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Ali A, Islam J, Paul R, Parvin S, Mohammed Mohiuddin Chowdhury AT, Islam R, Siddique S, Rahman A, Tasnim ST, Hasna S. Geographic inequalities and determinants of anaemia among preeclamptic women: a cross-sectional sample-based study in Bangladesh. BMC Public Health 2024; 24:1650. [PMID: 38902634 PMCID: PMC11191240 DOI: 10.1186/s12889-024-18176-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 02/21/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Anaemia among preeclamptic (PE) women is a major undefined health issue in Bangladesh. This study explored the risk factors associated with anaemia and mapped the regional influences to understand the geographical inequalities. METHODS Data from 180 respondents were prospectively collected from the Preeclampsia ward of Dhaka Medical College Hospital (DMCH), Bangladesh. Anaemia was defined as a blood haemoglobin level less than 11.0 g/dl. Preeclampsia was defined as systolic blood pressure (SBP) ≥ 140 mmHg and diastolic blood pressure (DBP) ≥ 90 mmHg with proteinuria. Factors associated with anaemia were explored using the chi-square test. Logistic regression (LR) was done to determine the level of association with the risk factors. RESULTS Among the participants, 28.9% were identified as having early onset and 71.1% reported late onset of PE. 38.9% of the subjects were non-anaemic, whereas mild, moderate, and severe anaemia was found among 38.3%, 17.8%, and 5% of patients respectively. The following factors were identified; including age range 25-34 (OR: 0.169, p < 0.05), a lower education level (OR: 3.106, p < 0.05), service-holder mothers (OR: 0.604, p < 0.05), pregnancy interval of less than 24 months (OR: 4.646, p < 0.05), and gestational diabetes mellitus (OR: 2.702, p < 0.05). Dhaka district (IR: 1.46), Narayanganj district (IR: 1.11), and Munshiganj district (IR: 0.96) had the highest incidence rates. CONCLUSION Determinants of anaemia must be considered with importance. In the future, periodic follow-ups of anaemia should be scheduled with a health care program and prevent maternal fatality and fetus morbidity in patients with PE.
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Affiliation(s)
- Ahasan Ali
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - Jahirul Islam
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia
| | - Ratna Paul
- Department of Gynecology and Obstetrics, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh
| | - Shahinur Parvin
- Department of Nursing, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | | | - Rafiqul Islam
- Daffodil International University Dhaka, Dhaka, Bangladesh
| | - Sharmina Siddique
- Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Atiqur Rahman
- Plastic, Aesthetic and Maxillofacial surgery, Xian Jiaotong University, Xi'an, Shaanxi, P.R. China
| | | | - Suraiya Hasna
- Ad-din Women Medical College Hospital Dhaka, Dhaka, Bangladesh
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Okunade KS, Olowoselu FO, Oyedeji OA, Oshodi YA, Ugwu AO, Olumodeji AM, Adejimi AA, Adenekan MA, Ojo T, Ademuyiwa IY, Adaramoye V, Okoro AC, Olowe A, Adelabu H, Akinmola OO, Yusuf-Awesu S, Oluwole AA. Prevalence and determinants of moderate-to-severe anaemia in the third trimester of pregnancy: a multicenter cross-sectional study in Lagos, Nigeria. Sci Rep 2024; 14:11411. [PMID: 38762586 PMCID: PMC11102504 DOI: 10.1038/s41598-024-61487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/06/2024] [Indexed: 05/20/2024] Open
Abstract
The high burden of anaemia during pregnancy underscores the urgent need to gain a comprehensive understanding of the factors contributing to its widespread occurrence. Our study assessed the prevalence and the trends of moderate-to-severe anaemia (MSA) in late pregnancy (28 to 36 weeks) and then investigated the key determinants driving this prevalence among women in Lagos, Nigeria. We conducted a secondary data analysis involving 1216 women enrolled in the Predict-PPH study between January and March 2023. We employed a multivariate binary logistic regression model with a backward stepwise selection approach to identify significant predictors of MSA. The study revealed a 14.5% prevalence of MSA during pregnancy. Independent predictors of MSA included having given birth to two or more children (adjusted odds ratio = 1.46, 95% confidence interval: 1.03-2.07), having a maternal body mass index (BMI) of 28 kg/m2 or higher (adjusted odds ratio = 1.84, 95% confidence interval: 1.29-2.61), having less than tertiary education (adjusted odds ratio = 1.51, 95% confidence interval: 1.08-2.11), and being unemployed (adjusted odds ratio = 1.97, 95% confidence interval: 1.19-3.26). It is crucial for pregnant women, particularly those with higher parities and elevated BMI, to be monitored regularly for anaemia and its consequences during their antenatal care. Additionally, addressing the link between low education, unemployment, and anaemia necessitates comprehensive strategies that empower women in terms of education and economic status to enhance the overall well-being of individuals and communities, ultimately reducing the prevalence of anaemia and associated health issues in pregnancy.
