Reducing the global burden of anaemia

01 March 2021
Key Researchers
Acting Deputy Director
Laboratory Head

Iron deficiency and anaemia are common but serious health conditions that represent a significant global disease burden.

In Australia, 12 per cent of women are iron deficient and six per cent have anaemia. But if you look at global statistics, iron deficiency and anaemia are far more prevalent. Worldwide, 42 per cent of children and one in three women are anaemic. The condition is less common in men.

Anaemia is a reduction in haemoglobin – the oxygen-carrying pigment in red blood cells. While there are many causes of anaemia, most relate to iron deficiency. Symptoms of anaemia include fatigue or lethargy, irritability, breathlessness and headaches. In children it can lead to poor feeding, behavioural issues and delayed development. Pregnant women with anaemia are at increased risk of haemorrhage, delivering a low birthweight or premature baby, and even death.

WEHI receives WHO designation

Recently, WEHI was designated the World Health Organization (WHO) Collaborating Centre for Anaemia Detection and Control.

The designation enlists WEHI researchers, led by Associate Professor Sant-Rayn Pasricha, to support WHO to determine the best approaches and policies to diagnose and treat anaemia and recognises the expertise of WEHI researchers in combatting anaemia.

Associate Professor Pasricha said the WHO Collaborating Centre designation would enable researchers from WEHI to support the activities of the WHO and generate the knowledge needed to form guidelines and advice to countries throughout the world.

“Policies put in place by the WHO in relation to anaemia impact nearly every child and pregnant mother in low-income countries”
Associate Professor Sant-Rayn Pasricha

Global health effort

Associate Professor Pasricha and his team have made significant advances in assessing better approaches to diagnose and manage anaemia, particularly through large-scale clinical trials in low-income countries. He said the team was currently running five randomised controlled studies in Bangladesh, South Asia and Malawi, Africa.

“The populations, environments and dietary conditions reflect these two important regions of the world. We also have excellent local partners and long-established relationships with field workers in both countries.” Anaemia is considered one of the world’s top burdens of disease.

Dr Pasricha’s program comprises three large trials investigating whether an intravenous iron treatment, given to anaemic women in pregnancy, is better than standard-of-care (oral) iron therapy in improving the physical and psychological health of mothers and their babies. Key outcomes include maternal haemorrhage, birthweight, prematurity and child brain development. These trials, set in both Malawi and Bangladesh, are funded by the Bill & Melinda Gates Foundation with grants worth more than AUD$16 million. The first of these trials should have results by late 2021.

In addition, Dr Pasricha is leading two large trials evaluating the effects of iron interventions given to infants, assessing critical child developmental and growth outcomes. These programs are funded by more than AUD$5 million in funding from the National Health and Medical Research Council. The programs have also benefitted from philanthropic funding from the Geok Hua Wong Trust, to purchase a robotic workstation for use in the laboratory in Victoria to support the research process.

“By the end of this program, we will have knowledge of the effects of iron on both the pregnancy and the baby and whether it is actually feasible to use these treatments in low-income countries”
Associate Professor Sant-Rayn Pasricha

New guidelines for managing iron deficiency

While iron deficiency is often caused by a lack of iron in the diet, it can also be a sign of serious health problems such as bowel cancer or coeliac disease.

Associate Professor Pasricha and Associate Professor Jason Tye-Din, who are both also clinicians at the Royal Melbourne Hospital, recently released a paper in The Lancet on best practice for clinicians to diagnose and manage iron deficiency, together with colleagues from the University of Heidelberg, Germany, and Radboud University Medical Center, Netherlands.

“It’s really important that the cause of iron deficiency is properly investigated, rather than patients just being instructed to take iron supplements. If doctors don’t take iron deficiency seriously and investigate why it is happening, serious health problems could be overlooked. In some cases, these could be potentially life-threatening”
Associate Professor Jason Tye-Din
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