Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Hotspot analysis of anaemia among pregnant women in Ethiopia: hotspot analysis of national demographic and health survey data

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.

Determinants of Hemoglobin Among Pregnant Women at Agro-Pastoralist Communities in South Omo Zone, Ethiopia: Community Based Cross-Sectional Study, Nutrition Experience from Movable Community

Background

Low hemoglobin level is the most common public health problem during pregnancy in developing countries including Ethiopia, which is affecting both mother and fetus. However, the determinants of anemia among pregnant women are not well studied.

Objective

To assess the determinates of hemoglobin among pregnant women in rural agro-pastoralist communities in the South Omo zone, Ethiopia.

Method

Community-based cross-sectional study was done in rural agro-pastoralist communities. A multistage stratified sampling technique was used to select 526 pregnant women. Data were collected by using structured questionnaires. Hemoglobin level was measured by using HemoCue ® Hb301. Data were analyzed by using a statistical package for the social science version 26. Descriptive (Mean, standard deviation, frequency, range), bivariate and multivariate analysis was carried out to check the association between lower hemoglobin levels and independent variables. The output is presented in tables and figures.

Result

The mean (±SD) of hemoglobin concentration was 11.8 ± 1.7. The overall prevalence of anemia was 39.9% [95% CI: 35.5, 44.4], 19.4% (95% CI: 16.0, 23.2) was mild, 19.6% (95% CI: 16.27, 2.5) was moderate and 0.9% (95% CI: 0.25, 2.25) was severe anemia. Not taking IFA (AOR = 5.7(3.3, 9.8)), severe under nutrition (AOR = 8.9(2.1, 37.3)), no fish food (AOR = 2.4(1.3, 4.5)), drinking coffee (AOR = 1.6(1.0, 2.6)), moderate food insecurity (AOR = 2.5(1.4, 4.6)), and no malaria infection (AOR = 0.6(0.4, 0.9)) were statistically significant with anemia.

Conclusion

The anaemia is a public health problem in this study area. Therefore, nutrition education and counselling to enhance iron supplementation, dietary diversity and a flesh diets are very essential to enhance haemoglobin levels.

Dietary diversity and iron deficiency anemia among a cohort of singleton pregnancies: a cross-sectional study

BACKGROUND

Iron deficiency anemia (IDA) is considered one of the most common medical disorders observed during pregnancy. In low- and middle-income countries (LMICs), anemia and micronutrients deficiencies among pregnant women are associated with low consumption of animal products, monotonous starchy-diets, and seasonal consumption of vegetables and fruits.

METHODS

A cross-sectional study was conducted with 198 pregnant mothers aged between 19-45 years who visited the antenatal care clinics in Northern Jordan to document the prevalence of IDA and to describe the associations between dietary diversity, diet quality scores and oral iron supplementation with the pregnant women iron status. Participants were stratified into three groups by gestational age (n = 66 women per group). Gestational age, blood parameters, minimum dietary diversity score (MDD-W), and prime diet quality score for healthy (PDQSHF) and unhealthy foods (PDQSUF) were assessed using 24- hour dietary recall.

RESULTS

Prevalence of mild to moderate anemia was 27.8% among pregnant women. Third-trimester pregnant women were most affected. 52.5% have depleted iron stores (ferritin < 15 ng/ml), of them 30.8% have iron deficiency, and 21.7% have IDA. The (M ± SD) of the MDD-W, PDQSHF, and PDQSUF were 4.8 ± 1.6, 12.8 ± 3.9, and 7.2 ± 2.8 respectively. 52.5% achieved the MDD-W, 68% consumed < 4 servings/week of healthy food groups, and 50% consumed > 4 servings/week of unhealthy food groups. Mothers with higher MDD-W and PDQS had higher Hb and serum concentrations. Those taking iron supplements had significantly (p = 0.001) higher means of Hb, serum ferritin, and gestational weight gain. Significant differences were also found between PDQSHF, PDQSUF and the first and third trimester.

CONCLUSIONS

Mild to moderate IDA is prevalent among pregnant mothers, especially in the third trimester. However, the prevalence of IDA among Jordanian pregnant women is lower than the global average. A high-quality, diverse diet, combined with oral iron supplementation and food fortification with iron, will help improve iron status, prevent anemia, and reduce its prevalence.

Anaemia among adolescent girls, pregnant and lactating women in the southern rural region of Bangladesh: Prevalence and risk factors

Anaemia is a major public health concern in developing countries, particularly among children, adolescents, and women of reproductive age. The study aimed to assess the anaemia status among adolescent girls, pregnant, and lactating women with their contributing factors in the southern rural regions of Bangladesh. This cross-sectional study was conducted among 400 adolescent girls, 375 pregnant, and 375 lactating women using a multistage cluster-random sampling technique. Anaemia was measured through haemoglobin concentration in blood capillaries collected with a Hemocue 301 machine. Multinomial logistic regression was used to determine the factors associated with anaemia. The average age of pregnant and lactating women was 24 years and 15.2 years for girls. Overall, the prevalence of anaemia was 50% among pregnant women, 46% among lactating women, and 38% among adolescent girls. The risk of anaemia among adolescent girls was higher among non-Muslim (aOR = 2.13, 95%CI:1.05-4.31), belonged to families having >5 members (aOR = 2.24, 95%CI:1.16-4.31) while exposure to media reduced their risk (aOR = 0.33, 95%CI:0.15-0.74). Pregnant women who consumed a diversified diet, washed their hands after toilet, and received ≥4 ANC visits had a lower likelihood of developing anaemia. Lactating women who were employed, consumed a diversified diet, washed their hands before preparing food, and after toilet, had been exposed to media, received ≥4 ANC visits, and consumed ≥90 IFA, had a lower risk of developing anaemia. However, anaemia was more likely to be associated with lactating women who were non-Muslim (aOR = 3.75; 95%CI:1.26-11.22). The high prevalence of anaemia emphasizes the need to reconsider the existing strategy for the prevention and control of micronutrient deficiencies in Bangladesh.

Multilevel analysis of anemia and associated factors among women of reproductive age (15-49 years) in Liberia: Evidence from the 2019/20 Liberia demographic and health survey data

BACKGROUND

Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia.

METHODS

We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age.

RESULTS

The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97-46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20-24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25-29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30-34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35-39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40-44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45-49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia.

CONCLUSION

In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.

The epidemiology of gestational diabetes, gestation hypertension, and anemia in North Palestine from 2018 to 2020: A retrospective study

BACKGROUND

In Palestine, women face a challenging environment and a demanding lifestyle, which puts them at a higher risk of experiencing complications during pregnancy. This study aimed to examine the risk factors linked with abnormal hemoglobin (Hb) levels, gestational diabetes (GD), and gestational hypertension (GH) among pregnant women. The results was compared between women residing in cities or villages areas and those in refugee camps.

METHODS

Medical records (N = 7889) for pregnant women at primary healthcare centers in the North West Bank were reviewed for sociodemographic and medical data along with the reported fasting blood sugar, hemoglobin, and blood pressure in the first and second trimesters from July 2018 to July 2020. However, only 6640 were included in the analysis as 1249 were excluded for having multiple pregnancy or lost to follow up. Complications and risk factors were defined according to the available global guidelines. Then, descriptive analysis was used to show the percentages of different risk factors and complications among them. The correlation between the several characteristics and variables with these complications was assessed by calculating the odds ratios (OR) using logistic regression. P-values of <0.05 were considered significant.

RESULTS

The prevalence of adolescent pregnancy was the highest among women living in rural areas (9.8%) and grand multigravidity among refugee women (22%). The overall prevalence of anemia was higher in the second-trimester (16.2%) than in the first-trimester (11.2%), with anemic women in the first-trimester being more likely to be anemic in the second-trimester (OR = 8.223, P-value<0.001). Although anemia was less common in the first-trimester among refugees than among women living in urban areas (OR = 0.768, P-value = 0.006), it was more prevalent in the second-trimester (OR = 1.352, P-value<0.001). Moreover, refugee women were at lower risk than women living in urban areas of having GD (OR = 0.687, P-value<0.001) and diabetes mellitus (OR = 0.472, P-value<0.001) in the second-trimester. GH was associated with GD (OR = 1.401, P-value = 0.003) and DM (OR = 1.966, P-value<0.001).

