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Adugna DG, Mengstie MA, Admasu FT, Teshome MG, Aragie H, Dejenie TA. Multilevel analysis of anemia and associated factors among women of reproductive age (15-49 years) in Liberia: Evidence from the 2019/20 Liberia demographic and health survey data. PLoS One 2024; 19:e0296747. [PMID: 38662746 PMCID: PMC11045067 DOI: 10.1371/journal.pone.0296747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/14/2023] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia. METHODS We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age. RESULTS The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97-46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20-24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25-29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30-34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35-39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40-44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45-49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia. CONCLUSION In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.
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Affiliation(s)
- Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fitalew Tadele Admasu
- Department of Biochemistry, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Maritu Gebnie Teshome
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Hailu Aragie
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Biochemistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Hoteit M, Khadra R, Fadlallah Z, Mourad Y, Chahine M, Skaiki F, Al Manasfi E, Chahine A, Poh OBJ, Tzenios N. Prevalence and Time Trends of Low Serum B12 Levels and Inadequate B12 Dietary Intake in Lebanese Adults amidst the Food Insecurity Situation: Findings from a Nationally Representative Cross-Sectional Study. Nutrients 2024; 16:226. [PMID: 38257119 PMCID: PMC10818865 DOI: 10.3390/nu16020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Rising food insecurity (FI) and the increased prices of animal-based foods could compromise vitamin B12 (B12) intake and serum levels in food-insecure people. Our study aims to determine the prevalence of low levels of serum B12 and its inadequate dietary intake among a nationally representative sample of Lebanese adults aged 18 to 64 years, while exploring the impact of FI and identifying other potential predictors. The B12 intake was assessed using a food frequency questionnaire and the mean of two non-consecutive 24 h recalls. The B12 serum levels were also examined. To examine the time trends in the B12 serum levels and dietary intake, the data from a large representative digitized database of 6290 participants were collected, along with the examination of FAOSTAT food consumption data both before and during the economic crisis period. Our findings revealed that 47.3% of households in Lebanon experienced FI. The inadequate intake of B12 food sources was prevalent in 52.5% of participants, and 61.1% presented with low (23%) or intermediate (38.1%) levels of serum B12. The food-secure households had a higher proportion of B12 intake from meats (p = 0.004), while traditional foods contributed more to food-insecure households (p = 0.000). The participants who were female, unemployed, food-insecure, and had low dietary diversity were about two to three times more likely to have inadequate B12 intake. The predictors of low levels of serum B12 included residing in Beqaa (OR = 2.856 and 95% CI = 1.018-8.01) and having inadequate B12 intake (OR = 1.788 and 95% CI = 1.2-2.65). The findings from observing the time trends in the consumption and the serum levels of B12 indicate a considerable decline in the consumption of most animal-based foods compared to the pre-crisis period, associated with a decline in the serum levels of B12. In conclusion, an alarming prevalence of low dietary intake and low serum levels of B12 was revealed among Lebanese adults, and the indirect effect of FI on B12 serum levels mediated through B12 intake was inferred.
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Affiliation(s)
- Maha Hoteit
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
- Faculty of Public Health, Section 1, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Razan Khadra
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
| | - Zahraa Fadlallah
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
| | - Youmna Mourad
- Al Hadi Laboratory and IVF Center, Beirut 1103, Lebanon;
| | - Mohamad Chahine
- Biological and Chemical Technology, Kursk State Medical University, 305000 Kursk, Russia;
| | - Farouk Skaiki
- Department of Molecular Biology, General Management, Al Karim Medical Laboratories, Saida 1600, Lebanon;
| | | | | | | | - Nikolaos Tzenios
- Faculty of Public Health, Charisma University, London EC1V 7QE, UK
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Gebrerufael GG, Hagos BT. Anemia Prevalence and Risk Factors in Two of Ethiopia's Most Anemic Regions among Women: A Cross-Sectional Study. Adv Hematol 2023; 2023:2900483. [PMID: 38178972 PMCID: PMC10766469 DOI: 10.1155/2023/2900483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 01/06/2024] Open
Abstract
Background In Sub-Saharan African (SSA) nations, including Ethiopia, anemia is a significant public health issue. Ethiopia has continued to bear the enormous burden of anemia infections. Over time, the prevalence of anemia has significantly increased in Ethiopia. In addition, there is a paucity of literature and regional variations in the pace of increment expansion. Therefore, the primary goal of this study was to evaluate the prevalence of anemia and risk factors among women in Ethiopia's two most anemic regions. Methods 2,519 women participated in a community-based cross-sectional study from January 18 to June 27, 2016. In order to determine the causes of anemia in women in two of Ethiopia's most anemic regions, an ordinal logistic regression model was taken into consideration. The applicability of the proportional odds test was evaluated using the chi-square test of the parallelism assumption. A p value of 0.05 or below was used to define crucial and statistically significant predictor variables. Results The overall prevalence rate of anemia was 56.8% (95% CI (54.8%-58.7%)). The chi-square test of the parallelism assumption indicated that the odds ratios were constant across all cut-off points of women's anemia levels at a 5% significance level (p value = 0.122). Of the severity of anemia levels among women, 48.2, 46.1, and 5.7% had mild, moderate, and severe anemia levels, respectively. In multivariable ordinal logistic regression analyses, being born (lived) in the Somali region (AOR = 1.6, 95% CI: 1.37, 1.90), having a parity of 4-5 (AOR = 1.3, 95% CI: 1.05, 1.66), and having ≥6 children (AOR = 1.4, 95% CI: 1.1, 1.7), being a contraceptive user (AOR = 3, 95% CI: 2.5, 3.6), being currently pregnant (AOR = 2.8, 95% CI: 2.3, 3.4), having no ANC follow-up (AOR = 1.9, 95% CI: 1.6, 2.3), being married women (AOR = 1.4, 95% CI: 1.1, 1.9), and user of unimproved toilet facility (AOR = 1.3, 95% CI: 1.1, 1.6) were significantly positively associated with anemia. Conclusions Finally, the anemia burden was dangerously greater than the national average. The region, usage of contraceptives, being pregnant at the time, ANC follow-up, toilet facilities, parity, and marital status all had a substantial impact on anemia. Therefore, to lessen the prevalence of anemia in certain parts of Ethiopia, public health initiatives that improve maternal health service utilization are required, such as ANC follow-up to minimize parity.
