Beyond iron deficiency: A comprehensive national survey of anaemia etiology in Sri Lankan young adults
Issued Date
2026-12-01
Resource Type
eISSN
20452322
Scopus ID
2-s2.0-105037591207
Journal Title
Scientific Reports
Volume
16
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Scientific Reports Vol.16 No.1 (2026)
Suggested Citation
Amarasingha D., Silva R., Perera L., Wickramasinghe N., Piyathunga D., Gooneratne L., Jayatissa R., Dharmabandu S., Chen P., Fucharoen S., Perera S., Premawardhena A. Beyond iron deficiency: A comprehensive national survey of anaemia etiology in Sri Lankan young adults. Scientific Reports Vol.16 No.1 (2026). doi:10.1038/s41598-026-44168-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116635
Title
Beyond iron deficiency: A comprehensive national survey of anaemia etiology in Sri Lankan young adults
Author's Affiliation
The First Affiliated Hospital of Guangxi Medical University
University of Kelaniya
University of Ruhuna
University of Colombo Faculty of Medicine
Institute of Molecular Biosciences, Mahidol University
The Open University of Sri Lanka
Colombo North Teaching Hospital
International Institute of Health Sciences
Samitvej Srinakatin Hospital
German Sri Lanka Friendship Maternity Hospital
University of Kelaniya
University of Ruhuna
University of Colombo Faculty of Medicine
Institute of Molecular Biosciences, Mahidol University
The Open University of Sri Lanka
Colombo North Teaching Hospital
International Institute of Health Sciences
Samitvej Srinakatin Hospital
German Sri Lanka Friendship Maternity Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Previous studies in Sri Lanka have explored the prevalence and causes of anaemia, mainly emphasizing iron deficiency while overlooking other important factors such as enzymopathies, membranopathies, and haemoglobinopathies. Moreover, many studies reported unexplained cases of anaemia even after detailed evaluation. This study aimed to determine the prevalence and underlying causes of anaemia among community-based young adults in Sri Lanka. A descriptive cross-sectional study was conducted from January 2023 to December 2024 among young adults aged 18–30 years. Data and blood samples were collected using a pretested questionnaire. Anaemic individuals underwent serum iron studies, CRP, vitamin B12 and folate assays, and thalassaemia screening. Those with uncharacterized anaemia were further assessed using red cell enzyme assays, EMA dye binding assays, and whole-exome sequencing. The mean (± SD) age of the study participants was 23.90 ± 1.98 years. Anaemia prevalence was 15.0%. The main causes were iron deficiency (49.3%), folate deficiency (27.8%), vitamin B12 deficiency (14.4%), and haemoglobinopathy traits were identified in 25.6% of anaemic individuals, frequently in combination with nutritional deficiencies. A substantial proportion of anaemic individuals exhibited coexisting aetiologies rather than a single cause. Initially, 17.4% remained uncharacterized, but advanced testing identified variants suggestive of hereditary spherocytosis and congenital dyserythropoietic anaemia or dyskeratosis congenita. This first community-based Sri Lankan study integrating advanced diagnostics revealed that, although iron deficiency predominates, genetic and enzymatic disorders contribute notably, highlighting the need for broader diagnostic strategies in anaemia screening in the community.