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Ajoseh SM, Sifat RI, Whesu JT. Food-based domestic violence and anemia among women in sexual unions in Nigeria: the effect of urbanization. J Public Health Policy 2024; 45:523-536. [PMID: 38992219 PMCID: PMC11315663 DOI: 10.1057/s41271-024-00504-2] [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] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
In 2019, 1.74 billion people worldwide had anemia. In Nigeria, women of reproductive age are the most affected. Domestic violence affects the anemia prevalence, but few studies have examined the influence of urbanization on women in heterosexual unions (currently married, and cohabiting between). Using the social determinants of health framework, we argue that food-based violence and anemia vary among women residing in rural and urban areas. We used the Chi-square test and logistic regression to analyze the 2018 Nigeria Demographic and Health Survey records (n = 10,499). The study showed that anemia occurs more among women in rural (66%) than in urban (34%) areas. In rural areas, anemia was 29% higher among women who approved food-based domestic violence (OR: 1.29, CI 1.15-1.57) than those who did not. In urban areas, food-based domestic violence was not significantly associated with anemia. This study emphasizes the urgent need for culturally sensitive maternal health interventions aimed at re-orienting individuals and families on violence in rural areas.
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Affiliation(s)
- Seun Mauton Ajoseh
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL, 32603, USA
| | - Ridwan Islam Sifat
- School of Public Policy, University of Maryland, Baltimore County, Baltimore, MD, 21250, USA.
| | - John Tasheyon Whesu
- Department of Sociology, Case Western Reserve University, Cleveland, OH, 44106, USA
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Halder P, Verma M, Pal S, Mishra AK, Deori TJ, Biswas R, Tiwari J, Mamgai A, Rathor S, Prabhakar MC. Association of anaemia with indoor air pollution among older Indian adult population: multilevel modelling analysis of nationally representative cross-sectional study. BMC Geriatr 2024; 24:567. [PMID: 38951755 PMCID: PMC11218345 DOI: 10.1186/s12877-024-05171-2] [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: 03/26/2024] [Accepted: 06/24/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION Anaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels, but this has been studied less due to logistic constraints. A high proportion of the population in developing countries, including India, still depends on unclean fuel, which exacerbates IAP. The objective was to study the association between anaemia and IAP among the older Indian adult population (≥ 45 years) as per gender. METHODS Our study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017-18, Wave-1). We have documented the association of anaemia (outcome variable) with IAP (explanatory variable). To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was conducted. States and union territories were categorised cross tabulated as low, middle and high as per anaemia and IAP exposure. P value < 0.05 was considered statistically significant. SATA version 17 was used for analysis. RESULTS More than half (52.52%) of the participants were exposed to IAP (male (53.55%) > female (51.63%)). The odds of having anaemia was significantly 1.19 times higher (AOR 1.19 (1.09-1.31)) among participants using unclean/ solid fuel. The adjusted odds were significantly higher among participants exposed to pollution-generating sources (AOR 1.30; 1.18-1.43), and household indoor smoking (AOR 1.17 (1.07-1.29). The odds of having anaemia were significantly higher (AOR 1.26; 1.15-1.38) among participants exposed to IAP, which was higher in males (AOR 1.36; 1.15-1.61) than females (AOR 1.21; 1.08-1.35). Empowered Action Group (EAG) states like Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Bihar had both high anaemia and IAP exposure. CONCLUSION This study established the positive association of anaemia with indoor air pollution among older Indian adults through a nationally representative large dataset. The association was higher among men. Further research is recommended to understand detailed causation and to establish temporality. It is a high time to implement positive intervention nationally to decrease solid/ unclean fuel usage, vulnerable ventilation, indoor smoking, IAP and health hazards associated with these with more focused actions towards EAG states.