CONCLUSION

The findings of this study provide evidence-based data on the considerable prevalence of pregnancy complications, anemia, GD, and GH among Palestinian pregnant women living in the north of the West Bank. Multi gravida, gestational age, Hb levels, and the type of settings were strong predictors of pregnancy complications. Therefore, a national plan is needed to ensure adequate maternal care for all, especially disadvantaged women, those in rural areas and refugee camps.

Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study

BACKGROUND

Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection.

METHODS

A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis.

RESULTS

The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman's age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy.

CONCLUSIONS

A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.

Inadequate food diversity and food taboo associated with maternal iron deficiency among pregnant women living in slum settlements in Makassar City, Indonesia

BACKGROUND

Anemia in pregnancy is a major public health problem, especially in developing countries. The most common cause is nutritional deficiencies, especially iron deficiency. Adequate nutritional intake from food is essential during pregnancy. Therefore, this study aimed to investigate the relationship between food access and intake patterns with the incidence of iron deficiency among pregnant women living in the slum settlement in Makassar City.

MATERIALS AND METHODS

This research is a sub-study of the Indonesian Birth Cohort Study based in Makassar City. This sub-study used a cross-sectional design and recruited 173 pregnant women in their second and third trimesters using total sampling. All data were collected using a structured questionnaire and recorded using KoboToolbox software. Serum ferritin levels were examined for iron status using the ELISA method at the Microbiology Laboratory Unit at Hasanuddin University Teaching Hospital. The statistical data were analyzed using STATA version 14 with Chi-square analysis and logistic regression.

RESULTS

The prevalence of iron deficiency in pregnant women living in slum settlements in Makassar City was 78%. Logistic regression analysis showed that inadequate food diversity (AOR: 2.58; 95% CI: 1.17-5.69; P = 0.019) and food taboos (AOR: 2.81; 95% CI: 1.26-6.26; P = 0.011) were significantly associated with the incidence.

CONCLUSIONS

Most pregnant women living in slum settlements in Makassar City experienced iron deficiency. Pregnant women who experience iron shortages have been connected to food taboos and dietary diversity.

Knowledge, prevalence and factors associated with anaemia among women of reproductive age in Tamale Metropolis, Ghana: A cross-sectional study

INTRODUCTION

Anaemia is a global public health concern. Anaemia in women of reproductive age has negative outcomes on their health and reproduction.

OBJECTIVE

This study assessed the knowledge, prevalence and associated factors of anaemia among non-pregnant and non-lactating women of reproductive age in Northern Ghana.

DESIGN

This is a cross-sectional study.

METHOD

A systematic random sampling was used to select 317 participants from the Tamale Metropolis. A semi-structured questionnaire was used to collect data on the sociodemographic, knowledge level of anaemia and iron foods. Haemoglobin levels were determined using URIT-12. Haemoglobin status was classified according to the World Health Organization standards. Descriptive statistics and chi-square were used in the statistical analysis.

RESULTS

The mean age (SD) of participants was 26.4 ± 6.9. A large proportion (68.8%) of the women had knowledge about anaemia, and the source of information was mainly health professionals (56.4%). More than half of the participants knew of the symptoms (80%), causes (83.9%), prevention measures (81.2%), consequences of anaemia (64.2%) and iron-rich food sources (76%). A greater share of the participants, however, had no knowledge of both iron-enhancing foods (53.7%) and iron-inhibiting foods (51.8%). The prevalence of anaemia was high generally (63.1%) and was highest among females at the tertiary institutions (43%) and who were single (60.5%). A significant association existed between income status and haemoglobin status (χ2 = 6.3, p = 0.044).

CONCLUSION

The majority of participants knew about anaemia; however, they had limited knowledge of iron-enhancing and inhibiting foods. The prevalence of anaemia was high among women of reproductive age. Integrating economic empowerment and nutrition education with the inclusion of iron-enhancing and iron-inhibiting foods could help to reduce the high prevalence of anaemia among women of reproductive age.

Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study

INTRODUCTION

Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan.

OBJECTIVE

The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group.

DESIGN

A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years.

METHOD

The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed.

RESULTS

In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia.

CONCLUSION

The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.

Persistence of a high prevalence of anemia in rural areas among pregnant women in Burkina Faso. A cross-sectional study

Despite WHO recommendations to reduce the global prevalence of anemia among women of reproductive age by 2025, anemia remains a truly global public health problem, especially among pregnant women. The objective of our study was to examine the relationship between anemia and the place of residence in pregnant women. This cross-sectional study was conducted in six health facilities between December 2018 and March 2019. Anemia was diagnosed using HemoCue HB 301 and a hemoglobin concentration <11 g/dl was classified as anemic. Adjusted logistic regression analysis was performed to examine relation between anemia and the place of residence in pregnant women. A total of 1027 pregnant women were included in the study. The average age of females was 25.79±6.02 years. The prevalence of anemia was 57.2% (585/1023). In logistic regression analysis adjusted for age, wealth, education and parity, women living in rural areas were more likely to be anemic compared to women living in urban areas (ORa=1.33; 95% CI [1.01-1,74]. Rural women are more likely to be anemic. Strategies to prevent anemia among pregnant women need to be strengthened in rural areas.

Approaches to Address the Anemia Challenge

Anemia is a multifactorial condition; approaches to address it must recognize that the causal factors represent an ecology consisting of internal (biology, genetics, and health) and external (social/behavioral/demographic and physical) environments. In this paper, we present an approach for selecting interventions, followed by a description of key issues related to the multiple available interventions for prevention and reduction of anemia. We address interventions for anemia using the following 2 main categories: 1) those that address nutrients alone, and, 2) those that address nonnutritional causes of anemia. The emphasis will be on interventions of public health relevance, but we also consider the clinical context. We also focus on interventions at different stages of the life course, with a particular focus on women of reproductive age and preschool-age children, and present evidence on various factors to consider when selecting an intervention-inflammation, genetic mutations, nutrient delivery, bioavailability, and safety. Each section on an intervention domain concludes with a brief discussion of key research areas.

Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta-analysis

Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta-analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random-effects meta-analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta-analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66-2.65), while that for low birth weight was 2.04 (95% CI, 1.46-2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68-17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95-3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19-4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29-2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food-based dietary guidelines, should be strengthened.

Sociodemographic factors associated with anemia among reproductive age women in Mali; evidenced by Mali malaria indicator survey 2021: spatial and multilevel mixed effect model analysis

INTRODUCTION

Anemia is a severe global public health problem that threatens human health as well as social and economic development in both developing and developed nations. Anemia is a significant public health issue because; it affects people from all backgrounds. Anemia affected about one-third of non-pregnant women, 41.8% of pregnant women, and more than a quarter of the world's population. Any stage of a woman's life might result in anemia, due to physiological factors, infections, hormonal imbalances, pregnancy related complications, genetic factors, nutritional deficiency and environmental factors. Mali is a developing country with substantial anemia prevalence, particularly in the developing areas. In order to reduce anemia among women of reproductive age, the Mali government worked to enhance preventative and integrative interventions. One of the government's objectives is to reduce the prevalence of anemia in order to decrease maternal and infant mortality and morbidity.

METHODS

Secondary data analysis was conducted using data from Mali Malaria Indicator Survey 2021 datasets. The study comprised a total of 10,765 reproductive-age women. Spatial and multilevel mixed effect analysis, chi-square, bivariate and multivariate logistic regression were employed on determinant factors of anemia among reproductive age women in Mali. Finally, the percentage and odd ratio, its 95% confidence intervals, and the result of spatial analysis were reported.

RESULTS

This study includes a total weighted sample of 10,765 reproductive-age women from Mali Malaria Indicator Survey 2021. The prevalence of anemia was 38%. Of them, 1.4%, were severely anemic, while 23.5% and 13.1% were moderately and mildly anemic, respectively in Mali. In the spatial analysis, the spatial distribution of anemia showed that a higher proportion of anemia found in southern and south west region of Mali. The northern and north east region of Mali had a low of proportion of anemia. being youngest age [20-24] years [ AOR = 0.817; 95% CI = (0.638,1.047); P = 0.000], attending higher education [AOR = 0.401; 95% CI= (0.278,0.579); P = 0.000], being male headed household [AOR = 0.653; 95% CI= (0.536,0.794); P = 0.000] and being richest [AOR = 0.629; 95% CI= (0.524,0.754) P = 0.000] were protective factors for anemia among reproductive age women. In contrast to this, living in rural area [ AOR = 1.053; 95% CI = (0.880,1.260); P = 0.000], being animist religion follower [AOR = 3.10; 95% CI= (0.763,12.623) P = 0.04], using unimproved drinking water sources [AOR = 1.117; CI= (1.017,1.228); P = 0.021} and using unimproved toilet facility [AOR = 1.018; CI= (0.917,1.130); P = 0.041} were considered as the risk factors for anemia among reproductive age women.

