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Yosef T, Gizachew A, Fetene G, Girma D, Setegn M, Tesfaw A, Sisay BG, Shifera N. Infectious and obstetric determinants of anemia among pregnant women in Southwest Ethiopia. Front Glob Womens Health 2024; 5:1421884. [PMID: 39364186 PMCID: PMC11448344 DOI: 10.3389/fgwh.2024.1421884] [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: 04/23/2024] [Accepted: 09/05/2024] [Indexed: 10/05/2024] Open
Abstract
Background Anaemia, characterized by low red blood cell or haemoglobin levels, impairs oxygen transport in the body and poses a major global public health issue, particularly affecting pregnant women and children. This study focuses on identifying the factors contributing to anaemia among pregnant women receiving antenatal care (ANC) at Mizan-Tepi University Teaching Hospital (MTUTH) in southwest Ethiopia. Methods A hospital-based unmatched case-control study was conducted from July 1 to August 30, 2022, involving 370 pregnant women (90 with anaemia and 280 without). Data collection included questionnaires, laboratory tests (Hgb and stool examination), and anthropometric measurements. SPSS version 21 was used for data analysis, with binary logistic regression identifying factors associated with anaemia. The significance level was set at a p-value <0.05. Results The study achieved a 100% response rate for both cases and controls. Factors identified as determinants of anaemia among pregnant women included malaria infection (AOR = 7.83, 95% CI: 3.89-15.8), hookworm infection (AOR = 2.73, 95% CI: 1.39-5.34), short birth interval (AOR = 7.11, 95% CI: 3.59-14.2), and history of unsafe abortion (AOR = 5.40, 95% CI: 2.46-11.8). Conclusion This study found that malaria infection, hookworm infection, birth interval <33 months, and a history of unsafe abortion are factors contributing to anaemia in pregnant women. Strategies such as distributing insecticide-treated bed nets (ITNs) to combat malaria, improving sanitation, anthelmintic drugs, promoting family planning to prevent unwanted pregnancies and unsafe abortions, and providing preconception care can help reduce the incidence of anaemia.
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Affiliation(s)
- Tewodros Yosef
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC, Australia
| | - Asaye Gizachew
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Gossa Fetene
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Desalegn Girma
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Melsew Setegn
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Aragaw Tesfaw
- School of Public Health, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Binyam Girma Sisay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Nigusie Shifera
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Klu D, Kyei-Arthur F, Appiah M, Odame ML. Multilevel predictors of anaemia among pregnant women in Ghana: New evidence from the 2019 Ghana Malaria Indicator Survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003673. [PMID: 39236009 PMCID: PMC11376585 DOI: 10.1371/journal.pgph.0003673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/12/2024] [Indexed: 09/07/2024]
Abstract
Anaemia in pregnant women is a major public health concern. A number of multilevel factors have been attributed as contributors to anaemia in pregnancy. The purpose of this study was to examine the multilevel factors predicting anaemia among pregnant women in Ghana. Data for this study were obtained from the 2019 Ghana Malaria Indicator Survey (GMIS) conducted between September 25 and November 24, 2019 in all regions in Ghana. The weighted sample comprised 353 pregnant women aged 15-49 years. Data were analysed with SPSS version 25 using descriptive statistics, Pearson's chi-square test and binary logistic regression modelling. In this study, the outcome variable was anaemia status among pregnant women, while the predictor variables included individual, household, community, and health system level factors. The overall prevalence of anaemia among pregnant women was 28.7%. Of these, 14.5% had mild anaemia, and 13.2% and 1.1% had moderate and severe anaemia, respectively. The results indicate that a higher probability of anaemia in pregnancy is likely to be found among pregnant women less than 35 years (15-24 years, aOR = 3.31; C.I: 1.13-9.73) (25-34 years, aOR = 2.49; C.I:1.06-5.84). A higher likelihood of anaemia was found among pregnant women who did not take SP drug (aOR = 3.70; C.I:1.20-11.43) and also among household heads aged 30-39 years (aOR = 4.51; C.I:1.09-18.71). However, a lower odd of being anaemic was found among pregnant women who had attained secondary or higher education (aOR = 0.19; C.I:0.05-0.76), women in the richest households (aOR = 0.02; C.I:0.00-0.42) and those accessing unimproved drinking water (aOR = 0.37; C.I:0.14-0.95). Furthermore, pregnant women with health insurance coverage had lower probability (aOR = 0.24; C.I: 0.06-0.94) of being anaemic. The results highlight the importance of varying factors at different levels in understanding the prevalence of anaemia among pregnant women. Understanding these factors will play a major contributor to developing strategies and programmes aimed at addressing anaemia among pregnant women.
