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Guye AH, Hansa K, Ketema K, Moroda M, Shambi DB. Anemia and Associated Factors among Public Elementary School Children in Asella Town, Southeast Ethiopia: A Facility-Based Cross-Sectional Study. Anemia 2024; 2024:1519382. [PMID: 38694783 PMCID: PMC11062769 DOI: 10.1155/2024/1519382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/15/2024] [Accepted: 04/12/2024] [Indexed: 05/04/2024] Open
Abstract
Background Anemia has a negative impact on school children, including poor physical growth and reduced mental performance. Children show poor attentiveness, behavior, and memory and reduced school performance. There is limited evidence of the magnitude of anemia and associated factors in school-age children in Ethiopia, including the study area. Objective To assess the magnitude of anemia and associated factors among public elementary school children in Asella Town, Southeast Ethiopia, in 2022. Methods A school-based cross-sectional study was conducted in Asella Town from April 5 to May 5, 2022. A total of 442 school children aged 7-14 years were included in the study using the multistage sampling method. Data were collected using a pretested and semistructured questionnaire through a face-to-face interview technique. The hemoglobin concentration was determined by using the HemoCue 301+ analyzer. Anthropometric data and stool examinations were collected from participants. Data were entered into EpiData version 4.6, transported, and analyzed by Statistical Package for Social Sciences version 26. Bivariable and multivariable logistic regression analyses were carried out. Adjusted odds ratios along with their 95% confidence interval were used, and a p value of ≤0.05 was used for declaring statistical significance. Results A total of 435 students with a mean age and standard deviation of 10.77 ± 2.21 years participated in the study. The magnitude of anemia was 78 (17.9%), with a 95% CI (14.3, 21.47). Of the participants, 63 (14.5%) were mild anemic and 15 (3.4%) were moderately anemic. Children whose mothers have no formal education (AOR = 3.94, 95% CI: 1.89, 8.21), underweight children (AOR = 3.83, 95% CI: 1.98, 7.40), and parasites in their stool (AOR = 3.72, 95% CI: 1.50, 9.20) were significantly associated with anemia in school-age children. Conclusion Anemia among school-age children was found to be a mild public health problem. Uneducated mothers, intestinal parasite infections, and underweight children were found to be determinants of anemia among school-age children. Health professionals should provide health education for mothers about child-feeding practices and the consumption of dietary sources of iron.
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Affiliation(s)
- Ararso Hordofa Guye
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fiche, Ethiopia
| | - Kasim Hansa
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fiche, Ethiopia
| | - Kasahun Ketema
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fiche, Ethiopia
| | - Meseret Moroda
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fiche, Ethiopia
| | - Dame Banti Shambi
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fiche, Ethiopia
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Bahati Y, Nyanza EC, Asori M, Mutayoba R, Thomas DSK. Influence of intermittent iron and folic acid supplementation on cognitive abilities among adolescent girls in northwestern Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002079. [PMID: 37851636 PMCID: PMC10584093 DOI: 10.1371/journal.pgph.0002079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/12/2023] [Indexed: 10/20/2023]
Abstract
Iron and folic acid (IFA) supplementation to reduce anemia is key for improving substantial lost disability adjusted life years (DALYs) for adolescent girls. This study assessed the impact of weekly IFA supplementation (WIFAS) on cognitive ability among adolescent girls in the Simiyu Region in northernwestern Tanzania. This cross-sectional comparative evaluation study of 770 adolescent girls (396 -WIFAS supplemented; 374 -not supplemented) evaluated the association between WIFAS and cognitive ability through a face-to-face survey and cognitive ability assessment using standardized tests (Span-forward Test, Span-backward Test and Maze Test). Using a modified Poisson regression, we controlled for the geographic setting (urban vs rural), availability of potable water and feeding programs in schools, age and school level of adolescent girls, parental status, main parental economic activities, and the number of teachers. Participants were between the ages of 11 and 19 years, with more than half (57%) between 12-15 years of age. Those with WIFAS had higher cognitive ability (Span-forward scores, χ2 = 46.34% p <0.001; Span-forward, χ2 = 46.34% p <0.001; and Global Composite Cognitive Performance (GCCP), χ2 = 32.52% p<0.001). Among the IFA supplemented adolescent girls, secondary school level had a significantly higher score with respect to Span-backward (aPR = 1.43, 95% CI = 1.06-1.62); Span-forward ability (aPR = 1.26, 95% CI = 1.04-1.53) and Maze Test ability (aPR = 1.12, 95% CI = 1.01-1.25) as compared to their counterpart in primary school level. Individual adolescent girls with WIFAS and living with both parents performed much better on the Span-backward Test (aPR = 1.22, 95% CI = 1.07-1.68) as compared to those living with relatives and/or orphans. The presence of potable water program among the WIFAS schools resulted in a higher Span-backward ability (aPR = 1.34, 95% CI = 1.03-1.89); and GCCP (aPR = 1.27, 95% CI = 1.03-1.75). Adolescent girls from WIFAS schools with feeding program had higher Span-forward (aPR = 1.38, 95% CI = 1.03-1.63) ability as well as a higher Maze Test (aPR = 1.15, 95% CI = 1.07-1.26) score. The present study provides compelling evidence that WIFAS is positively associated with higher cognitive ability among adolescent girls. Nevertheless, IFA interventions are still rare in communities across Tanzania.