CONCLUSION

In this study, anemia was linked to socio-demographic characteristics, and there were regional variations in the frequency of anemia among women of reproductive age. The most important measures to prevent anemia among women of reproductive age in Mali included empowering women to have higher levels of education, raising the wealth index, rise in awareness of improved drinking water sources and toilet facilities, spreading anemia education through religiously acceptable routes, and using an integrated approach to prevention and intervention in high-prevalent regions of the country.

Prevalence of anemia and associated factors in a Moroccan population from the Northwestern region of Morocco (M'diq-Fnideq-Martil Prefecture)

Introduction

anemia remains a major public health challenge worldwide, frequently having multifactorial causes and wide-ranging, largely underestimated repercussions. The purpose of this paper is to assess the prevalence of anemia and identify associated factors in a group of children, adults, and pregnant women.

Methods

our sample consisted of a total of 1360 volunteers (group I: 410 school-aged children aged 5-11 years; group II: 533 adults aged 16 to 65 years; group III: 417 pregnant women aged 17 to 45 years) randomly selected from different towns of the M'diq-Fnideq prefecture, Morocco from March 2018 to September 2018. Data on socio-demographic, anthropometric, and dietary status were collected from a questionnaire survey. A complete blood count was performed using a hematology analyzer, Sysmex KX21N® (Sysmex Corporation, Kobe, Japan), in the hematology laboratory of the Mohamed VI Hospital of M'diq.

Results

anemia was found in 31% of children, 52.4% of adults, and 22.5% of pregnant women. Microcytic hypochromic anemia was the most dominant type of anemia in children, adults, and pregnant women with percentages of 40.6%, 48.7%, and 43.5%, respectively. Mild anemia was much more common than moderate and severe anemia in all groups. Furthermore, anemia was associated with low socioeconomic and educational levels in adults (22.8% versus 27.9%) and pregnant women (18.1% versus 16.8%). Schoolchildren with illiterate parents and low socioeconomic levels are the most affected by anemia, with a prevalence of 75% and 69.44%, respectively. Also, children with insufficient stature are at a high risk for anemia compared to children of normal stature (p<0.001). As for weight for age, the odds ratio (OR) was 4.32. A significant difference between underweight and anemia was revealed (p<0.001). A frequency of meat product, vegetables, and fruit consumption lower than 1.5 times per week increases the risk of anemia in schoolchildren.

Conclusion

these findings showed a significant prevalence of anemia in all study groups associated with socioeconomic, anthropometric, and nutritional factors. However, further studies are needed to focus on interventions and etiologies in order to limit potential complications, especially in schoolchildren and pregnant women.

Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data

BACKGROUND

The common cause of anemia in the general population is iron deficiency. Anemia is adversely affecting women of reproductive age and child health which in turn results in increased morbidity and maternal death, and also hamper social-economic growth. Reproductive women are more prone to anemia due to inadequate dietary intake and iron loss during menstruation and pregnancy.

OBJECTIVES

This study examined the level and trend of anemia prevalence among the socially disadvantaged group (SC&ST, OBC) of women as compared to the other women (general) and identified the main responsible factors behind this.

DATA AND METHODS

The data for this analysis has been taken from three rounds of National Family Health Survey (NFHS) conducted during 2005-2006 (NFHS 3), 2015-16 (NFHS 4) and 2019-21 (NFHS 5). Univariate and bivariate analyses were used to assess the level of anemia among reproductive age group women of different social groups. The regression model represents the relative risk of different confounding factors on the occurrence of anemia. GIS technique used for graphical representation of anemia prevalence rate among different social groups of women in different states of India.

RESULT

In India more than 15 states belong to the high prevalence (>%55) of anemia among socially backward groups in 2019-21. The anemia prevalence was high (>55%) in all social groups (SC & ST, OBC, general) observed in 7 states in NFHS-3, 4 in NFHS-4 and 11 states in NFHS-5. The overall result reveals that the SC&ST women were more prone to any anemia than OBC and general women and the prevalence rate slightly increased from 2005-06 to 2019-21. Among all variables, economic status dominantly controls the anemia level in all social groups. Anemia prevalence of the poor and poorest group of general women were much worse than the women of richer and richest groups of SC&ST, OBC. The odds of women having anemia were lower among higher educated and urban women as compared to the non educated and rural women, irrespective of social group. The prevalence of anemia decreases with increased age of women and increases with the number of child bearing. All differences were statistically significant.

CONCLUSIONS

The problem of iron deficiency remains a major issue in India, where the majority of the states (eastern, north-eastern and central) suffer from high anemia prevalence rate and it increases over time. It is observed that multiple socio-demographic factors ranging from poor economic and educational status, rural residence to higher childbearing of women are responsible for predicting anemia levels among the social groups of women in India. To eradicate this problem India should improve women's overall nutrition status and their income. Meanwhile, GOI should be more focused on the existing policies related to anemia and on their actual implementation on grassroots level.

The effect of dietary patterns on maternal anaemia in North Shewa, Ethiopia: A case-control study with Propensity Score Analysis

OBJECTIVE

This study aimed to assess the effect of dietary patterns during pregnancy on anaemia.

DESIGN, SETTING AND PARTICIPANTS

A case-control study with propensity score analysis was conducted among pregnant women selected from five health facilities in North Shewa Zone, Ethiopia from November 2018 to March 2019. A multivariable conditional logistic regression model was applied after propensity score matching to assess the effect of dietary patterns on anaemia, and a p < 0.05 was taken as significant. Four hundred and seventeen pregnant women were included (105 cases and 312 controls) with a 1:3 case-to-control ratio. Cases were pregnant women with a haemoglobin level <11 gram/Deci litter (g/dL), and controls were pregnant women with a haemoglobin level ≥11.0 g/dL.

RESULTS

A low dietary diversity score (adjusted odd ratio (AOR) = 2.14; 95% confidence interval (CI): 1.24, 3.69), reducing food intake (AOR = 6.89; 95% CI: 3.23, 14.70) and having no formal education (AOR = 3.13; 95% CI: 1.18, 8.32) were associated with higher odds of anaemia among pregnant women.

CONCLUSIONS

During pregnancy, intake of a low diversified diet, reduced food intake and low educational status were associated with higher odds of anaemia. Dietary counselling should be emphasised and strengthened in the existing prenatal health service program, with women strongly encouraged to increase their diversified food intake instead of reducing it during pregnancy.

Determinants of anemia among women of childbearing age: analysis of the 2018 Mali demographic and health survey

BACKGROUND

Anemia occurs at all stages of life and it is of public health concern as it serves as an indicator of quality nutrition and health of a society. Almost one third of the global prevalence of anemia occur among reproductive aged women and almost 40% of these women reside in sub-Saharan Africa including Mali. This study, therefore, sought to assess the determinants of anemia among women of childbearing age in Mali.

METHODS

Secondary data analysis of the 2018 Mali Demographic and health Survey (MDHS). Anemia in women was the outcome variable for the study. Data of 5,048 women aged 15-49 was used for the study. Using binary and multivariate logistic regression models, factors associated with anemia among women were identified. The analysis was conducted using Stata version 14.2 software and adjusted Odds Ratio (aOR) with a 95% Confidence Interval (CI) and p-value < 0.05 were used to see the significant association.

RESULTS

The prevalence of anemia among women of childbearing age in Mali is 63.5%. Of these, 4.3% and 24.9% were severely and mildly anemic respectively, and the rest 34.3% were moderately anemic. Women who had secondary education (aOR = 0.70, 95% CI: 0.58-0.84), overweight (aOR = 0.63, 95% CI: 0.50-0.81), exposure to mass media (aOR = 0.90, 95% CI = 0.76-1.49) and women with two births (aOR = 0.86, 95% CI = 0.71-1.05) were less likely to be anemic. Likely, richest wealth quintile (aOR = 0.73, 95% CI = 0.51-1.05), living in urban setting (aOR = 0.85, 95% CI = 0.70-1.03) and women in Kidal Region (aOR = 0.42, 95% CI = 0.27-0.65) were less likely to be anemic. However, pregnant women, women covered by health insurance, women with unimproved drinking water, women in communities with low literacy and low socioeconomic status had higher odds of anemia.