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Affiliation(s)
- Desmond Klu
- Centre for Malaria Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Eastern Region, Ghana
| | - Margaret Appiah
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Eastern Region, Ghana
| | - Michael Larbi Odame
- Department of Sustainable Development and Policy, University of Environment and Sustainable Development, Samanya, Eastern Region, Ghana
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Nasir M, Ayele HM, Aman R, Hussein K. Magnitude of anemia and associated factors among pregnant women attending antenatal care in governmental health facilities of Shashemene Town, Oromia region, Ethiopia. Front Public Health 2024; 12:1409752. [PMID: 39296845 PMCID: PMC11408211 DOI: 10.3389/fpubh.2024.1409752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 08/12/2024] [Indexed: 09/21/2024] Open
Abstract
Introduction Anemia during pregnancy is a common issue that significantly affects the health of both the mother and her child. Globally, anemia is a major public health concern, affecting both developing and developed countries, with approximately 1.3 billion people affected. Pregnant women are among the most vulnerable to anemia. Objective To assess the magnitude and risk factors of anemia among pregnant women attending antenatal care in Shashemene Town, Oromia, Ethiopia. Methods A facility-based cross-sectional study was conducted among 391 pregnant women in Shashemene Town in April 2022. Data were collected using interviewer-administered questionnaires, along with laboratory examinations of blood and stool samples. The data were entered into EpiData 3.1 and analyzed using the Statistical Package for Social Sciences (SPSS) version 22. Bivariate logistic regression was performed, and variables with a p-value of <0.25 were included in the multivariate logistic regression analysis to identify factors associated with anemia. Adjusted odds ratio (AOR) with 95% CIs were calculated, and a p-value of < 0.05 was considered statistically significant. Finally, the results are presented using narration, descriptive statistics, such as tables, graphs, and charts. Results The prevalence of anemia was found to be 30.9% (95% CI: 26.4, 35.4%). Factors significantly associated with a reduced risk of anemia included high dietary diversity (AOR = 0.217, 95% CI: 0.105-0.451), no history of excessive menstrual bleeding (AOR = 0.162, 95% CI 0.076-0.345), age 25-34 years (AOR = 0.391, 95% CI 0.173-0.883), and age ≥ 35 years (AOR = 0.068, 95% CI 0.011-0.444). Conversely, a mild upper arm circumference (MUAC) of <23 cm (AOR = 4.939, 95% CI 2.330-10.469), no use of contraceptives (AOR = 4.935, 95% CI 2.207-11.032), and no iron supplementation use (AOR = 3.588, 95% CI 1.794-7.175) were significantly associated with an increased risk of anemia. Conclusion According to the WHO classification, anemia in this study was found to be a moderate public health issue. High dietary diversity, no previous excessive menstrual bleeding, and age were significantly associated with a reduced risk of anemia, whereas a MUAC of <23 cm, no contraceptive use, and no iron supplementation were significantly associated with an increased risk of anemia. Therefore, promoting diverse diets among pregnant women, providing counseling on the benefits of family planning and iron-folic acid supplements, and improving women's education and empowerment are essential.
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Affiliation(s)
- Mekiya Nasir
- Department of Public Health, School of Health Science, Madda Walabu University, Bale Robe, Ethiopia
| | - Habtamu Molla Ayele
- Maternal and Child Health Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Rameto Aman
- Department of Public Health, School of Health Science, Madda Walabu University, Bale Robe, Ethiopia
| | - Kelil Hussein
- Department of Public Health, School of Health Science, Madda Walabu University, Bale Robe, Ethiopia
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Alie MS, Gichew S, Alemayehu D. Hotspot analysis of anaemia among pregnant women in Ethiopia: hotspot analysis of national demographic and health survey data. BMJ Open 2024; 14:e086539. [PMID: 39097301 PMCID: PMC11298733 DOI: 10.1136/bmjopen-2024-086539] [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: 03/19/2024] [Accepted: 07/23/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Anaemia is a significant global health problem, especially, in developing nations like Ethiopia. Despite increasing rates over the past two decades, there is limited research on the specific prevalence of anaemia among pregnant women in the country. OBJECTIVE To identify hotspot areas of anaemia-associated factors among pregnant women in Ethiopia. STUDY DESIGN Cross-sectional. SETTING Ethiopian demographic study from 2005 to 2016. PARTICIPANTS This study analysed 3350 pregnant women. PRIMARY AND SECONDARY OUTCOME MEASURES Hotspot area of anaemia among pregnant women, trend of anaemia and associated factors. RESULTS The prevalence of anaemia among pregnant women has shown significant fluctuations over the years. Between 2005 and 2011, there was a notable decrease from 30.9% to 21.5% while the prevalence increased from 21.5% in 2011 to 29.58% in 2016. The identified determinants of anaemia among pregnant women were female-headed household, belonging to the highest wealth quintile, being in the second or third trimester of pregnancy, being a working woman and residing in the Somalia region. Hotspot areas, where the prevalence of anaemia was particularly high, were identified in Somalia, Dire Dawa, Afar and Harari regions. CONCLUSION Anaemia during pregnancy is a major public health concern in Ethiopia, with a concerning increase between 2011 and 2016. Hotspot areas like Somali, Dire Dawa, Afar and Harari are particularly affected. Shockingly, nearly one in three pregnant women in Ethiopia suffer from anaemia. To address this issue effectively, targeted interventions prioritising economically disadvantaged households and pregnant women in their second and third trimesters are crucial. Monitoring spatial patterns and contributing factors is vital to develop tailored interventions and improve maternal health outcomes in these high-risk areas. By strategically targeting hotspot areas nationwide, significant progress can be made in reducing anaemia among pregnant women.
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Affiliation(s)
- Melsew Setegn Alie
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Simegnew Gichew
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dereje Alemayehu
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Adelaiye S, Wanonyi I, Adanikin A, Mairiga A, Kadas A, Morrupa J, Lavin T, Lamara A, Yahaya I, Tukur J, Chama C. Determinants of obstructed labour and associated outcomes in referral hospitals in Nigeria. BJOG 2024; 131 Suppl 3:55-63. [PMID: 38616567 DOI: 10.1111/1471-0528.17826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE To estimate the prevalence of obstructed labour, associated risk factors and outcomes across a network of referral hospitals in Nigeria. DESIGN Retrospective observational study. SETTING A total of 54 referral-level hospitals across the six geopolitical regions of Nigeria. POPULATION Pregnant women who were diagnosed with obstructed labour during childbirth and subsequently underwent an emergency caesarean section between 1 September 2019 and 31 August 2020. METHODS Secondary analysis of routine maternity care data sets. Random-effects multivariable logistic regression was used to ascertain the factors associated with obstructed labour. MAIN OUTCOME MEASURES Risk factors for obstructed labour and related postpartum complications, including intrapartum stillbirth, maternal death, uterine rupture, postpartum haemorrhage and sepsis. RESULTS Obstructed labour was diagnosed in 1186 (1.7%) women. Among these women, 31 (2.6%) cases resulted in maternal death and 199 (16.8%) cases resulted in postpartum complications. Women under 20 years of age (OR 2.03, 95% CI 1.50-2.75), who lacked formal education (OR 1.88, 95% CI 1.55-2.30), were unemployed (OR 1.94, 95% CI 1.57-2.41), were nulliparous (OR 2.11, 95% CI 1.83-2.43), did not receive antenatal care (OR 3.34, 95% CI 2.53-4.41) or received antenatal care in an informal healthcare setting (OR 8.18, 95% CI 4.41-15.14) were more likely to experience obstructed labour. Ineffective referral systems were identified as a major contributor to maternal death. CONCLUSIONS Modifiable factors contributing to the prevalence of obstructed labour and associated adverse outcomes in Nigeria can be addressed through targeted policies and clinical interventions.