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Affiliation(s)
- Yasinta Bahati
- Department of Environmental, Occupational, and Department of Environmental, Occupational Health, and GIS, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Amref Health Africa and Nutrition International, Regional Health Management Team-Simiyu Region, Simiyu Region, Tanzania
| | - Elias C. Nyanza
- Department of Environmental, Occupational, and Department of Environmental, Occupational Health, and GIS, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Moses Asori
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
| | - Rita Mutayoba
- Amref Health Africa and Nutrition International, Regional Health Management Team-Simiyu Region, Simiyu Region, Tanzania
| | - Deborah S. K. Thomas
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
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Yusufu I, Cliffer IR, Yussuf MH, Anthony C, Mapendo F, Abdulla S, Masanja M, Tinkasimile A, Ali AS, Mwanyika-Sando M, Fawzi W. Factors associated with anemia among school-going adolescents aged 10-17 years in Zanzibar, Tanzania: a cross sectional study. BMC Public Health 2023; 23:1814. [PMID: 37723498 PMCID: PMC10508009 DOI: 10.1186/s12889-023-16611-w] [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: 12/13/2022] [Accepted: 08/24/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Anemia among adolescents (ages 10-19 years) is a leading cause of morbidity and mortality in low- and middle-income countries and carries long-term health and economic consequences. To address the issue, policymakers and programmers require evidence of the burden of anemia among adolescents in specific contexts, as well as an understanding of the factors associated with anemia in this population. METHODS We conducted a cross-sectional survey as a baseline assessment to determine the prevalence and factors associated with anemia in secondary school students, as part of a cluster-randomized effectiveness trial testing different micronutrient supplementation strategies in addressing anemia among adolescents in Zanzibar. Between March 7th to 25th, 2022 the survey was conducted on 2,479 school-going adolescents aged 10-17 years from 42 schools on the island of Zanzibar, Tanzania. Hemoglobin concentration was measured along with the collection of socio-demographics, health, food frequency, and water, sanitation and hygiene data. RESULTS Based on the World Health Organization cutoffs for anemia, 53.3% of the sample had anemia (mild, moderate, or severe). Using chi-square tests and logistic regressions, we determined that females had higher odds of anemia than males (Adjusted OR = 1.47; 95% CI: 1.24, 1.74), those in the highest wealth quintile had lower odds of anemia than those in the lowest wealth quintile (Adjusted OR = 0.7; CI: 0.54, 0.91), stunted adolescents had higher odds of anemia than non-stunted students (Adjusted OR = 1.38; 95% CI: 1.06,1.81), and those who used shared toilets had higher odds of moderate or severe anemia than those with private toilet access (Adjusted OR = 1.68; CI: 1.07, 2.64). CONCLUSIONS The high prevalence of anemia in this sample indicates an urgent need to address anemia among adolescents in Zanzibar, and the factors associated with anemia point to the importance of water, sanitation, and hygiene interventions in addition to dietary and nutritional support. TRIAL REGISTRATION NCT05104554, registered 03/11/2021.
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Affiliation(s)
| | - Ilana R Cliffer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, 90 Smith Street, 3rd Floor, Boston, MA, United States of America.