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Affiliation(s)
| | - Bsrat Tesfay Hagos
- Department of Statistics, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia
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Um S, Sopheab H, Yom A, Muir JA. Anemia among pregnant women in Cambodia: A descriptive analysis of temporal and geospatial trends and logistic regression-based examination of factors associated with anemia in pregnant women. PLoS One 2023; 18:e0274925. [PMID: 38060474 PMCID: PMC10703242 DOI: 10.1371/journal.pone.0274925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Anemia is a major public health problem for thirty-two million pregnant women worldwide. Anemia during pregnancy is a leading cause of child low birth weight, preterm birth, and perinatal/neonatal mortality. Pregnant women are at higher risk of anemia due to micronutrient deficiencies, hemoglobinopathies, infections, socio-demographic and behavioral factors. This study aimed to: 1) assess temporal and geospatial trends of anemia in Cambodia and 2) identify factors associated with anemia among pregnant women aged 15-49 years old in Cambodia. We analyzed data from the Cambodia Demographic and Health Survey (CDHS) for 2005, 2010, and 2014. Data were pooled across the three survey years for all pregnant women aged 15-49 years. Survey weights were applied to account for the complex survey design of the CDHS. Descriptive statistics were estimated for key sociodemographic characteristics of the study population. We used logistic regressions to assess factors associated with anemia among pregnant women aged 15-49 years old. Anemia in pregnant women aged 15-49 in Cambodia decreased from 56% in 2005 to 53% in 2014. With the highest in Preah Vihear and Stung Treng provinces (74.3%), in Kratie province (73%), and in Prey Veng (65.4%) in 2005, 2010, and 2014 respectively. Compared to pregnant women from the wealthiest households, women from poorest households were more likely to have anemia (AOR = 2.8; 95% CI: 1.6-4.9). Pregnant women from coastal regions were almost twice as likely of having anemia (AOR = 1.9; 95% CI: 1.2-3.0). Pregnant women were more likely anemic if they were in their 2nd trimester (AOR = 2.6; 95% CI: 1.9-3.6) or 3rd trimester (AOR = 1.6 95% CI: 1.1-2.3). Anemia remains highly prevalent among pregnant women in Cambodia. Public health interventions and policies to alleviate anemia should be prioritized and shaped to address these factors.
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Affiliation(s)
- Samnang Um
- The National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
| | - Heng Sopheab
- The National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
| | - An Yom
- The National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
| | - Jonathan A. Muir
- The Global Health Institute, Emory University, Atlanta, Georgia, United States of America
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Lopes SO, Abrantes LCS, Azevedo FM, de Morais NDS, Morais DDC, Gonçalves VSS, Fontes EAF, Franceschini SDCC, Priore SE. Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15051074. [PMID: 36904074 PMCID: PMC10005365 DOI: 10.3390/nu15051074] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.
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Nagari SL, Egata G, Mehadi A, Hassen TA, Raru TB, Abdurke M, Yuya M, Abdulkadir S, Berhanu H, Roba KT. Anemia Among Women Using Family Planning at Public Health Facilities in Ambo Town, Central Ethiopia: Multi-Center Cross-Sectional Study. J Blood Med 2023; 14:83-97. [PMID: 36789372 PMCID: PMC9922510 DOI: 10.2147/jbm.s400191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Background Anemia affects more than a quarter of non-pregnant women over the globe, with Sub-Saharan Africa bearing a disproportionate share. Although the use of family planning is beneficial in reducing anemia, lack of scientific study on anemia among family planning users of reproductive-age women is notable, particularly in the study setting. The purpose of this study was to determine the extent of anemia and associated factors in women who used family planning. Methods A cross-sectional multi-centered study was conducted from March 3 to 29, 2019, among 443 non-pregnant reproductive age (15 to 49 years) women receiving family planning services in Ambo town. Sample size was calculated using Epi-info version 7 software. Participants were selected by systematic random sampling technique. Trained data collectors collected data using a structured pretested questionnaire, as well as venous blood and stool samples. Epi-Data and SPSS were used to enter and analyze data. The effect of independent variables on the outcome variable was determined by binary logistic regression analysis with adjusted odds ratio at 95% confidence interval and 5% margin of error. P-value <0.05 was used to declare statistical significance. Results This study revealed 28% (95% CI:23.9%, 32.3%) magnitude of anemia. Age of 25-35 years [AOR:2.84, 95% CI:1.74, 4.64], implantable family planning method [AOR: 0.34, 95% CI: 0.12, 0.96], no previous use of family planning [AOR:2.62, 95% CI: 1.62, 4.24], household food insecurity [AOR: 2.04, 95% CI: 1.06, 3.93], parasite infestations [AOR:2.01, 95% CI: 1.12, 3.63], and regular intake of coffee/tea within 30 minutes post meal [AOR:3.85, 95% CI:1.24, 11.92] were independently associated with anemia. Conclusion Anemia is a moderate public health concern among reproductive-age women receiving family planning services in the study area. There are missed opportunities to address the anemia burden during family planning services. This study emphasizes the importance of nutritional screening for early detection and targeted interventions for healthcare workers in reducing missed opportunities to prevent and control anemia in vulnerable populations.
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Affiliation(s)
| | - Gudina Egata
- College of Health and Medical Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ame Mehadi
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia,Correspondence: Ame Mehadi, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, Tel +251919118839, Fax +251256668081, Email
| | - Tahir Ahmed Hassen
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Yuya
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shemsedin Abdulkadir
- College of Health and Medical Sciences, Arsi University, Asella, Oromia, Ethiopia
| | - Hiwot Berhanu
