2026-02-11
Running low on iron?
Hematology
By Ana Espino | Published on February 11, 2026 | 3 min read
Iron deficiency anemia (IDA) is the most common form of anemia in children, resulting from a lack of iron, a key element in erythropoiesis and neurological development. Among school-aged children (5–12 years), this deficiency is linked to reduced cognitive performance, weakened immunity, and poorer academic outcomes, with potentially long-lasting effects on human capital.
Despite these consequences, IDA management in this age group remains largely insufficient. Current prevention and treatment strategies focus mainly on iron supplementation and food fortification, but they prioritize children under five and pregnant women. Moreover, the lack of reliable global epidemiological data, variability in diagnostic criteria, and insufficient use of inflammatory biomarkers limit both accurate identification of affected children and the effectiveness of interventions.
In this context, a key step forward is to accurately quantify the actual burden of IDA among school-aged children, to support the development of screening and supplementation strategies tailored to this overlooked population.
The aim of this study was therefore to provide a global, updated estimate of IDA prevalence among children aged 5 to 12 years, through a systematic review and meta-analysis, with the goal of informing public health policies and guiding targeted nutritional interventions.
This review included 55 observational studies covering 2.1 million children. To be included, studies had to report both anemia (low Hb) and iron deficiency (low ferritin). Diagnostic definitions followed either WHO criteria or alternative thresholds.
Results showed a global average prevalence of IDA of 9.4% (95% CI: 6.5–12.7), which classifies it as a mild public health problem according to WHO standards. However, this average conceals wide regional disparities. Prevalence reached 21.9% in sub-Saharan Africa and 15.8% in South Asia. Low-income countries reported a prevalence of 29.7%, compared to 24.5% in lower-middle income countries.
The study also highlighted a significant methodological effect: studies using WHO diagnostic definitions reported lower prevalence (7.3%) compared to those using alternative definitions (12.4%). This underscores the need for harmonized diagnostic criteria, ideally incorporating biomarkers such as CRP or AGP to distinguish between nutritional and inflammation-related IDA.
Iron deficiency anemia is a largely neglected nutritional disorder in school-aged children, despite its well-documented impact on development, attention, immunity, and learning. The main challenge lies in the lack of reliable data, the absence of systematic screening, and the invisibility of this age group in global nutrition programs. This study aimed to provide a comprehensive global picture of IDA prevalence in children aged 5–12, to guide future prevention strategies.
The results show that, while global prevalence is moderate, certain countries and regions far exceed critical thresholds, justifying urgent and targeted interventions. IDA in school-aged children can no longer be considered a benign issue.
The results show that, while global prevalence is moderate, certain countries and regions far exceed critical thresholds, justifying urgent and targeted interventions. IDA in school-aged children can no longer be considered a benign issue.
However, limitations of this study remain and justify further research. These include the need for longitudinal studies in underrepresented regions, integration of standardized inflammatory biomarkers, and the development of harmonized global diagnostic criteria. It is also crucial to design school-based screening programs, adapt supplementation strategies to local contexts, and reintegrate school-aged children into global nutrition priorities, in order to break the invisible cycle of iron deficiency.
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
Iron deficiency anemia (IDA) is the most common form of anemia in children, resulting from a lack of iron, a key element in erythropoiesis and neurological development. Among school-aged children (5–12 years), this deficiency is linked to reduced cognitive performance, weakened immunity, and poorer academic outcomes, with potentially long-lasting effects on human capital.
Despite these consequences, IDA management in this age group remains largely insufficient. Current prevention and treatment strategies focus mainly on iron supplementation and food fortification, but they prioritize children under five and pregnant women. Moreover, the lack of reliable global epidemiological data, variability in diagnostic criteria, and insufficient use of inflammatory biomarkers limit both accurate identification of affected children and the effectiveness of interventions.
In this context, a key step forward is to accurately quantify the actual burden of IDA among school-aged children, to support the development of screening and supplementation strategies tailored to this overlooked population.
The aim of this study was therefore to provide a global, updated estimate of IDA prevalence among children aged 5 to 12 years, through a systematic review and meta-analysis, with the goal of informing public health policies and guiding targeted nutritional interventions.
Where is iron lacking?
This review included 55 observational studies covering 2.1 million children. To be included, studies had to report both anemia (low Hb) and iron deficiency (low ferritin). Diagnostic definitions followed either WHO criteria or alternative thresholds.
Results showed a global average prevalence of IDA of 9.4% (95% CI: 6.5–12.7), which classifies it as a mild public health problem according to WHO standards. However, this average conceals wide regional disparities. Prevalence reached 21.9% in sub-Saharan Africa and 15.8% in South Asia. Low-income countries reported a prevalence of 29.7%, compared to 24.5% in lower-middle income countries.
The study also highlighted a significant methodological effect: studies using WHO diagnostic definitions reported lower prevalence (7.3%) compared to those using alternative definitions (12.4%). This underscores the need for harmonized diagnostic criteria, ideally incorporating biomarkers such as CRP or AGP to distinguish between nutritional and inflammation-related IDA.
Iron: an urgent school priority?
Iron deficiency anemia is a largely neglected nutritional disorder in school-aged children, despite its well-documented impact on development, attention, immunity, and learning. The main challenge lies in the lack of reliable data, the absence of systematic screening, and the invisibility of this age group in global nutrition programs. This study aimed to provide a comprehensive global picture of IDA prevalence in children aged 5–12, to guide future prevention strategies.
The results show that, while global prevalence is moderate, certain countries and regions far exceed critical thresholds, justifying urgent and targeted interventions. IDA in school-aged children can no longer be considered a benign issue.
The results show that, while global prevalence is moderate, certain countries and regions far exceed critical thresholds, justifying urgent and targeted interventions. IDA in school-aged children can no longer be considered a benign issue.
However, limitations of this study remain and justify further research. These include the need for longitudinal studies in underrepresented regions, integration of standardized inflammatory biomarkers, and the development of harmonized global diagnostic criteria. It is also crucial to design school-based screening programs, adapt supplementation strategies to local contexts, and reintegrate school-aged children into global nutrition priorities, in order to break the invisible cycle of iron deficiency.
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
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