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Affiliation(s)
- Kehinde S Okunade
- Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria.
- Center for Clinical Trials, Research and Implementation Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria.
| | - Festus O Olowoselu
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olufemi A Oyedeji
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Yusuf A Oshodi
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Aloy O Ugwu
- Department of Obstetrics & Gynaecology, 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria
| | - Ayokunle M Olumodeji
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Adebola A Adejimi
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria
| | - Muisi A Adenekan
- Department of Obstetrics & Gynaecology, Lagos Island Maternity Hospital, Lagos Island, Lagos, Nigeria
| | - Temitope Ojo
- Department of Obstetrics & Gynaecology, Federal Medical Center, Ebute-Meta, Lagos, Nigeria
| | - Iyabo Y Ademuyiwa
- Department of Nursing Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria
| | - Victoria Adaramoye
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Austin C Okoro
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Atinuke Olowe
- Department of Nursing Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria
| | - Hameed Adelabu
- Center for Clinical Trials, Research and Implementation Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria
| | - Olukayode O Akinmola
- Department of Chemical Pathology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria
| | - Salimat Yusuf-Awesu
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ayodeji A Oluwole
- Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
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Berihun GA, Tesfaye G, Adissu W, Tadasa E, Adamu K, Kombe AT, Gedefaw L. Prevalence and Associated Factors of Anemia among Newborns at Jimma Medical Center, South-west Ethiopia. J Blood Med 2024; 15:129-140. [PMID: 38510843 PMCID: PMC10950678 DOI: 10.2147/jbm.s443312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Background Newborn anemia is among the most common hematological problems and it can cause asymptomatic or severe to acute life-threatening events. It leads to impairment in brain maturation and development, tissue hypoxia, and stunted growth and then arrested growth if left untreated. The prevalence of anemia among newborns ranges from 23.4-66% in sub-Saharan Africa. But, there is limited information in Ethiopia regarding the prevalence of newborn anemia and its risk factors. Therefore, this study aimed to determine the prevalence of newborn anemia and its associated factors at Jimma Medical Center (JMC), South-west Ethiopia. Methods A hospital-based cross-sectional study design was implemented from January 14 to February 28, 2021, involving 288 full-term newborns by employing consecutive convenient sampling technique for study participant selection. Socio-demographic data and other associated factors were collected through interviews and a review of medical records by a structured questionnaire. Three mL umbilical cord blood samples from each newborn were collected and analyzed for a complete blood count by an automated hematological analyzer. Data were entered into Epi Data version 3.1 and exported to Statistical Package for Social Science version 20 for analysis. Binary logistic regression were used to identify the predictors of newborn anemia. Results The overall prevalence of anemia among newborns was 26.4%; of them, 65.8%, 25%, and 9.2% were mild, moderate, and severe anemia types, respectively. Maternal vegetable consumption habit (AOR = 0.26, 95% CI: 0.11, 0.62) and maternal anemia (AOR = 0.34, 95% CI: 0.17, 0.69) were significantly associated with anemia in newborns. Conclusion In general, newborn anemia in this study was a moderate public health problem. Based on this study, early screening of anemia among newborns may reduce further complications. Prevention of maternal anemia during pregnancy by improving their nutritional status especially vegetable consumption had a positive impact on reducing anemia among newborns.