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Affiliation(s)
- Samuel Adelaiye
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | | | - Abiodun Adanikin
- Centre for Healthcare and Communities, Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Abdulkarim Mairiga
- University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Abubakar Kadas
- Obstetrics and Gynaecology Department, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Joel Morrupa
- Federal Medical Centre, Yola, Adamawa State, Nigeria
| | - Tina Lavin
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Abubakar Lamara
- Health Information Management Department, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Ibrahim Yahaya
- Health Information Management Department, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Jamilu Tukur
- Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Calvin Chama
- Obstetrics and Gynaecology Department, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
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Dufera T, Dheresa M, Dingeta T, Legesse M, Mesfin S, Balis B, Balcha T. Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study. Int Health 2024; 16:438-445. [PMID: 38226469 PMCID: PMC11218879 DOI: 10.1093/inthealth/ihad118] [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: 04/22/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. METHODS Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. RESULT The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7). CONCLUSION In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.
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Affiliation(s)
- Tadesse Dufera
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tariku Dingeta
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mezgebu Legesse
- School of Medicine, Department of Medical Biochemistry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tegenu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Jugha VT, Anchang JA, Sofeu-Feugaing DD, Taiwe GS, Kimbi HK, Anchang-Kimbi JK. Dietary micronutrients intake and its effect on haemoglobin levels of pregnant women for clinic visit in the Mount Cameroon health area: a cross-sectional study. Front Nutr 2024; 11:1341625. [PMID: 38774262 PMCID: PMC11106498 DOI: 10.3389/fnut.2024.1341625] [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: 11/20/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Background Nutritional deficiencies and its consequences such as anaemia are frequent among pregnant women residing in under resource settings. Hence, this study sought to investigate specific dietary micronutrient inadequacy and its effect on maternal haemoglobin levels. Methods This institution based cross-sectional survey enrolled 1,014 consenting pregnant women consecutively. Data on socio-demographic, economic and antenatal characteristics were recorded using a structured questionnaire. Minimum dietary diversity for women (MDD-W) was assessed using the 24-h recall method and haemoglobin (Hb) concentration (g/dL) determined using a portable Hb metre. Significant levels between associations was set at p < 0.05. Results Among those enrolled, 40.9% were anaemic while 89.6% had inadequate dietary nutrient intake. In addition, uptake of blood supplements, haem iron, plant and animal-based foods rich in vitamin A were 71.5, 86.2, 35.5 and 12.6%, respectively. Moreover, anaemia prevalence was significantly (p < 0.05) lower in women who took iron-folic acid along with food groups rich in haem iron (38.5%) or both plant and animal vitamin A (29.0%). Besides, mean maternal Hb levels was significantly (p < 0.001) higher in women who consumed haem iron (11.08 ± 1.35) and vitamin A food groups (11.34 ± 1.30) when compared with their counterparts who did not consume haem iron (10.54 ± 1.19) and vitamin A food groups (10.74 ± 1.31). Conclusion Dietary uptake of foods rich in haem-iron and vitamin A significantly improves Hb levels in Cameroonian pregnant women. Our findings underscore the importance of improving maternal nutritional awareness and counselling during antenatal period to reduce the anaemia burden.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Juliana Adjem Anchang
- International Centre for Agricultural Research in the Dry Areas, ICARDA, Cairo, Egypt
| | | | | | - Helen Kuokuo Kimbi
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
- Department of Biomedical Sciences, University of Bamenda, Bamenda, Cameroon
- Department of Microbiology and Immunology, College of Medicine, Drexel University, Philadelphia, PA, United States
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Haile B, Oumer A, Negese T, Temesgen M, Kebede A, Abdurahman D, Motuma A, Roba KT. Factors associated with compliance with weekly iron and folic acid supplementation among school adolescent girls in Debub Achefer district, northwest Ethiopia: school-based cross-sectional study. Sci Rep 2024; 14:9980. [PMID: 38693315 PMCID: PMC11063210 DOI: 10.1038/s41598-024-60800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/26/2024] [Indexed: 05/03/2024] Open
Abstract
Iron deficiency anemia is a public health problem among adolescents that could be addressed by weekly Iron Folic Acid Supplementation (IFAS). The Ethiopian government piloted weekly IFAS in schools, where its effectiveness depends on compliance. We assessed the determinants of compliance with the weekly IFAS in Ethiopia. A school-based survey was conducted in 506 adolescent girls on weekly IFAS. Compliance was considered when girls reported WIFAS for at least three months without discontinuation. Bivariable and multivariable logistic regression models were modeled, with odds ratios reported. Out of 506, 25.8% had limited access to educational resources, and 79.4% had no information on IFAS. Among these, 47.9% (95% CI: 45.5-49.9%) had poor compliance with weekly IFAS. Non-compliance was mainly due to school absenteeism (55.9%). Important predictors of poor compliance were adolescent girls' marital status (AOR = 5.21; 1.55-17.6), academic standing (AOR = 4.37; 2.20-8.70), family income (AOR = 1.85; 1.09-3.15), access to health education materials (AOR = 1.57; 1.02-2.40), problems with IFAS (AOR = 2.44; 1.26-4.74), a discouraging home environment for the program (AOR = 2.27; 1.54-3.34), and a lack of knowledge of the IFAS program (AOR = 1.40; 0.97-2.03). Compliance with weekly IFAS is optimal, which could be improved via strong adherence support and feasible supplementation schedules.
