affiliation: Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Ovidio
authors.initials: O
authors.lastname: Brignoli
authors.affiliation: Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cancian
authors.affiliation: Department of Transfusion Medicine, Local Health Authority n°5, Pordenone, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Masotti
authors.affiliation: IMS Health Information Solutions Medical Research srl, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Pegoraro
authors.affiliation: IMS Health Information Solutions Medical Research srl, Milan, Italy.
authors.forename: Nazarena
authors.initials: N
authors.lastname: Cataldo
authors.affiliation: IMS Health Information Solutions Medical Research srl, Milan, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Heiman
authors.affiliation: Health Search Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Chelo
authors.affiliation: Health Search Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Cricelli
authors.affiliation: Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cricelli
authors.affiliation: Health Search Italian College of General Practitioners and Primary Care, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lapi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D057286:Electronic Health Records; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D055815:Young Adult
keywords: Europe; determinants; incidence rate; iron deficiency anaemia