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Tsegaye Negash B, Ayalew M. Trend and factors associated with anemia among women reproductive age in Ethiopia: A multivariate decomposition analysis of Ethiopian Demographic and Health Survey. PLoS One 2023; 18:e0280679. [PMID: 36689422 PMCID: PMC9870172 DOI: 10.1371/journal.pone.0280679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In developing countries like Ethiopia, anemia is a public health problem. Unfortunately, the progress of anemia reduction has been slow. Although the issue of anemia has received considerable critical attention nowadays, trends and factors associated with anemia among women of reproductive age have not been explored in Ethiopia. OBJECTIVE This study aimed to determine trends and factors associated with anemia among women of reproductive age in Ethiopia from 2005 to 2016. METHOD Data from three consecutive Ethiopian Demographic and Health Survey (EDHS) from 2005-2016 were analyzed in this study. EDHS is a two-stage cluster sampling survey. Data were weighted to correct sampling bias in all surveys. A total of 46,268 samples were analyzed using a fixed effect model. For a measure of proportion, differences and slopes were computed. Bivariate and multivariable logistic regression analyses were done to identify predictors of the trend of anemia among women. Adjusted odds ratio (AOR) with a 95% Confidence Interval(CI) was computed, and the p-value < 0.05 is considered significant. RESULT Prevalence of anemia among women was 68%, 20.3%, and 27.3% in 2005, 2011 and 2016, respectively. The trend of anemia was reduced by 47.7 percentage points from 2005 to 2011; however, it increased by 7% points again from 2011 in 2016. Lack of mobile phones (AOR = 1.4, 95%CI, 1.2,1.6), Afar women (AOR = 1.5, 95%CI, 1.1,2.3) and Somali women (AOR = 1.5, 95%CI, 1.1,1.9) were associated with anaemia among women. On the contrary, the history of heavy menstruation in the last six months (AOR = 0.9; 95%CI, 0.85,0.98) was a factor negatively associated with anemia in 2005. In 2011, single women (AOR = 0.8,95%CI,0.7,0.9), watching TV less than once per wk (AOR = 0.9,95%CI,0.7,0.95), watching TV at least once per week (AOR = 0.8,95%CI,0.7,0.98) were variables associated with anemia. On the contrary, widowed women (AOR = 1.7,95%CI,1.4,2.0) were affected by anemia. In 2016, the richest women (AOR = 0.7, 95%CI, 0.6,0.8) and single (AOR = 0.8, 95%CI, 0.7,0.9) were affected little by anemia. Women of traditional belief followers (AOR = 2.2,95%CI,1.6,2.9) were more highly influenced by anemia than their counterparts. CONCLUSION The prevalence of anemia declined rapidly from 2005 to 2011, and increased from 2011 to 2016. Stakeholders should develop policies and programs to enhance the socio-demographic status of women and basic infrastructure for the community. Furthermore, they should design strategies for extensive media coverage of the prevention of anemia. The federal government should balance the proportion of anemia among regions by ensuring health equality.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of Midwifery, College of Medicine and Health sciences, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- Department of Psychatric Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Armah-Ansah EK. Determinants of anemia among women of childbearing age: analysis of the 2018 Mali demographic and health survey. Arch Public Health 2023; 81:10. [PMID: 36658651 PMCID: PMC9854152 DOI: 10.1186/s13690-023-01023-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/01/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Anemia occurs at all stages of life and it is of public health concern as it serves as an indicator of quality nutrition and health of a society. Almost one third of the global prevalence of anemia occur among reproductive aged women and almost 40% of these women reside in sub-Saharan Africa including Mali. This study, therefore, sought to assess the determinants of anemia among women of childbearing age in Mali. METHODS Secondary data analysis of the 2018 Mali Demographic and health Survey (MDHS). Anemia in women was the outcome variable for the study. Data of 5,048 women aged 15-49 was used for the study. Using binary and multivariate logistic regression models, factors associated with anemia among women were identified. The analysis was conducted using Stata version 14.2 software and adjusted Odds Ratio (aOR) with a 95% Confidence Interval (CI) and p-value < 0.05 were used to see the significant association. RESULTS The prevalence of anemia among women of childbearing age in Mali is 63.5%. Of these, 4.3% and 24.9% were severely and mildly anemic respectively, and the rest 34.3% were moderately anemic. Women who had secondary education (aOR = 0.70, 95% CI: 0.58-0.84), overweight (aOR = 0.63, 95% CI: 0.50-0.81), exposure to mass media (aOR = 0.90, 95% CI = 0.76-1.49) and women with two births (aOR = 0.86, 95% CI = 0.71-1.05) were less likely to be anemic. Likely, richest wealth quintile (aOR = 0.73, 95% CI = 0.51-1.05), living in urban setting (aOR = 0.85, 95% CI = 0.70-1.03) and women in Kidal Region (aOR = 0.42, 95% CI = 0.27-0.65) were less likely to be anemic. However, pregnant women, women covered by health insurance, women with unimproved drinking water, women in communities with low literacy and low socioeconomic status had higher odds of anemia. CONCLUSION These findings point to the need for community and household level public health sensitization interventions to highlight the pro-anemic factors and mitigating strategies. More especially, women with no education, pregnant women, women covered by health insurance, women from communities with low literacy and socioeconomic status ought to be the focus of such interventions.
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Affiliation(s)
- Ebenezer Kwesi Armah-Ansah
- grid.413081.f0000 0001 2322 8567Department of Population and Health, University of Cape Coast, Cape Coast, Ghana ,grid.410682.90000 0004 0578 2005Department of Population and Development, National Research University - Higher School of Economics, Moscow, Russia ,grid.413355.50000 0001 2221 4219Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
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Jindasereekul P, Jirarattanarangsri W, Khemacheewakul J, Leksawasdi N, Thiennimitr P, Taesuwan S. Usual intake of one-carbon metabolism nutrients in a young adult population aged 19-30 years: a cross-sectional study. J Nutr Sci 2023; 12:e51. [PMID: 37123390 PMCID: PMC10131051 DOI: 10.1017/jns.2023.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
One-carbon nutrients play an important role in epigenetic mechanisms and cellular methylation reactions. Inadequate intake of these nutrients is linked to metabolic perturbations, yet the current intake levels of these nutrients have rarely been studied in Asia. This cross-sectional study surveyed the usual dietary intake of one-carbon nutrients (folate, choline and vitamins B2, B6 and B12) among Thai university students aged 19-30 years (n 246). Socioeconomic background, health information, anthropometric data and 24-h dietary recall data were collected. The long-term usual intake was estimated using the multiple-source method. The average usual intake levels for men and women were (mean ± sd) 1⋅85 ± 0⋅95 and 2⋅42 ± 8⋅7 mg/d of vitamin B2, 1⋅96 ± 1⋅0 and 2⋅49 ± 8⋅7 mg/d of vitamin B6, 6⋅20 ± 9⋅5 and 6⋅28 ± 12 μg/d of vitamin B12, 195 ± 154 and 155 ± 101 μg dietary folate equivalent/d of folate, 418 ± 191 and 337 ± 164 mg/d of choline, respectively. Effect modification by sex was observed for vitamin B2 (P-interaction = 0⋅002) and choline (P-interaction = 0⋅02), where every 1 mg increase in vitamin B2 and 100 mg increase in choline intake were associated with a 2⋅07 (P = 0⋅01) and 0⋅81 kg/m2 (P = 0⋅04) lower BMI, respectively, in men. The study results suggest that Thai young adults meet the recommended levels for vitamins B2, B6 and B12. The majority of participants had inadequate folate intake and did not achieve recommended intake levels for choline. The study was approved by the Ethics Committee at the Faculty of Medicine, Chiang Mai University. This trial was registered at www.thaiclinicaltrials.gov (TCTR20210420007).