CONCLUSION

These findings point to the need for community and household level public health sensitization interventions to highlight the pro-anemic factors and mitigating strategies. More especially, women with no education, pregnant women, women covered by health insurance, women from communities with low literacy and socioeconomic status ought to be the focus of such interventions.

Spatial distribution and trends of anemia among pregnant women in Ethiopia: EDHS 2005-2016

Background

Anemia is a public health problem affecting both developed and developing nations worldwide with a significant consequence on health and economic growth. The problem is more severe in pregnant women. Hence, the main purpose of this study was to determine the factors of anemia levels among pregnant women in zones in Ethiopia.

Methods

We utilized data from 2005, 2011, and 2016 Ethiopian demographic and health survey (EDHSs), a population-based cross-sectional study. The study includes 8,421 pregnant women. An ordinal logistic regression model with spatial analysis was used to explore factors of anemia levels among pregnant women.

Result

About 224 (2.7%), 1,442 (17.2%), and 1,327 (15.8%) pregnant women were mild, moderate, and severely anemic, respectively. The spatial autocorrelation of anemia among the administrative zones of Ethiopia for the three consecutive was not significant. The middle wealth index of 15.9% (OR = 0.841, CI: 0.72-0.983) and richest wealth index of 51% (OR = 0.49, CI: 0.409-0.586) were less likely anemic compared to the poorest wealth index, age group of mother 30-39 was 42.9% (OR = 0.571, CI: 0.359-0.908) times less likely to be moderate and above anemic compared to <20 years, several household members 4-6 were 51% (OR = 1.51, CI: 1.175-1.94 more likely moderate and above anemic compared to 1-3.

Conclusion

Over one-third of the pregnant women (34.5%) were anemic in Ethiopia. Wealth index, age group, religion, region, number of household members, source of drinking water, and EDHS were significant factors in anemia levels. The prevalence of anemia among pregnant women varied among Ethiopian administrative zones. North West Tigray, Waghimra, Oromia special woreda, West shewa, and East shewa were a high prevalence of anemia.

The interaction between age and parity on adverse pregnancy and neonatal outcomes

Background

Although age and parity are recognized as associated factors for adverse pregnancy outcomes, there are no studies exploring the interaction between the two during pregnancy. This study aimed to investigate the impact of the interaction between age and parity on adverse pregnancy outcomes.

Methods

This was a retrospective cohort study with 15,861 women aged ≥20 years. All women were grouped according to age, parity, and a mix of the two. The data were analyzed using multivariate logistic regression analysis.

Results

Age, parity, and interaction between the two were related with the risk of gestational hypertension, eclampsia/pre-eclampsia, placenta previa, placental implantation, postpartum hemorrhage, preterm birth, cesarean section, and Apgar score <7 within 5 min of birth. The risk of gestational diabetes mellitus and transfer to the neonatal unit was linked with age and the interaction between age and parity, but the impact of parity was not statistically significant. The risk of anemia, placental abruption, premature rupture of the membrane, oligohydramnios, and macrosomia was only associated with parity; the risk of fetal distress was only associated with age.

Conclusion

The interaction between advanced age and parity might results in more adverse outcomes for both puerpera and infants, necessitating additional prenatal screening and health education throughout pregnancy.

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

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.

The geo-spatial perspective of biological, social and environmental determinants of early pregnancy anaemia in rural Sri Lanka: Need for context-specific approaches on prevention

We provide a novel approach to understanding the multiple causations of maternal anaemia in a geospatial context, highlighting how genetics, environment and socioeconomic disparities at the micro-geographical level lead to the inequitable distribution of anaemia. All first-trimester pregnant women registered for the antenatal care programme in Anuradhapura District, Sri Lanka from July to September 2019 were invited to the Rajarata Pregnancy Cohort (RaPCo), which assessed the prevalence of anaemia in early pregnancy. The combination of the prevalence of anaemia and minor haemoglobinopathy-related anaemia (MHA) with the poverty headcount index of the 22 health divisions in the district was investigated using GeoDa spatial K-means clustering. Sociodemographic and economic data at the divisional level were compared between identified clusters. Combining the analysis with the geographical and environmental characteristics of the region, further hypotheses regarding anaemia in this community were formulated. The study included data from 3,137 pregnant women in early pregnancy. The anaemia and MHA prevalence varied from 13.6 to 21.7% and from 2.6% to 5%, respectively. We identified four distinct spatial clusters. The cluster with the highest anaemia prevalence also included high poverty and the highest prevalence of MHA. The clusters had significant differences with regard to ethnic distribution, access to water, sanitation and dietary patterns. Areas supplied by major irrigation projects had significantly low levels of anaemia, probably attributable to internal migration and improved livelihood. It was evident that genetic, socioeconomic and environmental risk factors were grouped at the divisional level, and that their complex interactions make controlling anaemia with blanket interventions unsuccessful. Analysis of the distribution of heterogeneous risk factors at the micro-geospatial level helped identify context-specific approaches to tackle anaemia in pregnancy.

Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis

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.

Relationship between active Helicobacter pylori infection and anemia, iron deficiency, iron deficiency anemia: A cross‐sectional study in a sub‐Saharan setting

Background and Aim

There have been contradictory reports about the association between Helicobacter pylori infection and iron deficiency anemia (IDA). Based on the high frequency of H. pylori infection in Cameroon, we have evaluated the frequency of H. pylori infection as the cause of anemia, and IDA among dyspeptic patients in Cameroon.

Methods

This cross‐sectional study enrolled 842 dyspeptic patients (472 women and 370 men) in two reference hospitals in Douala‐Cameroon. Each participant gave a written consent, and the study was approved by the National Ethical Committee. Erythroid‐related indices and markers of iron deficiency (ID) measurement were done for each participant as well as H. pylori detection. Data were analyzed using SSPS statistical package.

Results

The prevalence of anemia, ID, IDA, and H. pylori infection was 65.08%, 31.47%, 25.65%, and 80.88%, respectively. H. pylori infected individuals had a significantly lower mean value of hemoglobin (P = 0.01), hematocrit (P = 0.04), ferritin (P = 0.03) and coefficient of transferrin saturation (CTS) levels (P = 0.04) and a significantly higher mean value of mean corpuscular hemoglobin concentration (MCHC) (P = 0.02). Compared with H. pylori non‐infected participants, H. pylori infected patients were 1.2938 (95% confidence interval [CI]: 0.9087–1.8421), 1.1851 (95% CI: 0.8122–1.7292), and 1.5636 (95% CI: 1.0206–2.3953) times at higher risk to develop anemia, ID, and IDA, respectively. A significant relationship was found between H. pylori infection and IDA (P = 0.04 and 0.04 for crude and age/sex‐adjusted, respectively).

Conclusion

H. pylori infection seems to be associated with anemia, and IDA among dyspeptic patients in our milieu.

Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis

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).

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia

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.

Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis

BACKGROUND

Anemia is one of the most critical health conditions affecting people worldwide. The disease is silent, with a slow progression and a few physical symptoms. Anemia during pregnancy carries the risk of premature birth, low birth weight, and fetus malformations and can impose additional costs on society and families. Therefore, the aim of this study is to conduct a systematic review and meta-analysis on the prevalence of anemia in pregnant women worldwide.

METHODS

In this work, we have conducted a systematic review and meta-analysis of the studies that have examined the prevalence of anemia in pregnant women globally. The Google Scholar, Cochrane, ScienceDirect, Medline (PubMed), and Web of Science (WoS) databases were searched for articles published between 1991 and 2021. The search keywords were anemia, pregnancy, prevalence, and meta-analysis. In order to analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies was examined using the I² index. Data analysis was performed within the Comprehensive Meta-Analysis software (Version 2).

