Nutritional anemia constitutes an important public health problem affecting all age groups in Guyana. This paper reports on a field study conducted to investigate the roles of iron deficiency, folic acid deficiency, and intestinal parasitic infestation in contributing to this anemia. Anthropometric (height and weight) and hematological (red blood cell count, hematocrit, hemoglobin, plasma and red cell folate, and serum ferritin) measurements, and stool investigations for intestinal parasites were performed for 257 anemic or nearly anemic subjects representing all age groups and both sexes in urban and rural areas. Socioeconomic data, data on the frequency of consumption of foods rich in the erythropoietic nutrients, and information on use of iron and vitamin supplements were also obtained. A limited amount of obstetrical information was obtained from women of childbearing age. Iron and folic acid deficiencies were found to be the major nutrient deficiencies contributing to nutritional anemia. Intestinal parasite infestation did not play a major role. The author recommends an applied intervention program involving nutrition education, an improved system of distributing iron and folic acid supplements to pregnant and lactating women, and fortification of a suitable vehicle with iron and folic acid. Also recommended is focusing nutrition education on the nature, symptoms, and causes of nutritional anemia and on how anemia can be prevented by a proper diet incorporating local foods. Radio, newspapers, posters, pamphlets, demonstrations, and cinema advertising are suggested as possible educational tools. Problems and possibilities associated with use of wheat flour, sugar, rice, and salt as the vehicle for iron and folic acid fortification are discussed. Iron (III)-EDTA is suggested as the most promising compound to use for iron fortification with ascorbic acid added to promote the absorption of iron from the food and to prevent folic acid deterioration. A 17-item bibliography (1956-78) is included. The protocol for collecting and processing blood samples and a copy of the questionnaire used in the study are appended.
