Aetiology of anaemia and public health implications in the Taabo health demographic surveillance system, south-central Côte d'Ivoire

Anaemia is a global public health problem, affecting an estimated 2 billion people worldwide. Although iron deficiency is considered as a major risk factor for anaemia, other nutritional deficiencies, infections and genetic diseases contribute to the global burden of anaemia. The World Health Organization advocates integrated approaches targeting the main aetiological agents to alleviate the intolerable burden due to anaemia. An accurate diagnosis of infectious diseases, measuring specific and sensitive micronutrient biomarkers and understanding local knowledge and perceptions of anaemia are important steps to further our understanding of the aetiology and public health implications of anaemia. This kind of information is crucial for the development of integrated and sustainable strategies aiming to decrease the burden of anaemia. The overarching goal of this PhD thesis was to deepen the understanding of the aetiology of anaemia in infants, school-aged children and young women in the Taabo health demographic surveillance system, south-central Côte d’Ivoire. Pursuing a 14-month prospective longitudinal monitoring, we identified specific socio-demographic, parasitic, inflammatory, and micronutrient variables that are associated with anaemia in the three target age groups. Further analysis investigated the effects of inflammation and Plasmodium falciparum infection on iron status biomarkers. These biomedical and demographic investigations were complemented with a more qualitative piece, studying cultural concepts and local knowledge of various anaemia-related diseases. Potential implications of these findings for public health are discussed