Epidemiology of iron deficiency anaemia in four European countries: a population-based study in primary care

Eur J Haematol. 2016 Dec;97(6):583-593. doi: 10.1111/ejh.12776. Epub 2016 Jun 8.


Objectives: 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.

Keywords: Europe; determinants; incidence rate; iron deficiency anaemia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / epidemiology*
  • Anemia, Iron-Deficiency / etiology
  • Child
  • Child, Preschool
  • Comorbidity
  • Databases, Factual
  • Electronic Health Records
  • Europe / epidemiology
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Population Surveillance*
  • Pregnancy
  • Prevalence
  • Primary Health Care
  • Risk Factors
  • Young Adult