Is Screening for Anemia in Newly Arrived Refugees Recommendable? A Cross-Sectional Study of Anemia Prevalence in Refugees Resettled in Aarhus, Denmark.

Background: Anemia is a major contributor to the global burden of disease and is associated with poor health outcomes and impaired quality of life. Refugees often flee from countries with poverty or conflict and deteriorating health systems. As a result, refugees are vulnerable to several underlying causes of anemia. This study aimed to investigate the prevalence of anemia and its associations with sociodemographic factors in refugees resettling in Denmark. Methods: This cross-sectional study is based on health assessments comprising medical interviews, physical examinations, and blood samples offered to newly arrived refugees in Aarhus Municipality from January 2014 - November 2018. Data on 1) hemoglobin level, 2) age, 3) sex, 4) pregnancy status, 5) country of origin, 6) educational attainment and 7) route of arrival were extracted for analysis. Results: Of 1261 refugees who participated in the health assessment, 45.8% were female. Main countries of origin were Syria, Eritrea and Iran. A total of 101 participants (8%) had anemia. Prevalence was high among pregnant woman and adults >25 years, and low among children <15 years. Prevalence was higher among refugees arriving through family reunification programs and programs coordinated by the United Nations High Commissioner for Refugees (UNHCR). The analysis revealed notable differences in prevalence when using hemoglobin thresholds defined by the World Health Organization (WHO) versus by local guidelines. Conclusion: Anemia is prevalent among refugees and is associated with various sociodemographic factors. Using internationally accepted hemoglobin thresholds may provide a more accurate estimate of anemia in refugee populations. Given the low cost and simplicity of hemoglobin measurement, we recommend including screening for anemia in health assessments for resettled refugees.