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Affiliation(s)
- Bisrat Haile
- Nutrition Coordination Office, Ministry of Health, Addis Ababa, Ethiopia
| | - Abdu Oumer
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Tarkegn Negese
- Nutrition Coordination Office, Ministry of Health, Addis Ababa, Ethiopia
| | - Mesfin Temesgen
- College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Dureti Abdurahman
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aboma Motuma
- 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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Temesgen H, Woyraw W, Feleke FW, Mezgebu GS, Taye K, Awoke T. Iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia: a multilevel complex data analysis of 2019 Ethiopian mini demographic and health survey data. Front Nutr 2024; 11:1348275. [PMID: 38435097 PMCID: PMC10904579 DOI: 10.3389/fnut.2024.1348275] [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: 12/02/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Background Iron and folic acid deficiency is a worldwide public health concern, particularly in low and middle-income countries. In Ethiopia, adherence to iron and folic acid supplements is still very low. Despite the fact that a number of studies on IFA supplementation have been conducted in Ethiopia, they do not indicate a nationwide problem and do not use advanced models to demonstrate clustering effects. The purpose of this study was to assess the level of non-adherence to iron folic acid supplementation and predictors among pregnant women in Ethiopia. Objective To assess iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia using data from the 2019 Mini-Ethiopian demographic health survey. Methods The Mini Ethiopian Demographic and Health Survey 2019 data were obtained from the official database website of the Demographic and Health Survey program (http://dhsprogram.com). The analysis included a sample of 2,356 weighted study participants. A multivariable multilevel mixed-effects logistic regression model was used Variables with p-values less than 5%) was reported as statistically significant variables in the multivariable analysis. Results The proportion of mothers who did not adhere to iron and folic acid supplements was 81.03% (95 %CI, 79.39, and 82.56). Birth interval less than 2 years [AOR: 2.03; 95% CI: 1.12, 3.66], women ever born less than six children [AOR: 1.99; 95% CI: 1.09, 3.64], starting ANC visit during first trimester [AOR: 2.74; 95 %CI: 1.03, 7.30], region [AOR = 0.24; 95% CI: 0.10], and having a high no ANC visit in the community [AOR = 1.77; 95% CI: 1.08, 2.88] were statistically significant factors. There was Intra-Custer Correlation (ICC = 17.72%), indicating that 17.72% variability in non-adherence levels was due to clusters. Conclusion and recommendation In Ethiopia, nearly four out of every five pregnant women did not receive iron folic acid supplementation for the recommended periods. Birth intervals, number of children, timing of ANC visits, region, and community level no ANC service were significant factors for non-adherence IFAS. As a result, the community, govern metal and non-governmental sectors enacting on health should focus on reducing non-adherence through tailored interventions on factors that influence it.
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Affiliation(s)
- Habtamu Temesgen
- Department of Nutrition, College of Health Science, Debre Markos University, Debre Marqos, Ethiopia
- School of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Wubetu Woyraw
- Department of Nutrition, College of Health Science, Debre Markos University, Debre Marqos, Ethiopia
- School of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Fentaw Wassie Feleke
- School of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Ethiopia
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Getachew Sale Mezgebu
- School of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Kefyalew Taye
- School of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Ethiopia
- Department of Public Health, College of Health Science, Ambo University, Ambo, Ethiopia
| | - Tadesse Awoke
- Institute of Public Health, College of Health Science, University of Gondar, Gondar, Ethiopia
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Izuka EO, Obiora-Izuka CE, Asimadu EE, Enebe JT, Onyeabochukwu AD, Nwagha UI. Effect of late antenatal booking on maternal anemia and fetus birth weight on parturients in Enugu, Nigeria: An analytical cross-sectional study. Niger J Clin Pract 2023; 26:558-565. [PMID: 37357470 DOI: 10.4103/njcp.njcp_117_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background The benefits of antenatal care are maximized when women book early for care. However, despite these resounding benefits, women still book late, while others do not book at all, resulting in dire feto-maternal consequences. Aim Determine the effect of late prenatal booking on maternal anemia and birth weight in babies of women who delivered in public health facilities in Enugu and deduce the reasons for booking late. Patients and Methods A cross-sectional study of two groups of women (235 participants in each group) who delivered in 4 randomly selected hospitals in Enugu. Descriptive statistics were obtained for continuous variables, and frequency and percentages were used for categorical variables. Degree of associations was determined using the Chi-square, the student's t-test, and 2 x 2 table. Results The prevalence of anemia among women that booked late and early were (69.7%; n = 147) and (50.7%; n = 107) respectively. Women who booked late were two times more likely to have anemia than those who booked early (OR = odds ratio, p = p-value, CI = confidence interval,). Those who booked late were six times more likely to deliver low birth weight babies than those who booked early (OR = 5.934, 95% CI = 1.299-27.119, P = 0.022). Conclusions Late prenatal booking is associated with a high prevalence of maternal anemia in labor, low mean maternal hemoglobin, and low birth weight compared to those of women who booked early and the reasons for booking late are multifactorial.