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Affiliation(s)
- Pritam Halder
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Saumyarup Pal
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, 110049, India
| | - Amit Kumar Mishra
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi, 110067, India
| | - Trideep Jyoti Deori
- Ministry of Health & Family Welfare, Regional Office for Health & Family Welfare, Six Mile, Guwahati, 781037, India
| | - Riya Biswas
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110049, India
| | - Jaya Tiwari
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anshul Mamgai
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Shivani Rathor
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Manish Chandra Prabhakar
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Doucoure M, Zeguime A, Niangaly A, Guindo MA, Doritchamou JYA, Assadou MH, Katile A, Kanoute MB, Perou S, Ouattara A, Sanogo S, Ouologuem B, Traore S, Dao B, Dembele D, Kone M, Kamate B, Sissoko K, Sankare S, Diarra S, Dolo A, Sissoko MS, Hume JCC, Cook D, Healy SA, Gorres JP, Traoré B, Gamiel J, Duffy PE, Sagara I. Normal Clinical Laboratory Ranges by Age and Sex, and Impact on Study Screening Outcomes in Rural Mali. Am J Trop Med Hyg 2024; 110:1021-1028. [PMID: 38531104 PMCID: PMC11066370 DOI: 10.4269/ajtmh.23-0719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/04/2024] [Indexed: 03/28/2024] Open
Abstract
The interpretation of a laboratory test result requires an appropriate reference range established in healthy subjects, and normal ranges may vary by factors such as geographic region, sex, and age. We examined hematological and clinical chemistry parameters in healthy residents at two rural vaccine trial sites: Bancoumana and Doneguebougou in Mali, West Africa. During screening of clinical studies in 2018 and 2019, peripheral blood samples from 1,192 apparently healthy individuals age 6 months to 82 years were analyzed at a laboratory accredited by the College of American Pathologists for a complete blood count, and creatinine and/or alanine aminotransferase levels. Based on manufacturers' reference range values, which are currently used in Malian clinical laboratories, abnormal values were common in this healthy population. In fact, 30.4% of adult participants had abnormal neutrophil levels and 19.8% had abnormal hemoglobin levels. Differences by sex were observed in those who were older, but not in those younger than 10 years, for several parameters, including hemoglobin, platelet, and absolute neutrophil counts in hematology, and creatinine in biochemistry. The site-specific reference intervals we report can be used in malaria vaccine clinical trials and other interventional studies, as well as in routine clinical care, to identify abnormalities in hematological and biochemical parameters among healthy Malian trial participants.
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Affiliation(s)
- M’Bouye Doucoure
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Merepen A. Guindo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Justin Y. A. Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mahamadoun H. Assadou
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Katile
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Moussa B. Kanoute
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sidiki Perou
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Adama Ouattara
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sintry Sanogo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Boucary Ouologuem
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Souleymane Traore
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Bakary Dao
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Drissa Dembele
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Mamady Kone
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Bourama Kamate
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Kourane Sissoko
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Seydou Sankare
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sadio Diarra
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amagana Dolo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Mahamadou S. Sissoko
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Jennifer C. C. Hume
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - David Cook
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Sara A. Healy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - J. Patrick Gorres
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Boubacar Traoré
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Jordyn Gamiel
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Issaka Sagara
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
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Let S, Tiwari S, Singh A, Chakrabarty M. Prevalence and determinants of anaemia among women of reproductive age in Aspirational Districts of India: an analysis of NFHS 4 and NFHS 5 data. BMC Public Health 2024; 24:437. [PMID: 38347505 PMCID: PMC10860231 DOI: 10.1186/s12889-024-17789-3] [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: 05/20/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Over one-third of women worldwide suffer from anaemia. The prevalence of anaemia is particularly pronounced among women of reproductive age (WRA) in developing countries, such as India. No prior study has ever exclusively studied the prevalence of anaemia across the Aspirational Districts of India. Therefore, the purpose of this study was to examine the prevalence of anaemia across Aspirational Districts of India