%0 Journal Article %J J Nutr %D 2021 %T Anemia Etiology in Ethiopia: Assessment of Nutritional, Infectious Disease, and Other Risk Factors in a Population-based Cross-sectional Survey of Women, Men, and Children %A Andersen, Christopher T %A Tadesse, Amare Worku %A Sabri Bromage %A Fekadu, Habtamu %A Hemler, Elena C %A Simone Passarelli %A Spiegelman, Donna %A Sudfeld, Christopher R %A Worku, Alemayehu %A Berhane, Yemane %A Fawzi, Wafaie W %X BACKGROUND: While the causes of anemia at an individual level (such as certain nutritional deficiencies, infections, and genetic disorders) are well defined, there is limited understanding of the relative burden of anemia attributable to each cause within populations. OBJECTIVE: To estimate the proportion of anemia cases attributable to nutritional, infectious disease, and other risk factors among women, men, and children in six regions of Ethiopia. METHODS: A population-based cross-sectional study was conducted. Data were obtained from 2520 women of reproductive age (15-49 years), 1,044 adult men (15-49 years), and 1,528 children (6-59 months). Participants provided venous blood samples for assessment of hemoglobin concentration, ferritin, folate, vitamin B12, C-reactive protein, and malaria infection. Stool samples were collected to ascertain helminth infection status. Sociodemographic questionnaires and a 24-hour diet recall were administered. Population-weighted prevalences of anemia and risk factors were calculated. Multivariable-adjusted associations of risk factors with anemia and partial population attributable risk percentages (pPAR%) were estimated using generalized linear models. RESULTS: Anemia prevalence was 17% (95% CI: 13%, 21%) among women, 8% (6%, 12%) among men, and 22% (19%, 26%) among children. Low serum ferritin contributed to 11% (-1%, 23%) of anemia cases among women, 9% (0%, 17%) among men, and 21% (4%, 34%) among children. The proportion of anemia attributable to low serum folate was estimated at 25% (5%, 41%) among women and 29% (11%, 43%) among men. Dietary iron intake was adequate for nearly all participants, while inadequacy was common for folate and vitamin B12. Inflammation and malaria were responsible for less than one in ten anemia cases. CONCLUSIONS: Folate deficiency, iron deficiency, and inflammation appear to be important contributors to anemia in Ethiopia. Folic acid food fortification, targeted iron interventions, and strategies to reduce infections may be considered as potential public health interventions to reduce anemia in Ethiopia. %B J Nutr %8 2021 Oct 14 %G eng %U https://academic-oup-com.ezp-prod1.hul.harvard.edu/jn/advance-article/doi/10.1093/jn/nxab366/6396756 %1 http://www.ncbi.nlm.nih.gov/pubmed/34647598?dopt=Abstract %R 10.1093/jn/nxab366