Prevalence of iron deficiency and iron deficiency anemia in children aged 6 - 59 months and pregnant women receiving antenatal care at Sebbi hospital, Uganda: a retrospective study

• Iron deficiency (ID) affected 40.5% of children, peaking at 50.2% in ages 6–23 months. • Children aged ≥24 months had significantly lower ID prevalence (p < 0.001). • IDA was present in 55.2% of anaemic children. • IDA affected 54.1% of iron-deficient pregnant women, with no trimester differences • Mentzer index provides cost-effective IDA screening using routine CBC parameters. . Iron deficiency (ID) and iron deficiency anemia (IDA) substantially contribute to anemia in Africa. However, epidemiological data from Uganda using cost-effective and accessible diagnostic tools remain limited. This study used the Mentzer index and complete blood count (CBC) parameters to determine the prevalence of ID and IDA among children and pregnant women. We retrospectively analyzed the CBC data of 2,906 participants (2,156 children aged 6–59 months and 750 pregnant women) attending Sebbi Hospital between August 2021 and August 20 24. ID was identified using CBC indices (MCH <27 pg, MCV <80 fL, and RDW >16%), whereas IDA was determined using the corrected Mentzer index (Mentzer index >13, MCH <27 pg, and age/trimester-appropriate hemoglobin thresholds). We calculated prevalence estimates with 95% confidence intervals and used chi-square tests with Bonferroni correction to assess associations between iron deficiency status and age, sex, and trimester. Among children, ID prevalence was 40.5% (95% CI: 38.4–42.6%), significantly higher in those aged 6–23 months versus 24–59 months (50.2% vs. 25.2%; OR=3.01, 95% CI: 2.48–3.65, p<0.001). IDA affected 55.2% (95% CI: 51.7–58.6%) of the children with anemia. Among pregnant women, ID prevalence was 8.1% (95% CI: 6.3–10.4%), with trimester variation showing overall significance (χ²=8.53, p=0.014) but no significant pairwise differences after Bonferroni correction (all adjusted p>0.17). IDA affected 54.1% (95% CI: 40.9–66.9%) of iron-deficient pregnant women. ID and IDA remain significant public health concerns in Uganda, with pronounced age-related disparities among children (6–23 months, most vulnerable) and a notable burden on pregnant women. Integrating CBC-based screening into routine pediatric and antenatal care could enhance early detection and facilitate targeted interventions. Future validation of the Mentzer index using gold-standard biomarkers and studies addressing confounding factors (inflammation, co-infections, and micronutrient deficiencies) are recommended. .