RESULTS

The search resulted in 338 deduplicated studies, of which 52 studies with a total sample size of 1,244,747 people were included in this review. According to the results of the meta-analysis, the overall prevalence of anemia in pregnant women is 36.8% (95% confidence interval: 31.5-42.4%). The highest prevalence of anemia is mild at 70.8 (95% CI 58.1-81) and highest in the third trimester of pregnancy with the prevalence of 48.8 (95% CI 38.7-58.9), while the highest prevalence of anemia in pregnant women was in Africa with the prevalence of 41.7 (95% CI 32.3-49.4).

CONCLUSION

The results of this study show a high prevalence of anemia among pregnant women worldwide, and the highest of this prevalence is mild anemia. The prevalence of anemia in the third trimester was higher than in the first and second trimesters. Anemia in pregnant women in developing countries is significantly higher than in developed countries due to pregnancy's economic, sociological, and health factors.

Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini

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.

Effectiveness of Health Information Package Program on Knowledge and Compliance among Pregnant Women with Anemia: A Randomized Controlled Trial

Despite the availability of iron supplements during pregnancy for all pregnant women receiving antenatal care in Saudi Arabia, anemia remains to be a global public health concern leading to adverse maternal, fetal, and neonatal effects. We aimed to evaluate the effectiveness of the Health Information Package Program on the knowledge anemic pregnant women had about anemia, their compliance with iron and folic acid supplementation, and their hemoglobin levels. A single-blind randomized controlled trial was carried out in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines between January and May 2021. Pregnant women (n = 196) aged 18–45 years old and diagnosed with anemia during the first trimester of their pregnancy were randomly assigned into two groups: the intervention group (Health Information Package Program plus routine care, n = 98) and the control group (routine care only, n = 98). Knowledge, the ability to select appropriate food, and hemoglobin levels were assessed at baseline and after three months, while compliance with iron and folic acid supplementation was also measured at the end of three months. This study indicated that the post-education mean knowledge score, food selection ability score, compliance rate, and hemoglobin level were significantly higher for the intervention group than for the control group. The Health Information Package Program with regular follow-ups using the WhatsApp platform was an effective educational intervention for anemic pregnant women.

Severe Maternal Outcomes and Quality of Maternal Health Care in South Ethiopia

Objective

To assess the incidence of severe maternal outcomes (SMO) and quality of maternal health care in south Ethiopia.

Methods

A facility-based prospective study was conducted in three hospitals among all women who presented while pregnant, during and after childbirth between 12 July and 26 November 2018. Participants were followed from the time of admission to discharge. The World Health Organization (WHO) maternal near-miss (MNM) approach was used to assess SMO indicators and quality of maternal health care.

Results

Of 2880 live births, 315 had potentially life-threatening conditions and 108 had SMOs (90 MNM and 18 maternal deaths). The SMO incidence ratio was 37.5 per 1000 live births (95% CI 30.6–44.4) and MNM incidence ratio was 31.3 per 1000 live births (95% CI 24.9–37.7). The ratio of near-miss to maternal deaths was 5:1. The hospitals’ maternal mortality ratio (MMR) was 625 per 100,000 live births. Most (82.1%) SMO cases were referred from other health facilities. The most common cause of SMO was eclampsia (37%) followed by postpartum haemorrhage (33.3%). The highest mortality index (MI) was among women with sepsis (27.3%). The intensive care unit (ICU) admission rate was 13% for women with SMO and 83.3% of maternal deaths occurred without ICU admission.

Conclusion

The SMO ratio was comparable to other studies in the country. Most women with SMO were referred from other health facilities, which demonstrate the presence of the first delay (seeking care) and/or the second delay (reaching care) in the study area. The study suggests that effectively using the ICU, reducing delays, and improving the referral system may reduce SMO and improve the quality of care in the hospitals. Furthermore, continuous reviewing of SMO is needed to learn what treatment was given to women who experienced complications in the hospitals.

Impact of helminthiasis on gestational anemia in low- and middle-income countries: a systematic review and meta-analysis of more than 19,000 women

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.

Prevalence and determinants of Anemia among pregnant women in sub-Saharan Africa: a systematic review and Meta-analysis

BACKGROUND

Anemia is one of the world's leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was carried out very prudently in order to give up the pooled prevalence and determinants of anemia in Sub-Saharan Africa.

METHODOLOGY

To carry out this ephemeral systematic review and meta-analysis, a correlated literature review was done from various sources, PubMed Medline and Google Scholar Journals. Anemia related searching engine was used to make the study more evocative and intensive. We used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to evaluate the quality of the study in relations of their inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was tracked to conduct this study. The pooled effect size was computed using the review manager and Compressive Meta-analysis software.

RESULTS

Twenty-fife studies, which encompassed 15,061 pregnant women, were chosen for the analysis. From those an overall prevalence of anemia in pregnancy in SSA was 35.6%. However, the result from meta-analysis showed that women who were infected with intestinal parasite were 3.59 times more likely to develop anemia compared to those who were not infected [OR:3.59, 95% CI (2.44,5.28)].The result showed that women who had no iron and folic-acid supplementation were 1.82 times more likely to develop anemia compared to those women who had iron and folic-acid supplementation {OR:1.82, 95% CI (1.22,2.70]. Women who had women were in third trimester pregnancy were 2.37 times more likely to develop anemia compared to those who were in first and second trimester [OR:2.37, 95% CI (1.78, 3.24)]. Women who had low dietary diversity score were 3.59 times more likely to develop anemia compared to those who had high dietary diversity score [OR: 3.59, 95% CI (2.44, 5.28].

CONCLUSIONS

Our finding from this systematic review and meta-analysis displays the high case in prevalence of anemia among pregnant women in Sub-Saharan Africa. Predictors for this includes: intestinal parasite, iron and folic-acid supplementation, third trimester pregnancy and dietary diversified intake score were statistically correlated positively with anemia in pregnancy. These need cautious evaluation of impact of prevention effort for operational policy, programs and design nutrition intrusions for refining maternal food consumption during pregnancy. Also, dietary education intrusion requires to be prearranged to satisfy the desires of pregnant women. The finding of this work will be used as an evidences for policy makers of Africa; entirely for maternal and child health care. Lastly, we suggested further investigations to be carried out in the area of the study for more rigorous and comprehensive recommendations.

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

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.

The Burden of Anemia in Pregnancy Among Women Attending the Antenatal Clinics in Mkuranga District, Tanzania

Introduction: The burden of anemia in pregnancy is of global health importance. Tanzania is no exception. Its effects vary from one region to another due to the differing causes. Overall, it is a significant cause of maternal mortality. This study sought to assess the prevalence and factors associated with anemia among pregnant women attending the antenatal clinic (ANC) in the Mkuranga district of the Pwani region of Tanzania. Methodology: This cross sectional study was conducted among 418 pregnant women aged 15-49 years attending the Mkuranga District Hospital and Kilimahewa Health Center. The outcome variable of interest was anemia in pregnancy defined as a hemoglobin concentration of 11 g/dl or less. Data was collected using face-to-face interviews with a standardized pretested questionnaire, and through blood samples collected for hemoglobin testing. Descriptive analysis was used to determine the prevalence of anemia while multiple logistic regression was used to determine factors associated with anemia in pregnancy. Results: Anemia was prevalent among 83.5% of pregnant women attending the two major ANCs in Mkuranga district. Categorically, the hemoglobin of 16.3% of the included women was normal, 51.9% had moderate anemia, 24.4% had mild anemia, and 7.2% had severe anemia. Factors associated with anemia included being in the third trimester (AOR = 2.87, p = 0.026), not consuming vegetables (AOR = 2.62, p = 0.008), meat (AOR = 2.71, p = 0.003), eggs (AOR = 2.98, p = 0.002), and fish (AOR = 2.38, p = 0.005). The finding of unadjusted analysis revealed that women with inadequate minimum dietary diversity were having significantly greater odds of being anemic as compared with those with adequate dietary diversity (OR = 1.94, P = 0.016). Conclusion: More than 80% of pregnant women attending ANC in Mkuranga districts were anemic. Such unprecedented burden of anemia is associated with several factors, which include poor dietary practices such as not consuming iron-rich foods, for example vegetables, meat, eggs, and fish. Women in their third trimester were also more likely to suffer from anemia. This unprecedented burden of anemia in pregnancy can be addressed if efforts to improve feeding practices and early monitoring at the ANCs are sustained.

