Prevalence of anemia in Northeast India: A review and overview

Anemia remains a major public health challenge in India, exhibiting marked regional heterogeneity across age groups and populations. Northeast India represents one of the country’s most ethnically diverse regions and demonstrates distinct epidemiological patterns of anemia. Nationally, anemia affects a substantial proportion of children, women of reproductive age, adults, and older individuals, with a particularly high burden in early childhood. The Northeast Indian states show wide interstate variability, with some states reporting among the highest childhood and female prevalence, while others demonstrate comparatively lower rates. Nutritional deficiency, predominantly iron deficiency, remains the leading cause, especially among children and women. However, inherited hemoglobinopathies, most notably hemoglobin E, sickle cell anemia, and β-thalassemia, in their compound heterozygous states, constitute a major region-specific contributor. Infectious diseases, including malaria and parasitic infestations, further exacerbate anemia. In adults, autoimmune disorders, chronic kidney and liver disease, malignancies, and chronic inflammation increasingly account for non-nutritional anemia. The heterogeneous etiology of anemia in Northeast India underscores the need for region-specific, multifactorial diagnostic and management strategies that integrate nutritional, genetic, infectious, and chronic disease considerations to effectively reduce disease burden.