Although anemia and iron deficiency remain substantial
problems, the data are encouraging because the prevalence of
these disorders is considerably less than previously reported.
The lower prevalence of malaria parasitemia among women in
the last month of pregnancy also suggests a benefit of medical
intervention with intermittent presumptive treatment. There
was an inverse relationship between sickle cell trait and iron
deficiency, and we speculate that sickle cell trait may confer a protective benefit against the occurrence of iron deficiency.
Increased research and programmatic emphasis should be
placed on decreasing modifiable risk factors for anemia, iron
deficiency, and malaria parasitemia, such as improved nutritional
intake of iron-rich local foods, wider use of insecticideimpregnated
bed nets and the expanded use of intermittent
presumptive treatment in the prenatal period. The potential
benefits of preconception compared to intra-pregnancy iron
supplementation should be investigated, as well as strategies
for improving compliance with preventive therapies.