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Affiliation(s)
- Phachara Jindasereekul
- Faculty of Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
| | - Wachira Jirarattanarangsri
- Faculty of Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Innovative Food & Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
| | - Julaluk Khemacheewakul
- Faculty of Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Innovative Food & Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Agro Bio-Circular-Green Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
| | - Noppol Leksawasdi
- Faculty of Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Agro Bio-Circular-Green Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
| | - Parameth Thiennimitr
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si Phum, Meuang, Chiang Mai 50200, Thailand
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, 110 Intawaroros Road, Si Phum, Meuang, Chiang Mai 50200, Thailand
| | - Siraphat Taesuwan
- Faculty of Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Innovative Food & Agro-Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Cluster of Agro Bio-Circular-Green Industry, Chiang Mai University, 155 Moo 2, Mae Hia, Meuang, Chiang Mai 50100, Thailand
- Corresponding author: Siraphat Taesuwan,
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Belay DG, Adane SM, Ferede OL, Lakew AM. Geographically weighted regression analysis of anemia and its associated factors among reproductive age women in Ethiopia using 2016 demographic and health survey. PLoS One 2022; 17:e0274995. [PMID: 36136977 PMCID: PMC9498958 DOI: 10.1371/journal.pone.0274995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Anemia in reproductive age women is defined as the hemoglobin level <11g/dl for lactating or pregnant mothers and hemoglobin level <12 g/dl for none pregnant or non-lactating women. Anemia is a global public health problem affecting both developing and developed countries. Therefore this study aims to determine geographically weighted regression analysis of anemia and its associated factors among reproductive age women in Ethiopia using the 2016 Demographic and Health Survey. Method In this study, a total of 14,570 women of reproductive age were included. Multi-level binary logistic regression models were employed using STATA version 14. Odds ratio with a 95% confidence interval and p-values less than 0.05 was used to identify significant factors. Spatial scan statistics were used to identify the presence of anemia clusters using Kulldorf’s SaTScan version 9.6 software. ArcGIS 10.7 software was used to visualize the spatial distribution and geographically weighted regression of anemia among reproductive age women. Result Overall 23.8% of reproductive-age women were anemic. The SaTScan spatial analysis identified the primary clusters’ spatial window in Southeastern Oromia and the entire Somali region. The GWR analysis shows that having a formal education, using pills/injectables/implant decreases the risks of anemia. However, women who have more than one child within five years have an increased risk of anemia in Ethiopia. In addition to these, in multilevel analysis women who were married and women who have >5 family members were more likely to have anemia. Conclusion In Ethiopia, anemia among reproductive age women was relatively high and had spatial variations across the regions. Policymakers should give attention to mothers who have a low birth interval, married women, and large family size. Women’s education and family planning usage especially pills, implants, or injectable should be strengthened.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Shumet Mebrat Adane
- Department of Epidemiology, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, Hawassa University, Hawassa, Ethiopia
| | - Oshe Lemita Ferede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tefera AA, Seifu D, Menon M, Talargia F, Belete AM. Red blood cell folate level and associated factors of folate insufficiency among pregnant women attending antenatal care during their first trimester of pregnancy in Addis Ababa, Ethiopia. SAGE Open Med 2022; 10:20503121221118987. [PMID: 36051782 PMCID: PMC9424885 DOI: 10.1177/20503121221118987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: Folate is an essential vitamin for de novo DNA synthesis and cell
proliferation. Folate insufficiency at the time of conception and during the
first trimester of pregnancy is associated with unintended pregnancy and
birth outcomes, particularly neural tube defects. Hence, this study aimed to
assess folate status and associated factors of folate insufficiency among
pregnant women attending antenatal care during their first trimester of
pregnancy in Addis Ababa, Ethiopia. Materials and methods: A cross-sectional study was conducted from 8 August 2017 to 3 January 2018 in
Addis Ababa. In this study, 160 participants were enrolled via the
convenience sampling method. Red blood cell folate was measured by the
electrochemiluminescence binding assay method. Data were entered into
Epi-Data version 3.1 and analyzed by SPSS version 22.0. Descriptive
statistics were used to describe demographic characteristics and to
determine the magnitude of folate deficiency. Logistic regression was used
to identify the risk factors for folate deficiency. A
p-value of less than 0.05 was considered statistically
significant. Results: In this study, 44/160 (27%) participants had red blood cell folate level
<400 ng/mL, insufficient to prevent neural tube defect. Multivariate
regression showed that regular vegetable consumption was an independent
determinant factor for red blood cell folate level (adjusted odds ratio:
0.41, confidence interval: 0.18–0.93). Conclusion: This study shows that a large magnitude of the first-trimester pregnant women
had red blood cell folate concentrations below levels that are maximally
protective against neural tube defects. Folic acid supplementation and
supplemental nutrition containing green leafy vegetables should be promoted
during the periconceptional period. In addition, the policymakers should set
rules for mandatory folic acid fortification.
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Affiliation(s)
- Alemu Adela Tefera
- Department of Biomedical Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Daniel Seifu
- Division of Biomedical Sciences, Department of Biochemistry, University of Global Health Equity, Kigali, Rwanda
| | - Menakath Menon
- Department of Biochemistry, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia
| | - Feredegn Talargia
- Department of Biomedical Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abebe Muche Belete
- Department of Biomedical Science, Debre Berhan University, Debre Berhan, Ethiopia
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12
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Abd Rahman R, Idris IB, Isa ZM, Rahman RA, Mahdy ZA. The Prevalence and Risk Factors of Iron Deficiency Anemia Among Pregnant Women in Malaysia: A Systematic Review. Front Nutr 2022; 9:847693. [PMID: 35495961 PMCID: PMC9051477 DOI: 10.3389/fnut.2022.847693] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Anemia in pregnancy is defined as a hemoglobin level of <11 g/dl, and is commonly due to iron deficiency. This systematic review was conducted to determine the prevalence and risk factors of anemia and iron deficiency among pregnant women in Malaysia. A systematic literature search was conducted in Google Scholar, PubMed, and Cochrane Library databases. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. Eight studies comprising a total number of 2,638 pregnant women were included in this review. Only two studies focused on iron deficiency, whereas the other six investigated anemia in pregnancy without specifying iron deficiency or any other nutritional cause for the anemia, signifying the lack of published literature on this important public health nutritional issue in Malaysia. The overall prevalence of anemia in pregnancy ranged from 19.3 to 57.4%, while the prevalence of iron deficiency was 31.6 to 34.6%. Factors that were significantly associated with anemia in pregnancy were extremes of reproductive age, late antenatal booking, non-compliance to hematinics, Indian ethnicity, being in the second or third trimester, low maternal educational level, low family income, and unemployment. The prevalence of anemia in pregnancy was found to be higher in rural compared to urban areas. Meanwhile, in terms of iron deficiency anemia, grandmultiparity, late antenatal booking and Indian ethnicity were significant determinants. It is certainly plausible that the anemia in pregnancy reported in these studies is not entirely secondary to iron deficiency and may be attributable to other nutritional deficiencies, emphasizing the importance of researching deeper into this subject. Nevertheless, in the meantime, focusing on iron supplementation in high-risk mothers with emphasis on compliance, seems to be the best option, in view of the high prevalence of iron deficiency found in this review.
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Affiliation(s)
- Raudah Abd Rahman
- Public Health Division, Health Department of Wilayah Persekutuan Kuala Lumpur & Putrajaya, Kuala Lumpur, Malaysia
| | - Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
- *Correspondence: Idayu Badilla Idris
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
| | - Rahana Abdul Rahman
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
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13
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Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2972617. [PMID: 35071591 PMCID: PMC8776466 DOI: 10.1155/2022/2972617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022]
Abstract
Objective The purpose was to evaluate the treatment effect of iron proteinsuccinylate oral solution combined with vitamin A and D drops on children with nutritional iron deficiency anemia. Methods 124 children treated in the outpatient department of our hospital from January 2017 to January 2020 were selected as the study subjects. They were randomly divided into control and observation two groups. The control group was treated with iron proteinsuccinylate oral solution (1.5 mL/kg) in the morning and evening, respectively. The observation group received adjuvant treatment with oral vitamin A and D drops based on the treatment of the control group. The treatment effect of proteinsuccinylate oral solution combined with vitamin A and D drops was evaluated by the serum iron (SI), serum ferritin (SF), and transferrin (TRF) levels, the values of CD3+, CD4+, and CD4+/CD8+, and other evaluation indicators. Results After treatment, the SI and SF levels of children in both groups significantly increased (P < 0.01) while the TRF level significantly decreased (P < 0.01), and the SI and SF levels in the observation group increased more significantly, and the TRF level decreased more significantly compared with those in the control group (P < 0.01). After treatment, the values of CD3+, CD4+, and CD4+/CD8+ of children in both groups significantly increased compared with those before treatment (P < 0.01), and the values of CD3+, CD4+, and CD4+/CD8+ increased more significantly in the observation group compared with those in the control group (P < 0.01). In addition, the evaluation results of treatment effect showed that the markedly effective rate in the observation group was significantly higher than that in the control group (P < 0.01). Conclusion Iron proteinsuccinylate oral solution combined with vitamin A and D drops can better improve the anemia symptoms in children, with high application value.
