Iron deficiency anaemia is a major health problem worldwide, but may be complicated in underdeveloped nations by deficiencies of other micronutrients with consequences for adequate treatment. The World Health Organization (WHO) estimates that 2 billion people – over 30% of the world’s population – are anaemic, approximately 50% of cases of anaemia are considered to be due to iron deficiency. Aim: Since a combined deficiency of trace elements has great consequences in the approach of this problem, zinc status was assessed in blood of iron deficient anaemic patients in Sudan representing sub-Saharan Africa and compared with Dutch anaemic patients representing Western Europe. Method: Zinc as well as iron were measured with instrumental neutron activation analysis (INAA) in 22 Sudanese anaemic patients and four controls as well as in 17 Dutch anaemic patients and four controls. Result: In the Sudanese patients very low concentrations of zinc were measured, 3 ± 1 mg/L compared to a control group of healthy individuals (5 ± 1 mg/L), while all Dutch patients had normal zinc levels (5 ± 1 mg/L). When matched for haemoglobin level, the Sudanese patients still showed lower zinc concentrations. Even in the Sudanese patients without a known history of malnutrition and in patients with the anaemia of chronic disease zinc levels were significantly lower than in the controls. A positive correlation was observed between Fe and Zn in blood of the Sudanese subjects (r=0.654), while there is no or a very week relation between Fe and Zn in blood of the Dutch group (r=0.08). The low level of Fe and Zn for the Sudanese group might be ascribed to the poor intake of these two nutrients with the main dietary food (cereals) in this area. Conclusion: In iron deficiency anaemia in Sudanese patients, a deficiency of zinc should be taken into account in case of supplementation. @en