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Affiliation(s)
- Gebeyaw Arega Berihun
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Girum Tesfaye
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Edosa Tadasa
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kidist Adamu
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abinet Tantu Kombe
- School of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Lealem Gedefaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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S T PK, Lahiri B. Conditional selection of multifactor evidence for the levels of anaemia among women of reproductive age group. EVALUATION AND PROGRAM PLANNING 2023; 100:102344. [PMID: 37437494 DOI: 10.1016/j.evalprogplan.2023.102344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023]
Abstract
The study aims at ascertaining the conditional selection of key indicators affecting severe, moderate, mild, and no anaemia levels for women of reproductive age in India. The secondary data for levels of anaemia and personal records of individuals collected for India from the 7th phase of District Health Survey program of the United States Agency for International Development data depository. The data was cleaned and summarised using frequency and percentages. Then the variables were tested for association with levels of anaemia using the Chi-square (χ2) test. The multinomial logistic regression model was employed to ascertain the key indicators through a conditional selection of reference categories. Results suggest that severe anaemia was significantly prevalent among women in the reproductive stage, especially among the 15-29 age groups. Secondary and higher education had a negative effect on the severity of severe, moderate, and mild anaemia. The poorest wealth index stratum had higher and more significant severe anaemia, and households with two adults of the opposite sex had a significant negative effect (β = -0.116, OR = 0.89, p < 0.001) on severe anaemia level while having a significant positive effect on moderate and mild anaemia. Rural households were associated negatively and significantly with moderate and mild anaemia, and nuclear household structures had a higher prevalence of severe anaemia. Therefore, these indicators across different levels of anaemia should be considered for a faster rate of reduction at the national level. Despite several initiatives by the public sector, the anaemia level has remained elevated among women of reproductive age. Education, wealth index, age, pregnancy, relationship structure, household structure, and place of residence were found to be key indicators for the level of anaemia. The significant variables will act as a crucial input to formulate cost-effective public interventions and finally encourage the faster reduction of anaemia levels.
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Affiliation(s)
- Pavan Kumar S T
- College of Community Science, Central Agricultural University, Tura, Meghalaya 794005, India.
| | - Biswajit Lahiri
- College of Fisheries, Central Agricultural University, Lembucherra, Tripura, India
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Margawati A, Syauqy A, Utami A, Adespin DA. Prevalence of Anemia and Associated Risk Factors among Pregnant Women in Semarang, Indonesia, during COVID-19 Pandemic. Ethiop J Health Sci 2023; 33:451-462. [PMID: 37576178 PMCID: PMC10416334 DOI: 10.4314/ejhs.v33i3.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 03/19/2023] [Indexed: 08/15/2023] Open
Abstract
Background The coronavirus disease-2019 (COVID-19) pandemic has caused several changes that affect overall health, including the prevalence of anemia in pregnant women. Several risk factors, including iron deficiency during pregnancy, diabetes, maternal smoking, preterm birth, low birth weight, and multiple pregnancies, can influence poor iron intake in infants. This study aims to analyze the prevalence and factors associated with anemia in pregnant women during the COVID-19 pandemic. Methods A cross-sectional study was conducted on 238 pregnant women from two districts in Semarang, Indonesia. The study population was selected using a cluster sampling technique. Trained enumerators collected data through interviews using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to estimate participants' food intake and anthropometric measurements. Additionally, hemoglobin levels were measured by trained nurses during antenatal care (ANC) visits. Univariate and multivariate analyses were performed using logistic regression to estimate the factors associated with anemia in pregnant women during the COVID-19 pandemic. Results Among all participants, 14.3% (n=34) were anemic, with 32.3% and 67.6% having moderate and mild anemia, respectively. Moreover, study variables such as less compliance with ANC (antenatal care) guidelines (p = 0.020), excessive phosphorus intake (p = 0.039), inadequate zinc intake (p = 0.003), and inadequate calcium intake (p = 0.043) were associated with anemia among pregnant women. Conclusion Anemia among pregnant women in Semarang, Indonesia, is a mild public health problem. Less compliance with ANC guidelines, excessive phosphorus intake, and inadequate zinc intake are significantly associated with anemia among pregnant women during the COVID-19 pandemic.