| | | | | | - Frank Mapendo
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | - Seif Abdulla
- Zanzibar Association for People Living with HIV/AIDS, Unguja, Zanzibar, Tanzania
| | - Mary Masanja
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | | | - Ali Salim Ali
- Zanzibar Association for People Living with HIV/AIDS, Unguja, Zanzibar, Tanzania
| | | | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, 90 Smith Street, 3rd Floor, Boston, MA, United States of America
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Andugula SK, Andugula V, Vadivel M, Rajapandian N, Jinka C, Babu S, Shankar AG. Impact of pumpkin seeds supplementation on anemia in antenatal mothers at Andhra Pradesh, India. Bioinformation 2022; 18:1092-1097. [PMID: 37693080 PMCID: PMC10484694 DOI: 10.6026/973206300181092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 09/12/2023] Open
Abstract
Anemia during pregnancy causes 40% of maternal fatalities in underdeveloped nations, according to statistics from the WHO. Pregnant women should meet the requirements for various nutrients, notably micronutrients, to ensure a better pregnancy outcome in the future. Cucurbita moschata (Pumpkin) seeds contain a variety of compounds, such as m-carboxyphenylalanine, amino butyrate, and citrulline, as well as a number of other amino acids. It has a wide variety of biological activity such as antioxidant, anticancer, anti-inflammatory etc. However, the community's use of pumpkin seeds is still limited. The present study was aimed to assess the impact of supplementation of pumpkin seeds on anemia among antenatal mothers in relation to Demographic and obstetric variables at Amalapuram Mandal, East Godavari district, Andhra Pradesh. In the third stage of the study, antenatal mothers' pre- and post-test scores for indicators of anaemia, pica, nail health, level of activity, heart rate, capillary refill, nutritional status, extremities, and level of hunger were compared. According to age, education, occupation, monthly income, and information source, the data demonstrates that according to three prenatal moms' consumption of pumpkin seeds in the morning, three in the afternoon, and one in the evening. The data available indicates that, of the 5 prenatal moms, 2 displayed symptoms of anemia with respect to the length of the menstrual cycle, the volume of menstrual flow, and the method of the previous delivery. Additionally, it was discovered that three of the pregnant mothers had appropriate hemoglobin levels and three of them had inadequate levels based on their past deliveries, menstrual flow volume, and cycle length. It also revealed that there is no discernible relationship between pregnant mothers in Amalapuram Mandal's diet of dry fruits and nuts and menstrual cycle length, flow volume, or method of prior birth.
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Affiliation(s)
- Swapna Kumari Andugula
- Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamilnadu, India
- KIMS College of Nursing, KIMS and RF, Amalapuram, East Godavari district, Andhra Pradesh, India
| | - Veerraju Andugula
- APR School (boys), Maredumilli, Rajahmundry, East Godavari district, Amalapuram, Andhra Pradesh,India
| | - Mani Vadivel
- Department of Biochemistry, Arunai Medical College and Hospital, Tiruvanamallai- 606603, Tamilnadu, India
| | - Nithya Rajapandian
- Department of Physiology, Arunai Medical College and Hospital, Tiruvanamallai- 606603, Tamilnadu
| | - Chaitra Jinka
- Syngene International Limited, Biocon park, Bangalore, Karnataka, India
| | - Shyamaladevi Babu
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India
| | - A Gouri Shankar
- General Medicine, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamilnadu, India
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Ameliorating Atopy by Compensating Micronutritional Deficiencies in Immune Cells: A Double-Blind Placebo-Controlled Pilot Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1889-1902.e9. [PMID: 35263681 DOI: 10.1016/j.jaip.2022.02.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Functional iron deficiency facilitates allergy development and amplifies the symptom burden in people experiencing allergies. Previously we selectively delivered micronutrients to immune cells with β-lactoglobulin as carrier (holoBLG), resulting in immune resilience and allergy prevention. OBJECTIVE The clinical efficacy of a food for special medical purposes-lozenge containing β-lactoglobulin with iron, polyphenols, retinoic acid, and zinc (holoBLG lozenge) was assessed in allergic women. METHODS In a randomized, double-blind, placebo-controlled pilot study, grass- and/or birch pollen-allergic women (n = 51) were given holoBLG or placebo lozenges over 6 months. Before and after dietary supplementation, participants were nasally challenged and the blood was analyzed for immune and iron parameters. Daily symptoms, medications, pollen concentrations, and well-being were recorded by an electronic health application. RESULTS Total nasal symptom score after nasal provocations improved by 42% in the holoBLG group versus 13% in the placebo group. The combined symptom medication score during the birch peak and entire season as well as the entire grass pollen season improved in allergic subjects supplemented with the holoBLG lozenge by 45%, 31%, and 40%, respectively, compared with the placebo arm. Participants ingesting the holoBLG lozenge had improved iron status with increased hematocrit values, decreased red cell distribution width, and higher iron levels in circulating CD14+ cells compared with the placebo group. CONCLUSIONS Targeted micronutrition with the holoBLG lozenge seemed to be effective in elevating the labile iron levels in immune cells and reducing the symptom burden in allergic women in this pilot study. The underlying allergen-independent mechanism provides evidence that dietary nutritional supplementation of the immune system is one of the ways to combat atopy.
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