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Affiliation(s)
- E O Izuka
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
| | - C E Obiora-Izuka
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - E E Asimadu
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
| | - J T Enebe
- Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology, ESUTH-Parklane, Enugu, Nigeria
| | - A D Onyeabochukwu
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - U I Nwagha
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
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11
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Determinants And Spatial Patterns of Anaemia And Haemoglobin Concentration Among Pregnant Women In Nigeria Using Structured Additive Regression Models. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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12
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Shitu K, Terefe B. Anaemia and its determinants among reproductive age women (15–49 years) in the Gambia: a multi-level analysis of 2019–20 Gambian Demographic and Health Survey Data. Arch Public Health 2022; 80:228. [PMID: 36348438 PMCID: PMC9644570 DOI: 10.1186/s13690-022-00985-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Anaemia is among the top list of the contemporarily public health burden in both developed and developing countries, by affecting mainly women's and children's health. Objective This study aimed to identify the burden of anaemia and its individual and community level factors among women in The Gambia. Method This study was based on an extensive national survey, Gambian Demographic and Health Survey. A total weighted sample of 5,858 reproductive-age women was included. Because of the hierarchical nature of the DHS data, a multi-level logistic regression model was applied to study individual and community-level factors that may influence anaemia. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance. Result The overall prevalence of anemia was found 44.28% (95% CI 0.43, 0.46). Current users of contraceptives were (AOR = 0.66, 95% CI: (0.55- 0.79)) and currently pregnant (AOR = 1.44. 95% CI: (1.16, 1.81)) less likely and more likely to develop anaemia compared to their counterparts respectively. In addition to this, living in the region of Brikama (AOR = 0.69, 95% CI: (0.50–0.97)) less likely to be exposed to anemia. From community level factor, high distance to the health facilities (AOR = 1.23,95% CI 1.02–1.48) were associated with anemia. Conclusion The study revealed that the burden of anaemia among reproductive age Gambian women was very high. Anaemia was affected by both individual and community levels of factors. Thus, the burden of anaemia could be significantly reduced if pregnant and contraceptive users' women were monitored and encouraged. Increasing the accessibility of health facilities, community mobilization, and awareness enhancement are also advisable.
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13
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Gildner TE, Eick GN, Schneider AL, Madimenos FC, Snodgrass JJ. After Theranos: Using point-of-care testing to advance measures of health biomarkers in human biology research. Am J Hum Biol 2022; 34:e23689. [PMID: 34669210 DOI: 10.1002/ajhb.23689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The rise and fall of the health technology startup Theranos is emblematic of the promise and peril of point-of-care testing (POCT). Instruments that deliver immediate results from minimally invasive samples at the location of collection can provide powerful tools to deliver health data in clinical and public health contexts. Yet, POCT availability is driven largely by market interests, which limits the development of inexpensive tests for diverse health conditions that can be used in resource-limited settings. These constraints, combined with complex regulatory hurdles and substantial ethical challenges, have contributed to the underutilization of POCT in human biology research. METHODS We evaluate current POCT capabilities and limitations, discuss promising applications for POCT devices in resource-limited settings, and discuss the future of POCT. RESULTS As evidenced by publication trends, POCT platforms have rapidly advanced in recent years, gaining traction among clinicians and health researchers. We highlight POCT devices of potential interest to population-based researchers and present specific examples of POCT applications in human biology research. CONCLUSIONS Several barriers can limit POCT applications, including cost, lack of regulatory approval for non-clinical use, requirements for expensive equipment, and the dearth of validation in remote field conditions. Despite these issues, we see immense potential for emerging POCT technology capable of analyzing new sample types and used in conjunction with increasingly common technology (e.g., smart phones). We argue that the fallout from Theranos may ultimately provide an opportunity to advance POCT, leading to more ethical data collection and novel opportunities in human biology research.
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Affiliation(s)
- Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - Alaina L Schneider
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.,Center for Global Health, University of Oregon, Eugene, Oregon, USA
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14
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Zhang J, Li Q, Song Y, Fang L, Huang L, Sun Y. Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis. Front Public Health 2022; 10:1041136. [PMID: 36311562 PMCID: PMC9615144 DOI: 10.3389/fpubh.2022.1041136] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 01/29/2023] Open
Abstract
Background Anemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial. Methods PubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers. Results A total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference < 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy. Conclusions Prevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.
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Affiliation(s)
- Jing Zhang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Quanhong Li
- Kunming Children's Hospital, Kunming, China
- Department of Pharmacy, Children's Hospital of Kunming Medical University, Kunming, China
| | - Ying Song
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Liping Fang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Lei Huang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Yu Sun
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
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15
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Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis. PLoS One 2022; 17:e0267005. [PMID: 35895619 PMCID: PMC9328503 DOI: 10.1371/journal.pone.0267005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background
In Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.
Materials and methods
The published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger’s and Begg’s tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.
Result
After screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.
Conclusion
Almost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.
Registration number
(ID: CRD42020211054).
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16
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Balis B, Dessie Y, Debella A, Alemu A, Tamiru D, Negash B, Bekele H, Getachew T, Eyeberu A, Mesfin S, Eshetu B, Merga BT, Habte S, Yadeta TA. Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia. Front Public Health 2022; 10:867888. [PMID: 35719616 PMCID: PMC9198702 DOI: 10.3389/fpubh.2022.867888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/28/2022] [Indexed: 01/23/2023] Open
Abstract
Background Anemia is a significant public health issue, accounting for 20–40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia. Methods A facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05. Result A total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5–29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia. Conclusion Anemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.
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Affiliation(s)
- Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Bajrond Eshetu
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Sisay Habte
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia.,School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
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17
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Dodzo RC, Ogunsakin RE, Ginindza TG. Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 35532109 PMCID: PMC9082230 DOI: 10.4102/phcfm.v14i1.3339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Anaemia is a global health problem affecting about a third of the world's population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. AIM This study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini. SETTING This study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital. METHODS This cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15-49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis. RESULTS A total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15-19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19-2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15-18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27-25.4) and second trimester (OR: 1.62; CI: 1.02-2.60). CONCLUSION Anaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country's burden of anaemia.