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Affiliation(s)
- Ani Margawati
- Department of Nutrition Science, Faculty of Medicine, Diponegoro University
| | - Ahmad Syauqy
- Department of Nutrition Science, Faculty of Medicine, Diponegoro University
| | - Aras Utami
- Department of Public Health and Prevention, Faculty of Medicine, Diponegoro University
| | - Dea Amarilisa Adespin
- Department of Public Health and Prevention, Faculty of Medicine, Diponegoro University
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Asmamaw DB, Negash WD, Bitew DA, Belachew TB. Multilevel analysis of intimate partner violence and associated factors among pregnant women in East Africa: Evidence from recent (2012-2018) demographic and health surveys. Arch Public Health 2023; 81:67. [PMID: 37088863 PMCID: PMC10122807 DOI: 10.1186/s13690-023-01065-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Globally, intimate partner violence (IPV) during pregnancy is the most common and major public health problem. It has a negative effect on the lives of both mother and fetus. Despite its prominence, many countries in East Africa have paid little attention to this issue. This study assessed the prevalence and associated factors of intimate partner violence among pregnant women in East African countries. METHODS The study adopted a secondary method data analysis that utilized recent Demographic and Health Surveys of 10 countries in East Africa between 2012 and 2018. A total of 23,521 women who gave birth in the 5 years preceding the survey were included. A multilevel mixed-effect logistic regression model was fitted to identify factors associated with IPV. Variables with a p-value < 0.05 were declared as significant factors associated with IPV. RESULTS The overall prevalence of IPV in East Africa was 37.14 (95% CI 36.53, 37.76). Women with age 25-34 (AOR = 1.20;95%CI; 1.06, 1.36), 35-39 (AOR = 1.40;95%CI; 1.24, 1.58), and 40-49 (AOR = 1.66;95%CI; 1.43, 1.95), women with no education (AOR = 1.27;95%CI; 1.16, 1.39), women with no occupation (AOR = 1.36; 95%CI; 1.27, 1.47), women from households with the poorest (AOR = 1.51; 95%CI: 1.33, 1.71), poorer (AOR = 1.40;95% CI:1.24, 1.58), middle (AOR = 1.32;95%CI:1.17, 1.48), and richer (AOR = 1.26;95%CI: 1.13, 1.40), husband drinks alcohol (AOR = 2.54; 95%CI 2.39, 2.71), ≥ 5 number of living children (AOR = 1.28; 95%CI: 1.31, 2.57) and rural areas (AOR = 1.14; 95%CI: 1.03, 1.25) were significantly associated with IPV. CONCLUSION More than one-third of pregnant women experienced intimate partner violence in East Africa. Promoting the educational status of women, the economic capacity of women, and the healthy behavior of the husband by reducing alcohol consumption, with particular attention to rural women and violence during pregnancy, is vital to reduce the prevalence of IPV.
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Affiliation(s)
- Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Faghir-Ganji M, Amanollahi A, Nikbina M, Ansari-Moghaddam A, Abdolmohammadi N. Prevalence and risk factors of anemia in first, second and third trimesters of pregnancy in Iran: A systematic review and meta-analysis. Heliyon 2023; 9:e14197. [PMID: 36938395 PMCID: PMC10018475 DOI: 10.1016/j.heliyon.2023.e14197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Anemia is a common health problem during pregnancy worldwide that has many short-term and long-term effects on women. This study examined the Prevalence and Risk factors of anemia in first, second and third trimesters of pregnancy in Iran between 2000 and 2021. PubMed, Medline, Scopus, Google Scholar, and national databases of Magiran and SID were searched for articles, which were then subjected to PRISMA-compliant screening. A systematic review and meta-analysis (using a random-effects model in STATA version 17) were conducted on the 18 eligible cross-sectional studies (published between July 23, 2000 and September 1, 2021) that revealed significant data on the prevalence of anemia in pregnant women. This study included 18 reports with a total of 25,831 individuals in which 15% of study subjects had anemia (95% CI: 12-19%). The pooled prevalence of anemia was 13% in people older than 26 years old (95% CI: 9-17%) compared to 22% in people younger than 26 years old (95% CI: 15-29). It was 18% (95% CI: 11-27%) for pregnant women having their second child in comparison to 20% (95% CI: 11-32%) for women who have had three or more children. Anemia was thought to affect 11% of housewives (95% CI: 2-26%) and 10% of working women (95% CI: 6-16%). Anemia frequency was 22%, 17% and 13% amongst first (22%), second (17%), and third (13%) trimesters, respectively. Nevertheless, it happened much less often after the second trimester. Moreover, poor education, a history of low birth weight in children, and a low socioeconomic level within women were associated with the prevalence of anemia. The pooled prevalence of anemia in pregnant women is marginally lower than in earlier report. However, it seems to be a health problem in developing countries including Iran currently. Therefore, the study suggest that health system should design comprehensive preventive and control measurements such as more effective treatments to minimize anemia in vulnerable segments of society, particularly mothers, and improve their health through increasing access to services for mothers.