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Zegeye B, Anyiam FE, Ahinkorah BO, Ameyaw EK, Budu E, Seidu AA, Yaya S. Prevalence of anemia and its associated factors among married women in 19 sub-Saharan African countries. Arch Public Health 2021; 79:214. [PMID: 34839822 PMCID: PMC8628470 DOI: 10.1186/s13690-021-00733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background Sub-Saharan Africa (SSA) remains the region with the highest burden of anemia globally. Since anemia has both health and non-health-related consequences, its reduction is one of the Sustainable Development Goals. Therefore, this study aimed to examine the prevalence of anemia and its associated factors among married women in SSA. Methods Using Stata version-14 software, the analysis was done on 89,029 married women from the Demographic and Health Surveys of 19 countries in SSA. Pearson Chi-Square test and Binary logistic regression analyses were used to examine the factors associated with anemia. The results were presented using adjusted Odds Ratio (aOR) at a 95% Confidence Interval (CI). A p-value less than or equal to 0.05 (p ≤ 0.05) was considered statistically significant. Results The pooled analysis showed that 49.7% of married women were anemic. Of these, 1.04% and 15.05% were severely and moderately anemic respectively, and the rest 33.61% were mildly anemic. Husband education (primary school-aOR = 0.84, 95% CI; 0.71–0.99), wealth index (middle-aOR = 0.81, 95% CI; 0.68–0.96, richer-aOR = 0.69, 95% CI; 0.57–0.84, richest-aOR = 0.68, 95% CI; 0.51–0.91), modern contraceptive use (yes-aOR = 0.68, 95% CI; 0.56–0.81) and religion (Muslim-aOR = 1.27, 95% CI; 1.11–1.46, others-aOR = 0.73, 95% CI; 0.59–0.90) were factors associated with anemia among married women. Conclusion The findings show that nearly half of the married women are affected by anemia. Enhancing partners’ educational levels, and economic empowerment of women, strengthening family planning services, and working with religious leaders to reduce the perception and religious beliefs related to food restrictions can be the main focus to reduce the burden of anemia among married women in SSA.
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Affiliation(s)
| | - Felix Emeka Anyiam
- Centre for Health and Development, University of Port Harcourt, Port Harcourt, Nigeria
| | | | | | - Eugene Budu
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Abdul-Aziz Seidu
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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15
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Paulsamy P, Easwaran V, Ashraf R, Alshahrani SH, Venkatesan K, Qureshi AA, Arrab MM, Prabahar K, Periannan K, Vasudevan R, Kandasamy G, Chidambaram K, Pappiya EM, Venkatesan K, Manoharan V. Association of Maternal Observation and Motivation (MOM) Program with m-Health Support on Maternal and Newborn Health. Healthcare (Basel) 2021; 9:healthcare9121629. [PMID: 34946355 PMCID: PMC8702075 DOI: 10.3390/healthcare9121629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 02/01/2023] Open
Abstract
Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable women to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and to live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A comparative study was done among 196 pregnant mothers (study group-94; control group-102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb and weight gain and newborn results such as birth weight and crown-heel length were obtained at baseline and at 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity, and maternal well-being. The MOM intervention included initial face-to-face education, three in-person visits, and eight virtual health coaching sessions via WhatsApp. The baseline data on Hb of the mothers show that 31 (32.98%) vs. 27 (28.72%) mothers in the study and control group, respectively, had anemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p < 0.001). The weight gain (p < 0.001), level of physical activity (p < 0.001), and maternal well-being (p < 0.01) also had significant differences after the intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with the consumption of milk (p < 0.001), fruits (p < 0.01), and green vegetables (p < 0.05). As per the physical activity and maternal well-being regression model, the birth weight and crown-heel length were strongly related with the physical activity and maternal well-being of mothers at 36 weeks of gestation (p < 0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers' human rights.
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Affiliation(s)
- Premalatha Paulsamy
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Vigneshwaran Easwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Rizwan Ashraf
- Department of Pharmacology, University College of Medicine and Dentistry, The University of Lahore, Lahore 55150, Pakistan;
| | - Shadia Hamoud Alshahrani
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
- Correspondence:
| | - Absar Ahmed Qureshi
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Mervat Moustafa Arrab
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
- Family and Community Health Nursing, Faculty of Nursing, Menoufia University, Shibin el Kom 32511, Egypt
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Kalaiselvi Periannan
- Department of Mental Health Nursing, Oxford School of Nursing & Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK;
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Kumarappan Chidambaram
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Ester Mary Pappiya
- Regional Nursing Administration, Directorate of General Health Affair, Ministry of Health, Najran 21431, Saudi Arabia;
| | - Kumar Venkatesan
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia;
| | - Vani Manoharan
- Georgia CTSA, Emory University Hospital, Atlanta, GA 30078, USA;
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Tsatsakis A, Tyshko NV, Goumenou M, Shestakova SI, Sadykova EO, Zhminchenko VM, Zlatian O, Calina D, Pashorina VA, Nikitin NS, Trebukh MD, Loginova MS, Trushina EN, Mustafina OK, Avrenyeva LI, Guseva GV, Trusov NV, Kravchenko LV, Hernández AF, Docea AO. Detrimental effects of 6 months exposure to very low doses of a mixture of six pesticides associated with chronic vitamin deficiency on rats. Food Chem Toxicol 2021; 152:112188. [PMID: 33836210 DOI: 10.1016/j.fct.2021.112188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to evaluate the long-term low-dose effects of exposure to a mixture of 6 pesticide active substances (diquat, imazamox, imazethapyr, tepraloxydin, bentazone, acifluorfen) and to elucidate if chronic vitamin deficiency can influence their toxicity. Two hundred Wistar rats were divided in 4 groups: a vitamin-sufficiency control group, a vitamin-deficiency control group, a vitamin sufficiency test group and a vitamin-deficiency test group. The test groups were treated with the aforementioned pesticides at doses 100 times lower than the corresponding NOAEL. After 6 months, ten rats from each group were sacrificed and a complete evaluation of blood and urine biochemistry, biomarkers of oxidative stress, xenobiotic detoxification enzymes and lysosomal enzymes and organ histopathology was performed. The pesticides mixture and vitamin deficiency determined an increase in alkaline phosphatase levels and urinary calcium levels, abnormal serum lipid profile, and a decrease of total blood proteins levels, red blood cells, haematocrit and haemoglobin. The combination of the two stressors up-regulated CYP1A1, CYP1A2, CYP2B1 and GST levels. This study provides a new proof for the need to move forward from single chemical testing to a more complex approach to account for the multitude of stressors that can challenge the setting of real safety levels.
