Infection and anemia are directly and indirectly related through a number of mechanisms (Roberts 2016). Certain infections cause anemia directly by destroying red blood cells or by decreasing their production. Some infections can also cause anemia directly by blood loss, or indirectly through depletion of iron stores (see Iron Deficiency section). Anemia is also caused by several chronic conditions, including HIV and AIDS (Calis et al. 2008; Volberding et al. 2004), peptic ulcer disease, gastritis and duodenitis, chronic kidney disease, and uterine fibroids (Kassebaum et al. 2014). These chronic conditions go beyond the scope of this guidance, although some countries may want to address them in the context of anemia. The inflammation that accompanies acute infections and chronic conditions can also indirectly cause anemia (see Inflammation section).
Which key infections can cause anemia?
- soil-transmitted helminths, particularly hookworm
Interventions that address these infections
- case management of malaria
- deworming for schistosomiasis
- deworming for soil-transmitted helminths
- indoor residual spraying
- intermittent preventive treatment during pregnancy
- long-lasting insecticide-treated bed nets.
For more information about these interventions, go to Step 4: Assess Status of Anemia Interventions.
Balarajan, Yarlini, Usha Ramakrishnan, Emre Ozaltin, Anuraj H. Shankar, and S. V. Subramanian. 2011. “Anaemia in Low-Income and Middle-Income Countries.” The Lancet 378 (9809): 2123–35. doi:10.1016/S0140-6736(10)62304-5.
Calis, Job C. J., Michaël Boele van Hensbroek, Rob J. de Haan, Peter Moons, Bernard J. Brabin, and Imelda Bates. 2008. “HIV-Associated Anemia in Children: A Systematic Review from a Global Perspective.” AIDS 22 (10): 1099–1112. doi:10.1097/QAD.0b013e3282fa759f.
Kassebaum, Nicholas J., Rashmi Jasrasaria, Mohsen Naghavi, Sarah K. Wulf, Nicole Johns, Rafael Lozano, Mathilda Regan, et al. 2014. “A Systematic Analysis of Global Anemia Burden from 1990 to 2010.” Blood 123 (5): 615–24. doi:10.1182/blood-2013-06-508325.
Roberts David J. 2016. “Hematologic Changes Associated with Specific Infections in the Tropics.” Hematology/Oncology Clinics of North America. 30 (2): 395–415. doi:10.1016/j.hoc.2015.11.007.
Volberding, Paul A., Alexandra M. Levine, Douglas Dieterich, Donna Mildvan, Ronald Mitsuyasu, Michael Saag, and Anemia in HIV Working Group. 2004. “Anemia in HIV Infection: Clinical Impact and Evidence-Based Management Strategies.” Clinical Infectious Diseases: 38 (10): 1454–63. doi:10.1086/383031.