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Affiliation(s)
- Monireh Faghir-Ganji
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Amanollahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Nikbina
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | | | - Narjes Abdolmohammadi
- Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
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Factors associated with undernutrition among pregnant women in Haramaya district, Eastern Ethiopia: A community-based study. PLoS One 2023; 18:e0282641. [PMID: 36893154 PMCID: PMC9997975 DOI: 10.1371/journal.pone.0282641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cut-off point for the significant association. RESULTS A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (APR = 1.19; 95% CI = 1.02-1.40), lower dietary diversity (APR = 1.58; 95% CI = 1.13-2.21) and those who were anemic (APR = 4.27; 95% CI = 3.17-5.76). CONCLUSION Nearly half of the pregnant women in study area were undernourished. High prevalence was found among women who had large family sizes, low dietary diversity and anemia during pregnancy. Improving dietary diversity, strengthening family planning services and giving special attention to pregnant women, supplementation of iron and folic acid, and early detection and treatment of anemia is essential to improve the high burden of undernutrition and the adverse effect on pregnant women and the fetus.
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Arero G. Undernutrition and associated factors among pregnant women in East Borena Zone, Liban District, Oromia regional state, Ethiopia. Front Nutr 2022; 9:1008701. [PMID: 36590217 PMCID: PMC9800510 DOI: 10.3389/fnut.2022.1008701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022] Open
Abstract
Background Undernutrition is cellular imbalance between supply of nutrients, energy and body's demand to ensure growth, maintenance, and specific function. However, there was no study conducted earlier on this topic in East Borena Zone. Objective To assess the prevalence of undernutrition and associated factors among pregnant women in East Borena Zone, Liban District. Method A community-based cross-sectional study was conducted on 420 study participants from November 20 to December 2021. The systematic sampling technique and simple random sampling methods were used to select study participants. Data were double entered into Epi-info software version 7 and SPSS version 21 software for analysis. Descriptive statistics were used to describe the characteristics of study participants. Bivariate and multivariable logistic regressions were carried out to identify the association between independent and dependent variables by measuring the adjusted odds ratio and 95% confidence interval. P-values less than 0.05 were considered statistically significant. Results Prevalence of undernutrition among pregnant women was about (44.9%) of family monthly income [AOR = 8.72 (4.80, 15.83)], women's decision-making autonomy [AOR = 0.40 (0.19, 0.82)], skipping meal [AOR = 2.62 (1.41, 4.89)], substance use [AOR = 2.01 (1.07, 3.77)], household food insecurity [AOR = 2.01 (1.06, 3.80)], lack of prenatal dietary advice [AOR = 2.73 (1.53, 4.89)], absence of household latrine [AOR = 9.23 (3.48, 24.46)], not participating health development army's meeting at village level [AOR = 3.01 (1.57, 5.72)] and hand washing habit [AOR = 6.55 (3.02, 14.20)] had shown statistically significant association with undernutrition. Conclusion The prevalence of undernutrition among pregnant women was high income. Women's decision-making autonomy, skipping meals, substances use, household food insecurity, lack of prenatal dietary advice, poor hand washing habit, lack household of latrine, and not participation in health development army's meeting were found to be predictors of the undernutrition.