and to identify the determinants of anaemia among WRA in these districts. METHODS From the National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21), data on 114,444 and 108,782 women aged 15-49 from Aspirational Districts were analyzed in our study, respectively. Bivariate statistics and multivariable binary logistic regression were used to identify the determinants of anaemia. RESULTS The national prevalence of anaemia among WRA has increased from 53% in NFHS-4 to 57% in NFHS-5 whereas anaemia among WRA in Aspirational Districts has increased from 58.7% in NFHS-4 to 61.1% in NFHS-5. Between 2015 and 2021, over 60% of Aspirational Districts experienced an increase in the prevalence of anaemia and one-fourth, specifically 29 out of 112, observed a rise by at least 10 percentage points (pp). Notably, there are significant variations in anaemia prevalence among districts, with Simdega and Udalgiri having the highest anaemia prevalence in NFHS-4 and NFHS-5 at 78.2% and 81.5%, respectively. During this period, Barpeta followed by Udalgiri of Assam have witnessed the maximum increase with 29.4% and 26.7% respectively. Moreover, pooled regression results show women with three to four children [AOR: 1.13, 95% CI: 1.08-1.17], women who breastfeed [AOR: 1.17, 95% CI: 1.13-1.20], Scheduled Tribe women [AOR: 1.39, 95% CI: 1.35-1.44], poorest women [AOR: 1.27, 95% CI: 1.22-1.33] and women those who consume fish occasionally [AOR: 1.14, 95% CI: 1.12-1.17] were more likely to be anaemic. CONCLUSION The significant increase in anaemia among WRA in Aspirational Districts of India is a matter of concern. Given the rise in anaemia among WRA, determinants-based and district-specific measures must be designed and implemented to reduce the prevalence of anaemia among Aspirational Districts of India.
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Affiliation(s)
- Subhojit Let
- Department of Geography, Banaras Hindu University, Varanasi, India
| | - Seema Tiwari
- Geography Section, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aditya Singh
- Department of Geography, Banaras Hindu University, Varanasi, India.
- Girl Innovation, Research, and Learning (GIRL) Center, Population Council, New York, NY, United States of America.
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Kuppusamy P, Prusty RK, Khan SA. Assessing the prevalence and predictors of anemia among pregnant women in India: findings from the India National Family Health Survey 2019-2021. Curr Med Res Opin 2024; 40:51-58. [PMID: 37888841 DOI: 10.1080/03007995.2023.2276851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. METHODS This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019-2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. RESULTS The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27-1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51-1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18-1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75-8.36) than their highly educated counterparts. CONCLUSION Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India.
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Affiliation(s)
- Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Shagufta A Khan
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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Derbo ZD, Debelew GT. The Effect of Fresh Moringa Leaf Consumption During Pregnancy on Maternal Hemoglobin Level in Southern Ethiopia: Multilevel Analysis of a Comparative Cross-Sectional Study. Int J Womens Health 2023; 15:1125-1137. [PMID: 37489178 PMCID: PMC10363345 DOI: 10.2147/ijwh.s412241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose Anemia, especially iron-deficiency anemia during pregnancy, significantly impacts maternal health, fetal growth, and development. Moringa leaf is an iron-rich food that can overcome anemia, but there is a lack of evidence on the association between fresh moringa leaf consumption and maternal hemoglobin level during pregnancy. The aim of this study is to test the effect of fresh moringa leaf consumption during pregnancy on maternal hemoglobin levels in southern Ethiopia. Methods A community-based comparative cross-sectional study was conducted from May to June 2022 among 230 fresh moringa leaf consumers and 230 non-consumers pregnant women. Data were collected using an interviewer-administered structured questionnaire and hemoglobin level was determined by HemoCue Hb 301. Multivariate multilevel linear regression models were fitted using Statistical Software for Data Science (STATA) version 14. Results The overall mean hemoglobin level among pregnant women was 11.76 g/dl ± 1.47 [12.06 g/dl ± 1.22 among fresh moringa leaf consumers and 11.45 g/dl ± 1.64 among non-consumers] with a significant coefficient of association (β) of 0.90 g/dl [β = 0.90 g/dl, 95% CI: 0.54, 1.27]. A number of under-five children, bleeding during the current pregnancy, male-headed household, and current antenatal care visit were the individual-level factors. Distance from the nearest health facility and urban dweller was identified as the community-level factor associated with maternal hemoglobin level during pregnancy. Conclusion This study showed that the consumption of fresh moringa leaf during pregnancy increases the level of hemoglobin. So policymakers and maternal and child health program managers need to target moringa tree scale-up and encourage fresh moringa leaf consumption during pregnancy, but its use needs additional rigorous clinical trials. In addition to this, mark the above factors in their efforts to increase maternal hemoglobin levels during pregnancy.
