Plasmodium falciparum malaria causes a profound anemia during and after acute infection. The anemia is caused by hemolysis of red cells combined with suppression of erythropoiesis. Consequently, body iron is shifted from hemoglobin to storage forms. Whether malaria increases iron losses from the body is not fully understood but is unlikely. The increased red cell turnover may bring about folate deficiency, especially during pregnancy when folate requirements are already high. For these reasons, detecting and treating malaria are essential for treating severe anemia where P. falciparum malaria is endemic. Where P. falciparum malaria is endemic, the use of insecticide-impregnated bednets in communities decreases the prevalence of severe anemia in young children. Malaria prophylaxis during pregnancy may reduce the prevalence of anemia in first and second pregnancies and improve birth weight. Malaria prophylaxis has less benefit as a public health measure in multiparous women. Although malaria-related anemia is usually not primarily iron deficiency anemia, such distinctions are not important to primary health care providers and some recommendations about the use of antimalarial drugs are included in these guidelines.