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Affiliation(s)
- Godana Arero
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
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Bizuneh AD, Azeze GG. Knowledge on anaemia and benefit of iron–folic acid supplementation among pregnant mothers attending antenatal care in Woldia town, Northeastern Ethiopia: a facility-based cross-sectional study. JOURNAL OF HEALTH, POPULATION AND NUTRITION 2022; 41:32. [PMID: 35927693 PMCID: PMC9351271 DOI: 10.1186/s41043-022-00315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 07/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Anaemia in pregnancy is the leading cause of maternal morbidity and mortality and poor birth outcomes in low- and middle-income countries. The most common cause of anaemia during pregnancy is acute blood loss and iron deficiency due to physiological changes and increasing demand for iron on the mother and growing foetus. Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anaemia during pregnancy. The mother’s knowledge of anaemia and the benefit of iron–folic acid is crucial in reducing the magnitude of anaemia due to iron deficiency. In Woldia town, despite the efforts made to reduce iron deficiency anaemia during pregnancy, information on pregnant mother knowledge on anaemia and the benefit of iron–folic acid and its associated factors are scarce. Methods A facility-based cross-sectional study design was conducted, on 414 pregnant mothers attending antenatal care in Woldia town, Northern Ethiopia. Systematic random sampling methods were used to select study participants. The data were entered into Epi-data version 4.2 and analysed using SPSS version 24. Bivariable and multivariable analysis was done to see the association between the dependent variable and independent variables. Results This study revealed that 54.1% and 57.7% of pregnant women had good knowledge of anaemia and the benefit of iron–folic acid, respectively. Maternal education status (AOR = 2.19, 95% CI 1.32–3.64), good knowledge of iron–folic acid (AOR = 5.85, 95% CI 3.60–9.50) and residence (AOR = 5.43, 95% CI 2.36–12.51) were statistically associated with pregnant mothers knowledge on anaemia. Obtained counselling on the benefit of iron–folic acid (AOR = 2.04, 95% CI 1.11–3.75), having four or more antenatal care visit (AOR = 3.12, 95% CI 1.38–7.07) and good knowledge of anaemia (AOR = 5.88, 95% CI 3.63–9.50) was statistically associated with pregnant mothers knowledge on the benefit of iron–folic acid. Conclusions Promoting frequent antenatal care visits and giving counselling on the benefit of iron–folic acid and cause, prevention and treatment of anaemia were essential strategies to raise knowledge of pregnant mother on anaemia and the benefit of iron–folic acid.
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Adequacy of antenatal care services utilisation and its effect on anaemia in pregnancy. J Nutr Sci 2022; 11:e80. [PMID: 36304821 PMCID: PMC9554427 DOI: 10.1017/jns.2022.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 07/11/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022] Open
Abstract
Anaemia in pregnancy remains a critical public health concern in many countries including Ghana and it poses severe consequences in the short to long-term for women and their unborn babies. Although antenatal care (ANC) is largely provided for pregnant women, the extent its utilisation protects against anaemia in pregnancy remains largely understudied. The study assessed the adequacy of ANC services utilisation and its effect on anaemia among pregnant women in the Wa Municipality of Ghana. A facility-based cross-sectional survey was conducted. Probability proportionate to size sampling and systematic random sampling were used to select the facilities and 353 respondents. While 80⋅2 % of the pregnant women reported having received a sufficient number of ANC services provided, the prevalence of the overall ANC adequacy was only 44⋅2 %. After adjusting for potential confounders, pregnant women who could not achieve adequate ANC attendance were 2⋅3 times more likely to be anaemic in the third trimester of gestation AOR = 2⋅26 (95 % CI 1⋅05, 4⋅89), compared to their counterparts who maintained adequate ANC attendance. Adequate ANC attendance was a consistent and significant predictor of anaemia in pregnancy in the third trimester. Health and nutrition education on the need for early initiation of ANC attendance and support for the consumption of diversified diets are two possible interventions that can help contain anaemia in pregnancy.
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Intimate Partner Violence and Its Predictors among Pregnant Women in Eastern Ethiopia: Generalized Structural Equation Modeling. Int J Reprod Med 2022; 2022:7827234. [PMID: 36035446 PMCID: PMC9410972 DOI: 10.1155/2022/7827234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/23/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Intimate partner violence (IPV) has a negative impact on women’s physical, mental, sexual, and reproductive health. Identifying the determinant factors of IPV among pregnant women is of paramount importance to overcome its negative consequences thereby increasing the performance of women in all activities. Thus, this study applied a generalized structural equation model (GSEM) to determine the prevalence of intimate partner violence among pregnant women and its predictors in Eastern Ethiopia. Methods. A community based cross-sectional study was conducted in Kersa Health and Demographic Surveillance System (KHDSS), Eastern Ethiopia. Data were collected form a sample of 1051 pregnant women using structured questionnaires. Descript findings were presented in percentage with 95% confidence interval. The generalized structural equation model was used to determine factors associated with each domain of IPV (physical, emotional, and social violence). Adjusted odds ratio (AOR) with a 95% CI were used to declare significant factors associated with intimate partner violence. Results. The overall prevalence of IPV in the Eastern Ethiopia was 48.57% (95% CI: 45.45, 51.69). The highest intimate partner violence was observed in the sexual domain of IPV (31.6%, 95% CI: (28.8, 34.58)). In GSEM, being a farmer (
, 95% CI: 0.19, 0.91) was significantly associated with psychological domain of IPV. Age (
, 95% CI: 0.95, 0.99) and educational status (neither read nor write) (
, 95% CI: 1.61, 3.89) were significantly associated with physical domain of IPV. Being in medium (
, 95% CI: 0.46, 0.90) and rich (
, 95% CI: 0.36, 0.78), wealth quintiles were significantly associated with sexual domain of IPV, whereas husband controlling behavior was significantly associated with all domains of IPV. Conclusions. The magnitude of IPV among pregnant women was relatively high in Eastern Ethiopia. This finding pin a light to pay special consideration to pregnant women at each point of service delivery to alleviate consequence of IPV. Being a farmer, older ages and being in higher wealth quintiles were protective factor, whereas being uneducated increase the risk of IPV. Improving socioeconomic status and promoting legal rights of women is needed to alleviate the problem, and younger women require special attention.
