GSTM1 and malnutrition: However, these estimates do not reflect the real burden of MiP related SMA in Indian context for at least four reasons: (i) different thresholds for hemoglobin level were used for diagnosing severe anemia (e.g., Hb < 5 g/dL or < 7 g/dL), (ii) in some studies, moderate and severe anemia were collectively diagnosed with the same Hb threshold (e.g., Hb < 9 g/dL) (41), (iii) very few studies appraised other severe anemia-inducing conditions such as malnutrition (49), and (iv) none of the studies included parasitemia threshold for defining SMA as per WHO guidelines (Tables 2, 3).