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Affiliation(s)
- Aristidis Tsatsakis
- Center of Toxicology Science & Research, Medical School, University of Crete, Heraklion, Crete, Greece.
| | - Nadezhda V Tyshko
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Marina Goumenou
- Center of Toxicology Science & Research, Medical School, University of Crete, Heraklion, Crete, Greece; General Chemical State Laboratory of Greek Republic, 71202, Heraklion, Greece.
| | - Svetlana I Shestakova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - El'vira O Sadykova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Valentin M Zhminchenko
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Ovidiu Zlatian
- Department of Microbiology, University of Medicine and Pharmacy, Faculty of Pharmacy, Craiova, 200349, Romania.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Valentina A Pashorina
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Nikolaj S Nikitin
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Marina D Trebukh
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Maria S Loginova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Eleanora N Trushina
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Oksana K Mustafina
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Ludmila I Avrenyeva
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Galina V Guseva
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Nikita V Trusov
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Lidiya V Kravchenko
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Ustinsky proyezd 2/14, 109240, Moscow, Russia
| | - Antonio F Hernández
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy, Faculty of Pharmacy, 200349, Craiova, Romania.
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Kwape L, Ocampo C, Oyekunle A, Mwita JC. Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana. JOURNAL OF ENDOCRINOLOGY, METABOLISM AND DIABETES OF SOUTH AFRICA 2021. [DOI: 10.1080/16089677.2021.1927586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- L Kwape
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - C Ocampo
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | - A Oyekunle
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | - JC Mwita
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana
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Finkelstein JL, Fothergill A, Johnson CB, Guetterman HM, Bose B, Jabbar S, Zhang M, Pfeiffer CM, Qi YP, Rose CE, Williams JL, Bonam W, Crider KS. Anemia and Vitamin B-12 and Folate Status in Women of Reproductive Age in Southern India: Estimating Population-Based Risk of Neural Tube Defects. Curr Dev Nutr 2021; 5:nzab069. [PMID: 34027296 PMCID: PMC8128722 DOI: 10.1093/cdn/nzab069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Women of reproductive age (WRA) are a high-risk population for anemia and micronutrient deficiencies. However, there are few representative population-level data from India, which could help inform evidence-based recommendations and policy. OBJECTIVE To conduct a population-based biomarker survey of anemia and vitamin B-12 and folate status in WRA as part of a periconceptional surveillance program in southern India. METHODS Participants were WRA (15-40 y) who were not pregnant or lactating. Whole blood (n = 979) was analyzed for hemoglobin via a Coulter counter (Coulter HMX). Plasma, serum, and RBCs were processed and stored at -80°C or less until batch analysis. Vitamin B-12 concentrations were measured via chemiluminescence; RBC and serum folate concentrations were evaluated via microbiological assay. Anemia and severe anemia were defined as hemoglobin <12.0 g/dL and <8.0 g/dL, respectively. Vitamin B-12 deficiency and insufficiency were defined as total vitamin B-12 <148 pmol/L and <221 pmol/L, respectively. Folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L. A previously developed Bayesian model was used to predict neural tube defect (NTD) prevalence per 10,000 births. RESULTS A total of 41.5% of WRA had anemia and 3.0% had severe anemia. A total of 48.3% of WRA had vitamin B-12 deficiency and 74.3% had vitamin B-12 insufficiency. The prevalence of RBC folate deficiency was 7.6%, and 79.3% of WRA had RBC folate <748 nmol/L, the threshold for optimal NTD prevention. Predicted NTD prevalence per 10,000 births based on RBC folate concentrations was 20.6 (95% uncertainty interval: 16.5-25.5). CONCLUSIONS The substantial burden of anemia, vitamin B-12 deficiency, and RBC folate insufficiency in WRA in this setting suggests an opportunity for anemia and birth defects prevention. Findings will directly inform the development of a randomized trial for anemia and birth defects prevention in southern India.This study was registered at clinicaltrials.gov as NCT04048330.
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Affiliation(s)
- Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- St John's Research Institute, Bangalore, Karnataka, India
| | - Amy Fothergill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | | | - Beena Bose
- St John's Research Institute, Bangalore, Karnataka, India
| | - Shameem Jabbar
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mindy Zhang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christine M Pfeiffer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yan Ping Qi
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles E Rose
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wesley Bonam
- Arogyavaram Medical Centre, Andhra Pradesh, India
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial. Nutrients 2021; 13:nu13041237. [PMID: 33918630 PMCID: PMC8069550 DOI: 10.3390/nu13041237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022] Open
Abstract
Nutritional deficiencies are a leading underlying risk factor contributing to the global burden of disease. In Pakistan, late adolescence is considered a nutritionally vulnerable period, as micronutrient requirements are increased to support maturation, and dietary staples are nutrient poor. However, there has been limited evaluation of micronutrient status beyond anemia and its determinants. Using cross-sectional data from late adolescent and young women (15–23 years) at enrolment in the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial, we aimed to describe the prevalence of key micronutrient deficiencies of public health concern, and generate hierarchical models to examine associations with proxies for social determinants of health (SDoH). The prevalence of micronutrient deficiencies was high: 53.6% (95% confidence interval (CI): 53.0–54.3%) had anemia; 38.0% (95% CI: 36.4–39.6%) iron deficiency anemia; 31.8% (95% CI: 30.2–33.3%) vitamin A deficiency; and 81.1% (95% CI: 79.8–82.4%) vitamin D deficiency. At least one deficiency was experienced by 91.0% (95% CI: 90.1–92.0%). Few SDoH were maintained in the final hierarchical models, although those maintained were often related to socioeconomic status (e.g., education, occupation). To improve the micronutrient status of late adolescent and young women in Pakistan, a direct micronutrient intervention is warranted, and should be paired with broader poverty alleviation methods.