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Affiliation(s)
- Rumbidzai C Dodzo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Ministry of Health.
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18
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Alvarado-Gonzalez JC, Alvis-Zakzuk NR, Castillo-Saavedra DE, Lozada-Martinez ID, Picón-Jaimes YA, Narvaez-Rojas AR, Zakzuk J. Impact of helminthiasis on gestational anemia in low- and middle-income countries: a systematic review and meta-analysis of more than 19,000 women. LE INFEZIONI IN MEDICINA 2022; 31:36-48. [PMID: 36908393 PMCID: PMC9994832 DOI: 10.53854/liim-3101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/25/2023] [Indexed: 03/07/2023]
Abstract
Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational anemia. The aim of this study was to determine if there is a relationship between helminth infection and gestational anemia. A structured review of scientific literature was conducted through active search in the electronic databases MEDLINE® and LILACS® until December 2021, following 2020 PRISMA statement. The studies were reviewed independently by two authors, extracting the most relevant information from each study. Cross-sectional studies, case-control and ecological studies were included, with no date or language limit. Randomized clinical trials were excluded. A total of 38 studies were included in the systematic review. The study populations of all studies belonged to low- and middle-income countries: 28 studies from Africa, 6 from Asia, 3 from Latin America and 1 from Oceania. Overall, the average prevalence of gestational anemia among the included studies was 40% (95% CI 34-46%). Hookworm was the predominant species detected in most studies (19/38; 50%), followed by Ascaris lumbricoides (15/38; 39.5%). Gestational anemia was positively associated with A. lumbricoides (OR 1.86, 95% CI 1.12-3.08) and hookworms (OR 3.09, 95% CI 1.99-4.78). Prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk during meta-regression (p=0.5182). The results of this review indicate that there is a statistically significant association between helminthiasis and gestational anemia. Although hookworm is the main species associated with the outcome, prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk. The impact of other species needs to be defined given the expected bias that arises from polyparasitism when defining comparison groups.
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Affiliation(s)
- Juan Carlos Alvarado-Gonzalez
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
| | | | | | - Ivan David Lozada-Martinez
- Fac Ciències Salut Blanquerna, Univ Ramon Llul, Barcelona, Spain.,Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia
| | | | - Alexis Rafael Narvaez-Rojas
- Division of Breast Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine - Jackson Health System, Miami, FL, USA
| | - Josefina Zakzuk
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
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19
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Dagnaw A, Sahlie M, Mulugeta H, Shine S, Bediru W, Zebene A, Weldetensay Y, Abebe AM. Magnitude of Intestinal Parasite Infection and Associated Factors Among Pregnant Women Attending Antenatal Care Service in Shewarobit Town Health Facilities, North Shoa Zone, Amhara Region, Ethiopia. Infect Drug Resist 2021; 14:4921-4930. [PMID: 34853520 PMCID: PMC8627855 DOI: 10.2147/idr.s338326] [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: 09/14/2021] [Accepted: 11/04/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Intestinal parasites are the most common infectious gastrointestinal parasites in developing countries including Ethiopia. Globally, it remains a public health problem by affecting 3.2 billion people, of which 10% were pregnant women. In Sub-Saharan Africa, pregnant women are the risky group next to children for this infection. This study aimed to assess the magnitude and associated factors of intestinal parasite infection among pregnant women. Methods Facility-based cross-sectional study was conducted among 365 pregnant women attending antenatal care service in Shewarobit town health facilities, North Shoa Zone, Amhara Region, Ethiopia. Data were collected using an interview questionnaire and laboratory microscopic stool examination from February 1, 2020, to March 30, 2020. Descriptive statistics and multivariable analyses were used to characterize the data and to identify the associated factors with the outcome variable at a p-value <0.05, respectively. Results A total of 347 (95.1%) pregnant women participated in this study. The magnitude of intestinal parasite infection was 27.7% during the study period. Among the parasites, G. lamblia and S. mansoni were the most prevalent identified parasites. Pregnant mother, who did not have handwashing practice after using the toilet [AOR: 3.89, 95% CI (1.86–8.13)], had a habit of walking on barefoot [AOR: 5.65, 95% CI (1.72, 18.56)], had uncooked food meal habit [AOR: 5.12, 95% CI (1.24, 21.14)], use of water in unimproved water source [AOR: 3.20, 95% CI (1.11–9.24)], lack of health education [AOR: 4.08, 95% CI (2.01–8.27)], and not dewormed [AOR: 3.09, 95% CI (2.01–7.94)] were predictors for parasitic infection. Conclusion High prevalence of intestinal parasite infection is observed in pregnant women. Personal hygiene practice, health education, and water quality were factors identified as contributors to intestinal parasite infection in pregnant women. Public health measures on water and environmental sanitation, health education for intestinal parasite infection and personal hygiene practices, and early deworming are vital to reduce the intestinal parasites’ infection and assure safe pregnancy.
