All three micronutrient deficiencies exist here at levels of public health significance. Anemia is common among pregnant women and young children. Malarial infection and associated folic acid deficiency may also be primary causes of anemia among pregnant women. Malaria and intestinal parasites, particularly hookworm, are important contributing factors in children. The most recent survey showed a marked decline in goiter rates since the early 1970s.
Legislation mandates that all salt, which is entirely imported, be iodized.
Although it is estimated that nearly all salt is iodized, levels of iodate were adequate in less than half of the samples tested. VAD is a public health problem in several provinces of Zambia, notably Luapula Valley and Ndola. Anemia was most common in women under 20 years old, in the third trimester of pregnancy, and in February-April when malarial transmission is the highest. Malaria and folate deficiency secondary to malarial infection, were the two most important causes of severe anemia in pregnant women. 3 IDA related to low intakes of bioavailable iron and possibly hookworm infection was also present.