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Affiliation(s)
- Zeritu Dewana Derbo
- Department of Midwifery, Arba Minch Health Science College, Arba Minch, Ethiopia
| | - Gurmesa Tura Debelew
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Abbas G, Hussain A, Hussain A, Ahmed Z, Abbas Y, Nemat A. Geostatistical analysis for spatial distribution of anemia (Hb level) among women of reproductive age and determinant factors. Food Sci Nutr 2023; 11:4183-4190. [PMID: 37457163 PMCID: PMC10345706 DOI: 10.1002/fsn3.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/18/2023] Open
Abstract
The study was designed to assess the geostatistical spatial distribution of anemia and determinant factors among the women of reproductive age group (RAG) in Gilgit district, Pakistan. The Hb levels for 15-25 RAG, 26-35 RAG, and 36-45 group showed 10.22 g/dL, 10.41 g/dL, and 9.90 g/dL levels, respectively, while the Hb level showed a nugget/sill ratio of 0.21 inferring strong for the 15-25 group, weak for the 26-36, and moderate for 36-45 spatial dependence. Furthermore, 15-25 RAG showed 8% severe and 33.34% sufficient cases and 26-35 showed 12% severe and 29.33% sufficient results in their Hb level, whereas 36-45 had 9.34% severe and 29.33% sufficient.
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Affiliation(s)
- Ghulam Abbas
- Department of Biological SciencesKarakoram International UniversityGilgitPakistan
| | - Azhar Hussain
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Abid Hussain
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Zahoor Ahmed
- School of Food & Biological EngineeringJiangsu UniversityZhenjiangChina
- Department of Human Nutrition and Dietetics, School of Food and Agricultural SciencesUniversity of Management and Technology LahoreLahorePakistan
| | - Yasir Abbas
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Arash Nemat
- Kabul University of Medical SciencesKabulAfghanistan
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Ogbuabor DC, Ogbuabor AO, Ghasi N. Determinants of anaemia prevalence in women of reproductive age in Nigeria: A cross-sectional study using secondary data from Nigeria Demographic and Health Survey 2018. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142961. [PMID: 36515440 PMCID: PMC9756372 DOI: 10.1177/17455057221142961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anaemia disproportionately affects women of reproductive age in sub-Saharan Africa including Nigeria. Yet, community-based studies on the prevalence and determinants of anaemia among women of reproductive age are scarce in Nigeria. DESIGN A cross-sectional community-based survey using a nationally representative sample. OBJECTIVES This study described anaemia prevalence and its associated factors among women of reproductive age, pregnant women, and non-pregnant women in Nigeria. METHODS We analysed data from the 2018 Nigeria Demographic and Health Survey. Pregnant women with a haemoglobin level less than 11 g/dL and non-pregnant women with a haemoglobin level less than 12 g/dL were considered anaemic. Anaemia was also categorized as mild, moderate, and severe. Pearson's chi-square test was used to evaluate the association between anaemia status and independent variables. All variables with ρ ⩽ 0.25 in bivariate analyses were further analysed using complex sample logistic regression. RESULTS Anaemia prevalence was 57.8%, 57.4%, and 61.1% for women of reproductive age, non-pregnant women, and pregnant women, respectively. The prevalence of severe anaemia was 1.6%, 1.5%, and 2.3% for overall women of reproductive age, non-pregnant women, and pregnant women, correspondingly. The southern regions, rural residence, low education, unemployment, low wealth index, and non-use of modern contraceptives significantly increased the likelihood of anaemia and severe anaemia among women of reproductive age and non-pregnant women. The likelihood of being anaemic was significantly increased by large family size among women of reproductive age and by being underweight among non-pregnant women. The South-East region, rural residence, low education, and unemployment were significantly associated with anaemia among pregnant women. The South-South region and unemployment increased the likelihood of severe anaemia among pregnant women. Short stature significantly reduced the odds of being anaemic and severely anaemic among pregnant women. CONCLUSIONS Anaemia prevalence among all categories of women of reproductive age is high in Nigeria. Predictors of anaemia prevalence and severity should be considered in policies intended to reduce anaemia among women of reproductive age in Nigeria.