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Affiliation(s)
- Abinet Dagnaw
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Hailemichael Mulugeta
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Sisay Shine
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Woinshet Bediru
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Asmare Zebene
- Shewarobit Health Center, North Shoa Zone, Amhara Region, Ethiopia
| | | | - Ayele Mamo Abebe
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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20
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Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Pregnant Women Attending Antenatal Care in Yifag Health Center, Northwest Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:7291199. [PMID: 34721748 PMCID: PMC8553486 DOI: 10.1155/2021/7291199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023]
Abstract
Background A cross-sectional study was conducted from November 2019 to March 2020 to determine the prevalence and associated risk factors of intestinal parasitic infections (IPIs) among pregnant women attending antenatal care (ANC) at Yifag Health Center. Methods The data were collected by a questionnaire interview technique and collecting the stool samples from each pregnant woman. Wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 25, and P-values < 0.05 were considered statistically significant. Results Out of the total 280 pregnant women who were selected using a simple random sampling technique, 277 participated in the questionnaire survey and gave stool samples (a response rate of 98.9%). The prevalence of IPIs among pregnant women was 53.4% (95% CI: 47.37, 59.42). Taenia species (18.1%) was the predominant parasite followed by Giardia lamblia (12.6%), Entamoeba histolytica/dispar (9.4%), hookworms (9%), Ascaris lumbricoides (4%), Schistosoma mansoni (3.2%), Hymenolepis nana (0.7%), Strongyloides stercoralis (0.4%), and Enterobius vermicularis (0.4%). Eating raw vegetables (AOR = 2.721; 95% CI: 1.266, 5.849; P=0.010) and poor personal hygiene (AOR = 4.015; 95% CI: 1.456, 11.07; P=0.007) were associated risk factors for G. lamblia, while eating raw meat (AOR = 2.477; 95% CI: 1.252, 4.902; P=0.009) for Taenia species infections. The prevalence of intestinal parasites was high and still a health burden to the pregnant women in the study area. We recommend avoiding eating raw meat, strengthening sanitation and hygiene programs, and routine deworming of pregnant mothers to reduce the burden of IPIs among pregnant women.
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Animaw Z, Melese A, Demelash H, Seyoum G, Abebe A. Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:474. [PMID: 34210260 PMCID: PMC8252203 DOI: 10.1186/s12884-021-03908-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. METHODS Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. RESULTS Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. CONCLUSIONS Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.
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Affiliation(s)
- Zelalem Animaw
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Addisu Melese
- Department of Medical Microbiology, College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habtamu Demelash
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Girma Seyoum
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Abebe
- Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Demeke G, Mengistu G, Abebaw A, Toru M, Yigzaw M, Shiferaw A, Mengist HM, Dilnessa T. Effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia: Institution based prospective cohort study. PLoS One 2021; 16:e0250990. [PMID: 33970934 PMCID: PMC8109803 DOI: 10.1371/journal.pone.0250990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intestinal parasitosis is a common disease that causes misery and disability in poor populations. The number of individuals affected is staggering. From two billion peoples who harbor parasites worldwide, 300 million suffer severe morbidity and more than 25% of pregnant women are infected with hookworm, which causes intestinal bleeding and blood loss, and has been most commonly associated with anemia. Intestinal parasite infection during pregnancy has been associated with iron deficiency, maternal anemia, and impaired nutritional status, as well as decreased infant birth weight. OBJECTIVE This study aimed to assess the effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care in Debre Markos Referral Hospital from December 2017 to February 2019. METHOD A prospective cohort study design was conducted among 94 intestinal parasite-infected pregnant women as an exposed group and 187 pregnant women free from intestinal parasite were used as a control group. The effect of intestinal parasites on hematological profiles of pregnant women was assessed at Debre Markos Referral Hospital antenatal care ward. Socio-demographic data and nutrition status were assessed by using structured questionnaires and mid-upper arm circumference (MUAC), respectively. Two ml of venous blood and 2 gm of stool samples were collected to analyze the hematological profiles and detect intestinal parasites, respectively. Wet mount and formol-ether concentration (FEC) techniques were used to detect intestinal parasites. Hematological profile was analyzed using Mind ray BC-3000 plus instrument. Data were double entered into EpiData version 3.1 software and exported to SPSS version 24 software for analysis. Results were presented using tables and graphs. Associations of hemoglobin levels with intestinal parasitic infections were determined using binary logistic regression models. P≤0.05 was considered statistically significant. The mean hematological profile difference between parasite-infected and parasite-free pregnant women was computed using independent t-test. RESULTS In the present study, the predominant parasites identified were Entamoeba histolytica, hookworm, Giardia lamblia, Schistosoma mansoni, and Ascaris lumbricoides. About 8.2% of intestinal parasite-infected pregnant women had mild anemia while 4% had moderate anemia. Only 1.2% of intestinal parasite-free pregnant women developed moderate anemia. The mean HGB, HCT, MCV, MCH, and MCHC values of intestinal parasite-infected pregnant women were 12.8g/dl, 38.2%, 94.7fl, 33.1pg and 34.7g/dl, respectively. But the mean HGB, HCT, MCV, MCH and MCHC values of pregnant women who were free from intestinal parasites were 14.4 g/dl, 39.8%, 94.9fl, 33.9pg and 35.5g/dl, respectively. Anemia was strongly associated with hookworm (AOR = 21.29, 95%CI: 8.28-54.75, P<0.001), S.mansoni (AOR = 63.73, 95% CI: 19.15-212, P<0.001) and A.lumbricoide (AOR = 14.12, 95% CI 3.28-60.65, P<0.001). CONCLUSION Intestinal parasitic infection in pregnant women caused adverse impact on hematological profiles and was an independent predictor of anemia. Intestinal parasitic infection significantly decreased pregnant the level of HGB, HCT, MCV, MCH, and MCHC values. To minimize maternal anemia deworming could be good before pregnancy.