Determining Prevalence of Anemia and Its Associated Factors in Cameroon: A Multilevel Analysis

Background

Anemia constitutes a major public health concern, which is associated with maternal and perinatal mortality. In low- and middle-income countries, the burden of anemia is profoundly high. Cameroon, as one of the low- and middle-income countries, has a disproportionate anemia burden. Factors associated with anemia prevalence are largely unknown in Cameroon. Hence, we determined the prevalence of anemia and its individual/household and community-level factors among adult women in Cameroon.

Methods

We derived data from the 2018 Cameroon Demographic and Health Survey for analysis in this study. Using the Stata version 14 software, univariate multilevel logistic regression analysis was used to select variables that had significant association with anemia at p < 0.05. Statistically significant variables were included in a multivariable multilevel logistic regression modelling to examine their associations with anemia. Results were reported using adjusted odds ratios (AOR) with their respective 95% confidence interval (CI).

Results

A total of 6,809 women aged 15-49 years were involved in this study with a mean age 30 ± 11.87 years. Approximately two-fifths of women were anemic. Of them, 0.8% were severely anemic, while 17.4% and 21.5% were moderately and mildly anemic, respectively. Current employment status (yes AOR = 0.77, 95% CI; 0.61-0.96) and parity (1-2 children AOR = 0.61, 95% CI; 0.44-0.86) were the main individual level factors associated with anemia, whereas region (Douala region AOR = 2.65, 95% CI; 1.61-4.36, North-West region AOR = 0.53, 95% CI; 0.28-0.99) was the community-level factor associated with anaemia.

Conclusion

Empowerment of women through employment opportunities as well as focusing special attention in region where high prevalence of anemia could be crucial to decrease the burden of anemia and related maternal and perinatal mortality in the country.

Nutritional and Obstetric Determinant of Iron Deficiency Anemia among Pregnant Women Attending Antenatal Care Services in Public Health Hospitals in Abidjan (Côte d'Ivoire): A Cross-Sectional Study

Poorly diversified and micronutrient-deficient dietary intakes during pregnancy remain one of the major causes of nutritional anemia in developing countries. However, data on diet and its relation to anemia in pregnant women in Côte d'Ivoire are scarce. The objective of this study was to determine prevalence and iron deficiency anemia associated factors in pregnant women in Abidjan. A cross-sectional study was conducted among 389 pregnant women attending antenatal care services at public health hospitals in Abidjan. Sociodemographic, obstetrical, and dietary data were collected. Blood samples taken by venipuncture were analyzed for hemoglobin and iron biomarkers. Data were subjected to descriptive statistics and multivariate logistic regression. 47.8% of the pregnant women tested were anemic, 25.8% and 30.4% had iron deficiency and iron deficiency anemia, respectively. Based on AORs, the second and third trimesters of pregnancy (6.04 v 4.18, respectively), multiparity (13.18), skipping meals (3.05), inadequate energy (5.369), protein (2.74), and vitamin C (2.43) intakes and low dietary diversity (8.35) are the independent and significant determinants of iron deficiency anemia. The high prevalence of anemia among pregnant women in Abidjan reveals a real public health problem. Iron deficiency anemia is due to multiparity, gestational age, inadequate intake, low dietary diversity, and skipping meals.

Association of gestational anemia with pregnancy conditions and outcomes: A nested case-control study

BACKGROUND

Gestational anemia is a serious public health problem that affects pregnant women worldwide. Pregnancy conditions and outcomes might be associated with the presence of gestational anemia. This study investigated the association of pregnancy characteristics with anemia, exploring the potential etiology of the disease.

AIM

To assess the association of pregnancy parameters with gestational anemia.

METHODS

A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project (CPWCS-PUMC). A total of 3172 women were included. Patient characteristics and gestational anemia occurrence were extracted, and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.

RESULTS

Among the 3172 women, 14.0% were anemic, 46.4% were 25-30 years of age, 21.9% resided in eastern, 15.7% in middle, 12.4% in western 18.0% in southern and 32.0% in northern regions of China. Most women (65.0%) had a normal prepregnancy body mass index. Multivariable analysis found that the occurrence of gestational anemia was lower in the middle and western regions than that in the eastern region [odds ratio (OR) = 0.406, 95% confidence interval (CI): 0.309-0.533, P < 0.001)], higher in the northern than in the southern region (OR = 7.169, 95%CI: 5.139-10.003, P < 0.001), lower in full-term than in premature births (OR = 0.491, 95%CI: 0.316-0.763, P = 0.002), and higher in cases with premature membrane rupture (OR=1.404, 95%CI: 1.051-1.876, P = 0.02).

CONCLUSION

Gestational anemia continues to be a health problem in China, and geographical factors may contribute to the situation. Premature birth and premature membrane rupture may be associated with gestational anemia. Therefore, we should vigorously promote local policy reformation to adapt to the demographic characteristics of at-risk pregnant women, which would potentially reduce the occurrence of gestational anemia.

Determinants of Anemia in The Third Trimester of Pregnancy in Mojokerto

Background: Anemia is a pregnancy complication that increases the morbidity and mortality of mother and baby during pregnancy and until puerperium. In 2015, the incidence of anemia in Indonesia was 23%. Purpose: The aim of this study was to determine factors that influence anemia in the third trimester of pregnancy. Methods: The study was conducted on pregnant women in Mojokerto. This study used a case-control design. The sample calculation results obtained 70 cases and 70 controls. The primary and secondary data were obtained from the MCH book and from interviews conducted according to questionnaire guidelines. Data were analyzed via chi-squared test and logistic regression test. Results: The factors that influence anemia in the third trimester of pregnancy were found to be age (p value = 0.04; OR 2.08; 95% CI = 1.04–4.16), occupation (p value = 0.02; OR = 2.27; 95% CI = 1.15–4.47), birth interval (p value = 0.03; OR = 2.25; 95% CI 1.08-4.69), nutritional status (p value = 0.02; OR = 2.33; 95% CI = 1.14- 4.82), knowledge [about anemia] (p value = 0.01; OR = 3.17; 95% CI = 1.41-7.09), income per month (p value = 0.03, OR = 2.25; 95% CI =1.08–4.69), smoking activity (p value = 0.04; OR = 2.00; 95% CI = 1.02–3.92), perception (p value = 0.02; OR = 2.20; 95% CI = 1.10–4.40) , and spousal support (p value = 0.01; OR = 2.63; 95% CI = 1.16 – 5.93) Conclusion: The most influential factors on anemia in the third trimester of pregnancy were birth interval, nutritional status, and knowledge.

The urban-rural differential in the association between household wealth index and anemia among women in reproductive age in Ethiopia, 2016

BACKGROUND

Anemia is more prevalent among women, and it is a moderate public health problem in Ethiopia. The wealth status and place of residence of a woman have implications on the intervention of anemia. Studies that examined the relationship between women's wealth index status and residency in Ethiopia are scarce. We aimed to identify the urban-rural differential in the association between household wealth index and anemia among women of childbearing age in Ethiopia.

METHOD

A cross-sectional design was employed with a nationally representative sample of 14,100 women aged 15-49-year-old from the Ethiopian demographic and health survey conducted in 2016. We used the two-stage sampling method to select the sample size. The primary outcome was anemia in women of childbearing age. A hemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was the indicator of anemia. Using a three-level random intercept model to explore associated factors at the individual and household levels quantified the observed and unobserved variations between household wealth index and residence on anemia.

RESULTS

Women belonging to a lower household wealth index category were more anemic (29.6%) than those middle and above wealth index categories. Women who lived in rural areas (25.5%) were prone to anemia than those who lived in urban areas (17.5%). The odds of anemia were significantly higher in women of the low household wealth category who living in rural compared to women of the middle and above household wealth category who living in urban (AOR = 1.37, 95% CI 1.14-1.65, P < 0.001).

CONCLUSION

In this study, anemia is more common among women who live in rural with the low house wealth category. Therefore, novel public health interventions should target women who live in rural areas with the lowest household wealth status.

Anemia among Pregnant Women Attending Ante Natal Care Clinic in Adare General Hospital, Southern Ethiopia: Prevalence and Associated Factors

Background

Anemia is a global public health problem affecting both developing and developed countries. It is associated with increased morbidity and mortality in pregnant women and children. Nevertheless, information regarding the prevalence of anemia and associated factors among pregnant in the study area is limited. Therefore, this study was aimed to assess the prevalence of anemia and associated factors among pregnant women attending antenatal care clinic in Adare General Hospital, Southern Ethiopia.