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Affiliation(s)
- Daniel Chukwuemeka Ogbuabor
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria,Daniel Chukwuemeka Ogbuabor, Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria.
| | | | - Nwanneka Ghasi
- Department of Management, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Amarasinghe GS, Agampodi TC, Mendis V, Agampodi SB. Factors associated with early pregnancy anemia in rural Sri Lanka: Does being 'under care' iron out socioeconomic disparities? PLoS One 2022; 17:e0274642. [PMID: 36201463 PMCID: PMC9536542 DOI: 10.1371/journal.pone.0274642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Globally, more than a third of pregnant women are anemic, and progress in its prevention and control is slow. Sri Lanka is a lower-middle-income country with a unique public health infrastructure that provides multiple interventions across the lifecycle for anemia prevention, despite which anemia in pregnancy remains a challenge. Studying the factors associated with maternal anemia in this context would provide unique information on challenges and opportunities encountered as low-and-middle-income countries attempt to control anemia by improving health care coverage. All first-trimester pregnant women registered for antenatal care in the Anuradhapura district between July 2019 to September 2019 were invited to participate in the baseline of a cohort study. Interviewer-administered and self-completed questionnaires were used. Anemia was defined using a full blood count. A hierarchical logistic regression model was built to identify factors associated with anemia. Out of 3127 participants, 451 (14.4%) were anemic. According to the regression model (Chi-square = 139.3, p<0.001, n = 2692), the odds of being anemic increased with the Period of gestation (PoG) (OR = 1.07, 95% CI = 1.01-1.13). While controlling for PoG, age and parity, history of anemia (OR = 3.22, 95%CI = 2.51-4.13), being underweight (OR = 1.64, 95%CI = 1.24-2.18), having the last pregnancy five or more years back (OR = 1.57,95%CI = 1.15-2.15) and having used intrauterine devices for one year or more (OR = 1.63, 95%CI = 1.16-2.30) increased the odds of anemia. Breast feeding during the last year (OR = 0.66, 95%CI = 0.49-0.90) and having used contraceptive injections for one year or more (OR = 0.61,95%CI = 0.45-0.83) reduced the risk of anemia. Proxy indicators of being in frequent contact with the national family health program have a protective effect over the socioeconomic disparities in preventing early pregnancy anemia. Maintaining the continuum of care through the lifecycle, especially through optimizing pre and inter-pregnancy care provision should be the way forward for anemia control.
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Affiliation(s)
- Gayani Shashikala Amarasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Vasana Mendis
- Department of Pathology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Internal Medicine, Division of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
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Awoleye AF, Alawode OA, Chima V, Okunlola DA, Obiesie S. Rural-urban differentials in the relationship between household wealth index and maternal anaemia status in Nigeria. Health Care Women Int 2022:1-16. [PMID: 35708496 DOI: 10.1080/07399332.2022.2078327] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Anaemia - a condition of low haemoglobin level in the blood is prevalent among women in Nigeria despite years of interventions. Wealth status have implications for this prevalence but there is a dearth of research examining this relationship and residential dimensions in it. The social determinant of health framework was employed to understand the rural-urban dimension of this relationship. Chi-square test and multivariate logit regression models were used to analyse data from the 2018 Nigeria Demographic and Health Survey (n=13,575). We found that anaemia status is higher among rural women (66%). The odds of being anaemic is higher with decreasing wealth status irrespective of place of residence but the odds are higher for poor women in urban areas compared to poor women in rural areas after adjusting for covariates. Maternal health interventions should be more innovative in their design of programs by being sensitive of residential dimension.
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Affiliation(s)
- Abayomi Folorunso Awoleye
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Victor Chima
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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