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Affiliation(s)
- Gebreselassie Demeke
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Getachew Mengistu
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abtie Abebaw
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Milkiyas Toru
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigzaw
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Shiferaw
- Department of Midwifery, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Hylemariam Mihiretie Mengist
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tebelay Dilnessa
- Department of Medical Laboratory Science, College Health Science, Debre Markos University, Debre Markos, Ethiopia
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Liyew AM, Tesema GA, Alamneh TS, Worku MG, Teshale AB, Alem AZ, Tessema ZT, Yeshaw Y. Prevalence and determinants of anemia among pregnant women in East Africa; A multi-level analysis of recent Demographic and Health Surveys. PLoS One 2021; 16:e0250560. [PMID: 33905448 PMCID: PMC8078763 DOI: 10.1371/journal.pone.0250560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/11/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Anemia during pregnancy is a public health problem that leads to different life-threatening complications and poor pregnancy outcomes. So far, the evidence is scarce on pooled prevalence and determinants of anemia during pregnancy in East Africa for integrated intervention. Therefore, this study aimed to assess the prevalence and determinants of anemia among pregnant women in eastern Africa using recent Demographic and Health Surveys. Method Secondary data analysis was conducted using data from recent Demographic and Health Survey datasets from 10 East African countries. A total of 8583 (weighted sample) pregnant women were included in the analysis. The multi-level mixed-effects generalized linear model (Poisson regression with robust error variance) was fitted to identify determinants of anemia. Finally, the adjusted prevalence ratio (aPR) with 95% CI and random effects for the multilevel generalized linear mixed-effects model was reported. Results In this study, the overall prevalence of anemia among pregnant women was 41.82% (95% CI: 40.78, 42.87) with a large difference between specific countries which ranged from 23.36% in Rwanda to 57.10% in Tanzania. In the multi-level analysis, teenage pregnant women (aPR = 1.22;95%CI:1.02, 1.40), unmarried women (aPR = 1.14; 95% CI;1.02,1.28), pregnant women who had unimproved toilet facility (aPR = 1.17;95%CI:1.06,1.27), and those women from countries with high illiteracy level (aPR = 1.12;95%CI; 1.07,1.18) had a higher prevalence of anemia during pregnancy. Conclusion Anemia is still a public health problem in East Africa. Therefore, enabling the households to have improved toilet facilities by strengthening the existing health extension program, reducing teenage pregnancy, and improving the community literacy level is vital to reduce the prevalence of anemia during pregnancy in East Africa.
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Affiliation(s)
- Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, 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 and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
- Department of Human Physiology, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Ness TE, Agrawal V, Bedard K, Ouellette L, Erickson TA, Hotez P, Weatherhead JE. Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2020; 103:1958-1968. [PMID: 32840198 DOI: 10.4269/ajtmh.20-0503] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely to have anemia (combined odds ratio [cOR] 2.55 [2.20, 2.96], P < 0.001). In addition, pregnant woman with hookworm were more likely to have malaria coinfection (cOR 1.60 [1.38, 1.86], P < 0.001). Other effects on maternal and child health were investigated and summarized without systematic review or meta-analysis because of the limited study numbers. Despite current deworming recommendations in pregnant women, heavy hookworm burden, coinfection with malaria, and subsequent anemia persist. Although this is likely due, in part, to a lack of implementation of preventive chemotherapy, additional interventions such as health education, proper waste management, or linking malaria and soil-transmitted helminth treatment and prevention programs may also be needed. Further investigations on maternal-child outcomes as a result of hookworm infection during pregnancy will highlight public health interventional targets to reduce morbidity in pregnant women and children globally.
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Affiliation(s)
- Tara E Ness
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vedika Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn Bedard
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Timothy A Erickson
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Peter Hotez
- Department of Biology, Baylor University, Waco, Texas.,Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas.,National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jill E Weatherhead
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Woldegebriel AG, Gebregziabiher Gebrehiwot G, Aregay Desta A, Fenta Ajemu K, Berhe AA, Woldearegay TW, Mamo Bezabih N. Determinants of Anemia in Pregnancy: Findings from the Ethiopian Health and Demographic Survey. Anemia 2020; 2020:2902498. [PMID: 32566286 PMCID: PMC7293722 DOI: 10.1155/2020/2902498] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 11/20/2022] Open
Abstract
In Ethiopia, anemia during pregnancy is a major public health problem and affects both the mother's and their child's health. There is a scarcity of community-based evidence on determinants of anemia among pregnant women in the country. Therefore, this study aimed to assess the determinants of anemia among pregnant women in Ethiopia. Method. This study was based on the 2016 Ethiopian Demographic Health Survey (EDHS) that used a two-stage stratified cluster sampling technique. A cross-sectional study was conducted among 3080 pregnant women. Data analysis was done using STATA v.14. Variables with P value <0.05 in the bivariate analysis were candidates for the multivariable analysis to identify independent determinants of anemia among pregnant mothers. Odds ratios (OR) were calculated at 95% confidence interval (CI). Results. The overall prevalence of anemia among pregnant women was 41% of which 20% were moderately anemic, 18%, mildly anemic, and 3%, severely anemic. The following were significantly associated with anemia during pregnancy: an age of 30-39 years, receiving no education (AOR = 2.19; 95% CI 1.45, 2.49), belonging to the poorest wealth quintile (AOR = 1.29; 95% CI 1.22, 1.60), being a Muslim (AOR = 1.59; 95% CI 1.69, 2.65), number of house members being 4-6 (AOR = 1.44; 95% CI 1.05, 1.97), number of under-five children being two (AOR = 1.47; 95% CI 1.10, 1.97), head of the household being a female (AOR = 2.02; 95% CI 1.61, 2.54), current pregnancy wanted later (AOR = 1.75; 95% CI 1.23, 1.63), no terminated pregnancy (AOR = 1.49; 95% CI 1.15, 1.93), and an age of 13-17 years at the first sexual intercourse (AOR = 1.97; 95% CI 1.291, 3.00). Conclusions. The study revealed that more than one-third of the pregnant women in Ethiopia were found anemic. Its prevalence varied among regions in which the highest (62.7%) and the lowest (11.9%) were from Somali and Addis Ababa, respectively. Hence, efforts should be made by concerned bodies to intervene in terms of the identified risk factors.
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