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Teshale AB, Tesema GA, Worku MG, Yeshaw Y, Tessema ZT. Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model. PLoS One 2020; 15:e0238957. [PMID: 32915880 PMCID: PMC7485848 DOI: 10.1371/journal.pone.0238957] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/26/2020] [Indexed: 12/31/2022] Open
Abstract
Background Anemia in women of reproductive age is a major public health challenge for low- and middle-income countries with a long-term negative impact on the health of women, their children, and the economic growth of the society. Even though the world health organization targeted a 50% global reduction of anemia among women of reproductive age by 2025, with the current trend it is unlikely to achieve this goal. Objective This study aimed to assess the prevalence and associated factors of anemia among women of reproductive age in eastern Africa. Methods A secondary data analysis, using demographic and health survey (DHS) data of 10 eastern African countries, was conducted. For our study, a total weighted sample of 101524 women of reproductive age was used. We employed a multilevel mixed-effects generalized linear model (using Poisson regression with robust error variance). Both unadjusted and adjusted prevalence ratios with their 95% confidence interval were reported. Results The prevalence of anemia in eastern Africa was 34.85 (95%CI: 34.56–35.14) ranging from 19.23% in Rwanda to 53.98% in Mozambique. In the multivariable multilevel analysis, being older age, having primary and above education, being from households with second to highest wealth quantiles, being currently working, not perceiving distance as a big problem, use of modern contraceptive methods, and rural residence was associated with a lower prevalence of anemia. While, being married and divorced/separated/widowed, women from female-headed households, women from households with unimproved toilet facility and unimproved water source, ever had of a terminated pregnancy, having high parity, and being from large household size was associated with a higher prevalence of anemia. Conclusion The prevalence of anemia in eastern Africa was relatively high. Both individual level and community level factors were associated with the prevalence of anemia in women of reproductive age. Therefore, giving special attention to those women who are at a higher prevalence of anemia such as younger women, those who are from households with low socioeconomic status, unimproved toilet facility, and source of drinking water, as well as pregnant women could decrease anemia in women of reproductive age.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Association of antenatal vitamin B complex supplementation with neonatal vitamin B 12 status: evidence from a cluster randomized controlled trial. Eur J Nutr 2020; 60:1031-1039. [PMID: 32577886 DOI: 10.1007/s00394-020-02309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Evidence about the effect of maternal vitamin B12 supplementation on offspring's vitamin B12 status is limited. The present interventional study sought to evaluate the association of antenatal vitamin B complex supplementation with neonatal vitamin B12 status. METHODS In an ongoing cluster randomized controlled trial conducted in three rural counties in northwest China, pregnant women < 20 weeks of gestation were randomized to three treatment groups: blank control, iron supplements, or vitamin B complex supplements. All women were administered folic acid supplements during the periconceptional period. In a sub-study, we collected cord blood samples of 331 participants from the control or vitamin B complex groups in the Xunyi county from January 2017 to December 2017. Plasma concentrations of folate, vitamin B12, and homocysteine were measured. Linear mixed models with a random intercept for cluster were used to compare biochemical indexes between groups after controlling for covariates. RESULTS Compared with newborns whose mothers were in the control group, newborns of the vitamin B complex-supplemented women had significantly higher cord plasma vitamin B12 (P = 0.001) and lower homocysteine concentrations (P = 0.043). The association of antenatal vitamin B complex supplementation with cord blood vitamin B12 concentrations appeared to be more pronounced among newborns with high folate status than those with low folate status (Pinteraction = 0.060). CONCLUSIONS Maternal vitamin B complex supplementation during pregnancy was associated with better neonatal vitamin B12 status in rural northwest China.
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Miyan Z, Waris N. Association of vitamin B 12 deficiency in people with type 2 diabetes on metformin and without metformin: a multicenter study, Karachi, Pakistan. BMJ Open Diabetes Res Care 2020; 8:8/1/e001151. [PMID: 32448786 PMCID: PMC7252966 DOI: 10.1136/bmjdrc-2019-001151] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/01/2020] [Accepted: 03/18/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To assess the prevalence of vitamin B12 deficiency in people with type 2 diabetes mellitus (T2DM) on metformin and without metformin. METHODOLOGY Between May 2018 and January 2019, this prospective multicenter observational study recruited participants from seven centers in four provinces of Pakistan (Sindh, Punjab, Baluchistan and Khyber Pakhtunkhwa). Participants with T2DM treated with metformin for >2 years and those not on metformin underwent assessment of hemoglobin, vitamin B12, homocysteine and diabetic neuropathy (vibration perception threshold (VPT) >15V) and painful diabetic neuropathy (Douleur Neuropathique 4 (DN4) ≥4) and Diabetic Neuropathy Symptom (DNS) score ≥1. RESULTS Of 932 subjects, 645 (69.2%) were treated with metformin, while 287 (30.8%) were not on metformin. Overall, B12 deficiency (<200 pg/mL) was significantly higher in metformin users of 25 (3.9%), compared with non-metformin users of 6 (2.1%), while B12 insufficiency (200-300 pg/mL) was significantly lower in metformin users of 117 (18.4%) compared with non-metformin users of 80 (27.9%). Subjects with B12 deficiency and insufficiency with hyperhomocysteinemia (≥15) were found in 19 (76%) µmol/L and 69 (60.5%) µmol/L in metformin users compared with 6 (100%) µmol/L and 57 (73.1%) μmol/L in non-metformin users, respectively. VPT>25 and DN4 score ≥4 were significantly higher in B12-deficient metformin users compared with non-metformin users. Similarly, DNS score ≥1 was non-significantly higher in B12-deficient metformin users compared with non-metformin users. CONCLUSION This study shows that vitamin B12 insufficiency was frequently found in our population and may progress into B12 deficiency. It is also associated with neuropathy in subjects on metformin. Further interventional studies to assess the benefit of B12 treatment on painful neuropathy in patients on metformin may be warranted. B12 levels may be checked in people with T2DM using metformin for >2 years.
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Affiliation(s)
- Zahid Miyan
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nazish Waris
- Clinical Biochemistry and Psychopharmacology Research Unit, Department of Biochemistry, University of Karachi, Karachi, Pakistan
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
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Hakizimana D, Nisingizwe MP, Logan J, Wong R. Identifying risk factors of anemia among women of reproductive age in Rwanda - a cross-sectional study using secondary data from the Rwanda demographic and health survey 2014/2015. BMC Public Health 2019; 19:1662. [PMID: 31829161 PMCID: PMC6907339 DOI: 10.1186/s12889-019-8019-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/29/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap. METHODS A quantitative, cross-sectional study was conducted using data from the RDHS 2014-2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson's chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively. RESULTS The prevalence of anemia among WRA was 19.2% (95% CI: 18.0-20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40-0.91), being in the rich category (OR: 0.74, 95% CI: 0.63-0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74-0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50-0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09-1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05-3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09-1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11-1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06-1.88). CONCLUSION Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women's economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.
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Affiliation(s)
- Dieudonne Hakizimana
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda.
| | - Marie Paul Nisingizwe
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jenae Logan
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda
| | - Rex Wong
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda.,School of Public Health, Yale University, New Haven, CT, USA
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Asian Study of Cerebral Venous Thrombosis. J Stroke Cerebrovasc Dis 2019; 28:104247. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/10/2019] [Accepted: 06/02/2019] [Indexed: 11/21/2022] Open
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Kibret KT, Chojenta C, D'Arcy E, Loxton D. Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: a multilevel and spatial analysis. BMJ Open 2019; 9:e027276. [PMID: 30948614 PMCID: PMC6500301 DOI: 10.1136/bmjopen-2018-027276] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the spatial distribution and determinant factors of anaemia among reproductive age women in Ethiopia. METHODS An in-depth analysis of the 2016 Ethiopian Demographic and Health Survey data was undertaken. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas for anaemia among women of reproductive age. A multilevel logistic regression model was used to identify independent predictors of anaemia among women of reproductive age. RESULTS Older age (adjusted OR [AOR]=0.75; 95% CI 0.64 to 0.96), no education (AOR=1.37; 95% CI 1.102 to 1.72), lowest wealth quantile (AOR=1.29; 95% CI 1.014 to 1.60), currently pregnant (AOR=1.28; 95% CI 1.10 to 1.51, currently breast feeding (AOR=1.09; 95% CI 1.025 to 1.28), high gravidity (AOR=1.39; 95% CI 1.13 to 1.69) and HIV positive (AOR=2.11; 95% CI 1.59 to 2.79) are individual factors associated with the occurrence of anaemia. Likewise, living in a rural area (AOR=1.29; 95% CI 1.02 to 1.63) and availability of unimproved latrine facilities (AOR=1.18; 95% CI 1.01 to 1.39) are community-level factors associated with higher odds of anaemia. The spatial analysis indicated that statistically high hotspots of anaemia were observed in the eastern (Somali, Dire Dawa and Harari regions) and north-eastern (Afar) parts of the country. CONCLUSION The prevalence rate of anaemia among women of reproductive age varied across the country. Significant hotspots/high prevalence of anaemia was observed in the eastern and north-eastern parts of Ethiopia. Anaemia prevention strategies need to be targeted on rural residents, women with limited to no education, women who are breast feeding, areas with poor latrine facilities and women who are HIV positive.