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Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis. PLoS One 2022; 17:e0267005. [PMID: 35895619 PMCID: PMC9328503 DOI: 10.1371/journal.pone.0267005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background
In Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.
Materials and methods
The published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger’s and Begg’s tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.
Result
After screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.
Conclusion
Almost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.
Registration number
(ID: CRD42020211054).
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14
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Balis B, Dessie Y, Debella A, Alemu A, Tamiru D, Negash B, Bekele H, Getachew T, Eyeberu A, Mesfin S, Eshetu B, Merga BT, Habte S, Yadeta TA. Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia. Front Public Health 2022; 10:867888. [PMID: 35719616 PMCID: PMC9198702 DOI: 10.3389/fpubh.2022.867888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/28/2022] [Indexed: 01/23/2023] Open
Abstract
Background Anemia is a significant public health issue, accounting for 20–40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia. Methods A facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05. Result A total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5–29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia. Conclusion Anemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.
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Affiliation(s)
- Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Bajrond Eshetu
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Sisay Habte
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia.,School of Public Health, College of Health and Medical sciences, Haramaya University, Dire Dawa, Ethiopia
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15
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Nathem Rashed R. Effect biological life factors on pregnant woman. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.02.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Define anemia is the low concentration in the amount of hemoglobin according to age, sex and trimester pregnancy. The pregnant has three trimesters and has an exceptional hemoglobin range in every trimester. The pregnant has 124-135 g/dl in the 1st trimester, 110-117 g/dl in the 2nd trimester and 106-109 g/dl in the 3rd trimester. Many pregnant females had been found with anemia because of a low level of Iron. This leads to megaloblastic anemia because of iron deficiency anemia and B12 Vitamin, diet, gastrectomy, malabsorption, blood loss and physiological demand (pregnancy infancy and adolescence). The blood consists of Hemoglobin (Heam + globin) Heam and Iron protoporphyrin ring. Globin is the type of protein with a specific length of amino acid and a specific type of A, maybe 2 Alpha 2 Beta called A1 or 2 Alpha and 2 Bata called A2 or 2Alpha and Gamma called F Fetal. The production of hemoglobin depends on the previously mentioned factors. In this study, we focused on some factors associated with the amount of blood and how these factors affected anemia, which is the most important in Iron treatments, with considering other factors such as food, diversity, Economic situation, social status, number of the fetus, and number of pregnancies. Statistical analysis was used to detect the effect factors of anemia in pregnant. This study refers to 23.2% of anemia because of Iron deficiency during pregnancy. So, treatment of Iron deficiency reduces anemia during pregnancy time.
Keywords. Anemia; Hemoglobin; Pregnant Woman
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Affiliation(s)
- Rawya Nathem Rashed
- Umm Al-rabeein High School for Outstanding Students _Directorate General of Education Nineveh. Mosul - Iraq
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16
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Dodzo RC, Ogunsakin RE, Ginindza TG. Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 35532109 PMCID: PMC9082230 DOI: 10.4102/phcfm.v14i1.3339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Anaemia is a global health problem affecting about a third of the world's population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. AIM This study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini. SETTING This study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital. METHODS This cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15-49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis. RESULTS A total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15-19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19-2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15-18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27-25.4) and second trimester (OR: 1.62; CI: 1.02-2.60). CONCLUSION Anaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country's burden of anaemia.