Method

A facility-based cross-sectional study was conducted from October 1, 2020, to December 15, 2020, among 340 pregnant women aged 15 to 49 years who came for focused antenatal care follow-up. Trained data collectors administered questionnaires, and collected capillary blood and stool samples. Data were coded and entered into EPI Info 7 and the analysis was done using SPSS version 20.0. Factors associated with anemia were assessed using binary logistic regression. Those variables that had a P-value less than .25 on bi-variable regression analysis were considered for multi-variable regression analysis. Statistical significance was declared with P < .05.

Result

The prevalence of anemia among pregnant women was 24.1% (95% CI: 19.55%-28.69%). The majority of anemia cases were mildly anemic (62.2.0%). Increased odds of anemia was found among pregnant women with household monthly income ⩽2550 Ethiopian Birr (⩽69.67 United States Dollar) (AOR = 2.08; 95% CI: 1.15, 3.76), not attended formal education (AOR = 3.86; 95% CI: 1.42, 10.54), not using iron tablets (AOR = 2.64; 95% CI: 1.33, 5.27) and infected with Plasmodium vivax (AOR = 7.58; 95% CI: 3.11, 18.47).

Conclusions

Anemia had moderate public health significance in the study. Low monthly family income, educational status, iron tablet consumption during pregnancy and Plasmodium vivax infection were found to be independent predictors for anemia in pregnancy. The burden of anemia should be alleviated through enhancing maternal socio-economic status, prevention of illnesses targeting pregnant women, and strengthening the expansion of prenatal iron-folate supplementation.

Magnitude of Intestinal Parasitosis, Malnutrition, and Predictors of Anemia Among Nonpregnant Reproductive-Age Women Attending Healthcare Services in Olenchity General Hospital, Central Ethiopia

Background

Anemia and malnutrition remain a public health challenge in developing worlds. Anemia during a nonpregnant state is one of the neglected medical conditions affecting reproductive-age women around the world. Globally, it is estimated that one-third of all reproductive-age women are anemic. Although it has negative consequences and extensive burden, anemia in nonreproductive-age women is rarely studied in Africa. In Ethiopia, studies investigating anemia and malnutrition among nonpregnant reproductive-age women are limited. Therefore, this study was aimed to assess intestinal parasitic infection, malnutrition, and predictors of anemia among nonpregnant reproductive-age women in Olenchity General Hospital, central Ethiopia.

Methods

A facility-based cross-sectional study design was employed among 405 nonpregnant reproductive-age women in Olenchity General Hospital, central Ethiopia from February 14 to March 24, 2018. Data were collected using a pretested interviewer-administered questionnaire. Blood samples were collected and tested to determine hemoglobin levels by using a hematology analyzer machine. Collected data were entered into EpiData version 3.02 and exported to SPSS version 20 (IBM SPSS Statistics, 2012) for further analysis. Multivariable logistic regression analysis was done to identify factors independently associated with anemia after controlling for possible confounders. Statistical significance was declared at p-value &lt;0.05.

Result

Overall, the magnitude of anemia was found to be 47.4% [95% CI (42.7, 52.6)], of which 34.8% were mild, 11.4% were moderate, and 1.2% were severely anemic. The prevalence of intestinal parasitic infection, wasting, and overweight was 34.6%, 26.2%, and 8.1%, respectively. Having no formal education [AOR=2.25, CI (1.02, 4.97)], using three to five sanitary pads per day during menses [AOR=1.66 CI (1.02, 2.68)], history of chewing khat [AOR= 4.45, CI (1.18, 16.83)], being from households with mild food insecurity [AOR=3.41, CI (1.10, 10.58)], and intestinal parasitic infection [AOR=2.28, CI (1.39, 3.47)] were factors independently associated with anemia.

Conclusion

The magnitude of anemia, malnutrition, and intestinal parasitic infection among nonpregnant reproductive-age women was found to be a considerable public health problem. Therefore, attention should be given to nonpregnant reproductive-age women visiting different healthcare services to reduce risks of anemia and malnutrition for possible future pregnancies and to ensure women’s health. Deworming of nonpregnant reproductive-age women is also very crucial to reduce the risks of anemia.

Food Consumption as a Risk Factor of Anemia among Indonesian Pregnant Women: A Cross-sectional Study among Javanese Ethnic Group

BACKGROUND: Anemia during pregnancy causes several adverse effects. Furthermore, in Indonesia, this leads to restrictions among pregnant women. The information on this situation is still limited, and more research needs to be conducted. AIM: Therefore, this study aims to investigate the association between food consumption and anemia among pregnant women. METHODS: This is a cross-sectional descriptive research that involved 424 pregnant women. Furthermore, written informed consent was obtained from respondents before data collection. A self-administered questionnaire was used to assess the food consumption and demographic data. Hemoglobin concentration was further measured using a haemoglobinometer, and data were analyzed using a descriptive statistical Chi-square, and a Multiple Logistic Regression test. RESULTS: It was found that half of the respondents suffered from anemia (46.5%). Furthermore, the Multiple Logistic Regression test showed that tea, liver, eggs, and iron consumption with values of (odds ratio [OR] = 5.075, p < 0.001), (OR = 4.128, p < 0.001), (OR = 3.590, p < 0.01), and (OR = 3.837, p < 0.05), respectively, had significant correlations with anemia among pregnant women. CONCLUSIONS: Anemia is commonly experienced by Indonesian pregnant women. Therefore, health-care providers should focus on preventing anemia in pregnant women by reducing their tea intake and increasing the consumption of iron-rich foods or supplements.

Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

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.

Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis

BACKGROUND

Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women.

METHODS

We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]).

CONCLUSIONS

The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.

Burden of intestinal parasitic infections among pregnant women in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Comprehensive nationwide data on prevalence and distribution of intestinal parasites (IPIs) among pregnant women are lacking. Therefore, the aim of this study was to provide pooled prevalence estimate, prevalence in different regions and species-specific IPIs among pregnant women in Ethiopia.

METHODS

The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on published and unpublished data between 2008 and Sep 2020 for studies describing rate of IPIs among pregnant women in Ethiopian. A random-effects model and forest plots to estimate pooled effect size and effect of each study with their confidence interval (CI) were used to provide a visual summary of the data. We conducted meta-regression to understand the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.

RESULTS

A total of 3149 of the 9803 pregnant women were infected with one or more species of IPIs resulted in an overall prevalence of 29% (95% CI 22-37%). The prevalence estimate varied among studies with considerable heterogeneity (χ² = 2069.19, p < 0.001 I² = 98.84). The prevalence of IPIs was 36% (95% CI 22-50%) in Oromia region, 29% (95% CI 10-47%) in Amhara region, 24% (95% CI 17-32%) in southern nation, nationality and people region, 24% (95% CI 22-27%) in Tigray region and 24% (95% CI 20-29%) in Addis Ababa city. Hookworms with pooled prevalence estimate of 10% (95% CI 8-13%) followed by Ascaris lumbricoides 10% (95% CI 7-13%), and Entamoeba histolytica/dispar 6% (95% CI 4-8%) were the three common species of IPIs identified in this group of population.

CONCLUSION

The prevalence of IPIs among pregnant women is relatively high in comparison to other general population. Hookworms and Ascaris lumbricoides were the most dominant species of intestinal helminths, whereas Entamoeba histolytica/dispar was the dominant intestinal protozoa among pregnant women in Ethiopia.

Helminthiasis, iron intake, and hemoglobin levels in pregnant women

The study aims to analyze the correlation of helminthiasis, iron intake, and hemoglobin levels in pregnant women in the Public Health Center of Kemusu 2 Boyolali, Central Java, Indonesia. A cross-sectional research design was applied to 164 pregnant women who are in the second-third trimester and selected using simple random sampling. The Cyanmethemoglobin tool was utilized to measure the respondents' hemoglobin levels. The iron intake was obtained using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Data analysis applied the Pearson's correlation test. This study discovered that 12.2% of subjects are infected by Ascaris lumbricoides; 34.1% and 36.6% of the subjects suffer from iron intake deficiency and anemia. There is a correlation between helminthiasis, iron intake, and hemoglobin levels in pregnant women (p=.005 and p=.007). Nutrition program is still needed to prevent the helminthiasis, reduce the prevalence of anemia in pregnant women, and improve their iron intake through supplementation and nutrition education.

Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia

Background

Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia.

Methods

A community-based cross-sectional study design was carried out among 367 pregnant women from June 1 to 30, 2020. Systematic random sampling was used to select study subjects. Hemoglobin level was measured by using HemoCue HB 301. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the linearity, normality, multicollinearity, and homoscedasticity assumptions were checked. The unstandardized beta (β) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependant variables. Statistical significance was declared at P value < 0.05.

Results

The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia (hemoglobin level < 11 g/dl) among pregnant women was found to be 85 [23.16%, (95% CI: 18.3%-27.5%)]. Meal frequency [β = 0.40, (95% CI: 0.12, 0.69), P = 0.005], interpregnancy interval [β = 0.08, (95% CI: 0.02, 0.15), P = 0.007], mid-upper arm circumference measurement [β = 0.13, (95% CI: 0.07, 0.20), P ≤ 0.001], own fruits/vegetable [β = 0.55, (95% CI: 0.79, 0.31), P ≤ 0.001], coffee consumption [β = −1.00, (95% CI: -1.31, -0.68), P ≤ 0.001], and having history of still birth [β = −0.63, (95% CI: -1.06, -0.20), P = 0.004] were significantly associated with the hemoglobin level of pregnant women.

Conclusions

Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, promotion of fruits/vegetable consumption, and improving the nutritional status of the women during antenatal care follow-up. Moreover, early screening and management of women with a history of stillbirth for anemia are also essential.

Dietary diversity and practice of pregnant and lactating women in Ethiopia: A systematic review and meta-analysis

The dietary diversity of pregnant and lactating women remains unacceptably poor in resource-limited countries such as Ethiopia. Despite the presence of inconsistent and inconclusive small-scale studies, it is difficult to portray an actual picture of dietary diversity and dietary practices of women in Ethiopia. This study aimed to identify the prevalence of dietary diversity, dietary practice, and dietary patterns of pregnant and lactating women in Ethiopia. Electronic and gray literature sources were explored. A total of 3,256 articles were found, of which 38 were included in the final analysis. The data were analyzed by using STATA version 15. The pooled estimates were presented using random-effects models due to considerable heterogeneities among studies. In this study, 16,412 pregnant and lactating women were included. The pooled prevalence of low, medium, and high dietary diversity scores of pregnant women was 37.1%, 41.55%, and 39.3%, respectively. Likewise, low, medium, and high dietary diversity scores of lactating women were 50.31%, 41.22%, and 9.1%, respectively. The mean dietary diversity of pregnant and lactating women was 3.99 ± 0.20. Regarding the minimum dietary diversity, 56.6% of pregnant women and 50.21% of lactating women were found to have inadequate dietary diversities. Two-third (65.7%) of pregnant women were found to have poor dietary practice. Starchy foods were the main staple foods of study subjects, whereas organ meats were least consumed food types. The dietary diversity score, minimum dietary diversity, and dietary practices of women are suboptimal and below WHO and FAO recommendations. This could lead to both macro- and micronutrient deficiencies. Policymakers, program managers, healthcare workers, and stakeholders need to redesign nutrition promotion and intervention programs to alleviate this issue.

Epidemiology of soil transmitted helminths and risk analysis of hookworm infections in the community: Results from the DeWorm3 Trial in southern India

Since 2015, India has coordinated the largest school-based deworming program globally, targeting soil-transmitted helminths (STH) in ~250 million children aged 1 to 19 years twice yearly. Despite substantial progress in reduction of morbidity associated with STH, reinfection rates in endemic communities remain high. We conducted a community based parasitological survey in Tamil Nadu as part of the DeWorm3 Project—a cluster-randomised trial evaluating the feasibility of interrupting STH transmission at three geographically distinct sites in Africa and Asia—allowing the estimation of STH prevalence and analysis of associated factors. In India, following a comprehensive census, enumerating 140,932 individuals in 36,536 households along with geospatial mapping of households, an age-stratified sample of individuals was recruited into a longitudinal monitoring cohort (December 2017-February 2018) to be followed for five years. At enrolment, a total of 6089 consenting individuals across 40 study clusters provided a single adequate stool sample for analysis using the Kato-Katz method, as well as answering a questionnaire covering individual and household level factors. The unweighted STH prevalence was 17.0% (95% confidence interval [95%CI]: 16.0–17.9%), increasing to 21.4% when weighted by age and cluster size. Hookworm was the predominant species, with a weighted infection prevalence of 21.0%, the majority of which (92.9%) were light intensity infections. Factors associated with hookworm infection were modelled using mixed-effects multilevel logistic regression for presence of infection and mixed-effects negative binomial regression for intensity. The prevalence of both Ascaris lumbricoides and Trichuris trichiura infections were rare (<1%) and risk factors were therefore not assessed. Increasing age (multivariable odds ratio [mOR] 21.4, 95%CI: 12.3–37.2, p<0.001 for adult age-groups versus pre-school children) and higher vegetation were associated with an increased odds of hookworm infection, whereas recent deworming (mOR 0.3, 95%CI: 0.2–0.5, p<0.001) and belonging to households with higher socioeconomic status (mOR 0.3, 95%CI: 0.2–0.5, p<0.001) and higher education level of the household head (mOR 0.4, 95%CI: 0.3–0.6, p<0.001) were associated with lower odds of hookworm infection in the multilevel model. The same factors were associated with intensity of infection, with the use of improved sanitation facilities also correlated to lower infection intensities (multivariable infection intensity ratio [mIIR] 0.6, 95%CI: 0.4–0.9, p<0.016). Our findings suggest that a community-based approach is required to address the high hookworm burden in adults in this setting. Socioeconomic, education and sanitation improvements alongside mass drug administration would likely accelerate the drive to elimination in these communities.

Trial Registration:NCT03014167.

Approximately 1 in 5 people in India are infected with soil transmitted helminths (STH), leading to anaemia and malnutrition. To tackle this large burden of infection, the government of India launched one of the world’s largest school-based deworming programs in 2015 aiming to deworm all pre-school and school-aged children between 1 to 19 years of age twice yearly on the National Deworming Days. Deworming programs, including those in India, are focused on pre-school aged children, school aged children and women of reproductive age group. However, prevailing environmental and socioeconomic conditions, including poor sanitation, can contribute to high rates of reinfection from untreated adults and children. The DeWorm3 Project is a cluster-randomised trial evaluating the feasibility of interrupting STH transmission with community wide deworming of all individuals aged one to 99 years of age or older. As part of the study, we conducted a parasitological survey in the Deworm3 trial site in rural Tamil Nadu. Here we present the factors associated with STH infection and burden in these communities.

Prevalence and factors associated with anaemia in pregnant women in Cascades Region of Burkina Faso in 2012

Introduction

anaemia in pregnancy is a public health concern in Burkina Faso. This study aims at identifying the factors associated with the prevalence of anaemia in pregnant women at a regional level in Burkina Faso.

Methods

we conducted a cross-sectional study in the region called “Cascades”, located at the Western part of Burkina Faso. The study population included all pregnant women who attended antenatal care clinics in all public peripheral health facilities (districts) between May and June 2012 and agreed to participate in the study. They provided blood sample from which we measured the haemoglobin concentration using the Hemocue® system. The factors associated with anaemia in the study population were identified through multiple logistic regressions.

Results

the prevalence (95% CI) of anaemia in pregnancy in the Cascades region was 58.9% (56.6% - 61.2%). Anaemia in pregnancy was more common in district of Banfora (OR = 1.40; 95% CI: 1.07-1.83), among housewives (OR = 2.96; 95% CI: 1.10-8.0), in the Mossi ethnic group (OR = 1.39; 95% CI: 1.04-1.85) and among the wives of farmers and artisans (OR = 2.55; 95% CI: 1.59-4.07). Anaemia in pregnancy was less frequent among women who drank local beer (OR = 0.68; 95% CI: 0.49-0.94).

Conclusion

the prevalence of anaemia in pregnancy is high in Burkina Faso. Improving women's income level may contribute to reduce it. Further studies are needed to elucidate the link between the consumption of local beer, the local diet practices and anaemia in pregnant women.