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Affiliation(s)
- Kelemu Tilahun Kibret
- Priority Research Center for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Catherine Chojenta
- Priority Research Center for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ellie D'Arcy
- Priority Research Center for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Western New South Wales, Local Health District, Dubbo, New South Wales, Australia
| | - Deborah Loxton
- Priority Research Center for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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Clare CE, Brassington AH, Kwong WY, Sinclair KD. One-Carbon Metabolism: Linking Nutritional Biochemistry to Epigenetic Programming of Long-Term Development. Annu Rev Anim Biosci 2019; 7:263-287. [DOI: 10.1146/annurev-animal-020518-115206] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
One-carbon (1C) metabolism comprises a series of interlinking metabolic pathways that include the methionine and folate cycles that are central to cellular function, providing 1C units (methyl groups) for the synthesis of DNA, polyamines, amino acids, creatine, and phospholipids. S-adenosylmethionine is a potent aminopropyl and methyl donor within these cycles and serves as the principal substrate for methylation of DNA, associated proteins, and RNA. We propose that 1C metabolism functions as a key biochemical conduit between parental environment and epigenetic regulation of early development and that interindividual and ethnic variability in epigenetic-gene regulation arises because of genetic variants within 1C genes, associated epigenetic regulators, and differentially methylated target DNA sequences. We present evidence to support these propositions, drawing upon studies undertaken in humans and animals. We conclude that future studies should assess the epigenetic effects of cumulative (multigenerational) dietary imbalances contemporaneously in both parents, as this better represents the human experience.
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Affiliation(s)
- Constance E. Clare
- School of Biosciences, University of Nottingham, Sutton Bonington, Leicestershire LE12 5RD, United Kingdom
| | - Amey H. Brassington
- School of Biosciences, University of Nottingham, Sutton Bonington, Leicestershire LE12 5RD, United Kingdom
| | - Wing Yee Kwong
- School of Biosciences, University of Nottingham, Sutton Bonington, Leicestershire LE12 5RD, United Kingdom
| | - Kevin D. Sinclair
- School of Biosciences, University of Nottingham, Sutton Bonington, Leicestershire LE12 5RD, United Kingdom
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Yaya S, Ekholuenetale M, Bishwajit G. Differentials in prevalence and correlates of metabolic risk factors of non-communicable diseases among women in sub-Saharan Africa: evidence from 33 countries. BMC Public Health 2018; 18:1168. [PMID: 30309337 PMCID: PMC6182823 DOI: 10.1186/s12889-018-6085-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Even with the widespread recognition of non- communicable diseases (NCDs) in sub-Saharan Africa region, yet, sufficient evidence-based surveillance systems to confirm the prevalence and correlates of these diseases is lacking. In an attempt to understand the problem of NCDs in resource-constrained settings, this study was conducted to establish the pattern of the risk factors of NCDs in sub-Sahara Africa region. METHODS The current Demographic and Health Survey (DHS) data sets from 33 countries in sub-Sahara Africa region were used in this study. The individual woman component of DHS 2008-2016 was used. The outcome variables include anemia, hypertension and body mass index (underweight, overweight and obesity). BMI was categorized into; underweight (BMI < 18.5 kg/m2), normal (BMI 18.5-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2) and obesity (BMI ≥30 kg/m2). Hemoglobin level: anemic < 12.0 g/dL (< 120 g/L) for women. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. Binary and multinomial logistic regression models were used to investigate the correlates of the variables. RESULTS The percentage of hypertension was highest among women in Lesotho with about 17.3% and lowest among women in Burundi (1.0%). Anemia was prevalent among sub-Saharan Africa women; where more than half of the women from several countries were anemic with Gabon (60.6%) reporting the highest prevalence. The percentage of obesity in sub-Saharan Africa showed that Lesotho (19.9%), Gabon (18.9%) and Ghana (15.6%) were the prominent countries with obese women, while Madagascar (1.1%) had the minimum obese women. Body mass index was significantly associated with hypertension and anemia. The behavioural or modifiable factors of hypertension and body mass index were; smoking, fruits, vegetables and alcohol consumption. While the non-modifiable significant factors include; age, residence, religion, education, wealth index, marital status, employment and number of children ever born. However, anemia shared similar factors except that smoking and vegetable consumption were not statistically significant. In addition, involvement in exercise was associated with anemia and hypertension. CONCLUSION The problem of NCDs and associated factors remains high among women of reproductive age in sub-Sahara region. The findings of this study suggest that promotion of regular positive health care-seeking behaviour, screening and early treatment are essential to mitigate the burden of NCDs. Furthermore, preventive interventions of NCDs risk factors should be strengthened among key population through behavior change communication with support from government and stakeholders in health care.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
| | - Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
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Khan MF, Shamael I, Zaman Q, Mahmood A, Siddiqui M. Association of Anemia with Stroke Severity in Acute Ischemic Stroke Patients. Cureus 2018; 10:e2870. [PMID: 30148022 PMCID: PMC6107329 DOI: 10.7759/cureus.2870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective: To investigate the association of anemia with stroke severity in acute ischemic stroke patients. Material & methods: We enrolled 96 patients (mean age: 60.25 ± 11.92 years old) who were admitted to the stroke unit of Shifa International Hospital between 1st March 2015 and 31st August 2015. Each patient presented within 72 hours of onset of symptoms, underwent computed tomography (CT) of the head and blood tests, including hemoglobin concentration, on the first day of hospitalization. Stroke severity was assessed on admission using the National Institute of Health Stroke Scale. Anemia was evaluated according to the World Health Organization (WHO) criteria (men, <13 g/dL; women, <12 g/dL). We examined the frequency of anemia in patients with different severities of acute ischemic stroke. Results: World Health Organization defined anemia was positive in 38 (39.6%) and negative in 58 (60.4%) patients. Among the patients who were positive for anemia, seven (18.4%) had a minor stroke, 10 (26.3%) had a moderately severe stroke, and 21 (55.3%) had a severe stroke. There was a significant association between anemia and stroke severity (P-value 0.000). Conclusion: Our data indicated that anemia was a frequent finding in acute ischemic stroke patients, with increasing frequency corresponding to stroke severity.
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Affiliation(s)
| | | | - Qamar Zaman
- Neurology, Shifa International Hospital, Islamabad, PAK
| | - Asad Mahmood
- Medicine, Queens Medical Center, Nottingham, GBR
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