Control of iron and other micronutrient deficiencies in the English-speaking Caribbean

Abstract

Most micronutrient deficiencies affect relatively few people in the Caribbean, however, many Caribbean residents are affected by anemia that appears due primarily to a lack of dietary iron. While generally substantial, the prevalences of such anemia have differed a good deal from place to place and study to study, observed rates ranging from 27 percent to 75 percent in pregnant women, 19 percent to 55 percent in lactating women, and 15 percent to 80 percent in young children. Severe anemia, defined by a blood hemoglobin concentration below 8 g/dl, has been found in approximately 6 percent of the pregnant women and 11 percent of the preschool children in some Caribbean countries. The principal ways of controlling iron deficiency anemia are through food fortification, control of intestinal parasites, direct oral supplementation, and dietary modification. Progress has been made in iron fortification of wheat flour (the principal foodstuffs consumed by the general public in most of the English-speaking Caribbean). Data on control of relevant parasites in the Caribbean (primarily hookworm and to a lesser extent whipworm) are limited. Health services throughout the English-speaking Caribbean have been providing direct iron supplementation for pregnant women, but high levels of anemia during pregnancy still exist because of coverage, monitoring, and compliance problems. All the Caribbean countries also have education programs, which mainly advise pregnant women about iron-rich foods and iron absorption inhibitors and enhancers