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Affiliation(s)
- Rumbidzai C Dodzo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Ministry of Health.
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Nwankwo B, Joseph S, Usman N, Oyefabi A. Anemia in pregnancy: Prevalence among clients attending antenatal clinics in Chikun LGA, Kaduna, Nigeria. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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18
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Alvarado-Gonzalez JC, Alvis-Zakzuk NR, Castillo-Saavedra DE, Lozada-Martinez ID, Picón-Jaimes YA, Narvaez-Rojas AR, Zakzuk J. Impact of helminthiasis on gestational anemia in low- and middle-income countries: a systematic review and meta-analysis of more than 19,000 women. LE INFEZIONI IN MEDICINA 2022; 31:36-48. [PMID: 36908393 PMCID: PMC9994832 DOI: 10.53854/liim-3101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/25/2023] [Indexed: 03/07/2023]
Abstract
Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational anemia. The aim of this study was to determine if there is a relationship between helminth infection and gestational anemia. A structured review of scientific literature was conducted through active search in the electronic databases MEDLINE® and LILACS® until December 2021, following 2020 PRISMA statement. The studies were reviewed independently by two authors, extracting the most relevant information from each study. Cross-sectional studies, case-control and ecological studies were included, with no date or language limit. Randomized clinical trials were excluded. A total of 38 studies were included in the systematic review. The study populations of all studies belonged to low- and middle-income countries: 28 studies from Africa, 6 from Asia, 3 from Latin America and 1 from Oceania. Overall, the average prevalence of gestational anemia among the included studies was 40% (95% CI 34-46%). Hookworm was the predominant species detected in most studies (19/38; 50%), followed by Ascaris lumbricoides (15/38; 39.5%). Gestational anemia was positively associated with A. lumbricoides (OR 1.86, 95% CI 1.12-3.08) and hookworms (OR 3.09, 95% CI 1.99-4.78). Prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk during meta-regression (p=0.5182). The results of this review indicate that there is a statistically significant association between helminthiasis and gestational anemia. Although hookworm is the main species associated with the outcome, prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk. The impact of other species needs to be defined given the expected bias that arises from polyparasitism when defining comparison groups.
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Affiliation(s)
- Juan Carlos Alvarado-Gonzalez
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
| | | | | | - Ivan David Lozada-Martinez
- Fac Ciències Salut Blanquerna, Univ Ramon Llul, Barcelona, Spain.,Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia
| | | | - Alexis Rafael Narvaez-Rojas
- Division of Breast Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine - Jackson Health System, Miami, FL, USA
| | - Josefina Zakzuk
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
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Ahmed RH, Yussuf AA, Ali AA, Iyow SN, Abdulahi M, Mohamed LM, Mohamud MHT. Anemia among pregnant women in internally displaced camps in Mogadishu, Somalia: a cross-sectional study on prevalence, severity and associated risk factors. BMC Pregnancy Childbirth 2021; 21:832. [PMID: 34906104 PMCID: PMC8670163 DOI: 10.1186/s12884-021-04269-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia in pregnancy is a serious global public health problem in most developing countries and a major cause of maternal morbidity and mortality. Somalia which already had very high maternal mortality ratio of 829 per 100,000 live births, pregnant women in internally displaced camps (IDPs) remain at most exposed. The aim of the study was to determine the prevalence, severity and associated risk factors of anemia among pregnant women in internally displaced camps in Mogadishu, Somalia. METHODS A community based cross-sectional study was conducted among 383 households in the most IDP settled districts in Mogadishu. Every pregnant mother in these sampled households who was voluntarily consented was targeted. A sample of blood was also taken by pricking the fingertip and inserted into hemoglobin meter. Those with Hb < 11 g/dl from hemoglobin meter had been taken another sample of 3 cc blood and put into EDTA tube for CBC analysis to identify the type of anemia. Data on risk factors were collected using structured pretested questionnaire via an interview. Collected data was coded and entered in SPSS- Version 22 for analysis. Descriptive analysis, bivariate chi-square and multivariate logistic regression were done. RESULTS The overall prevalence of anemia among study participants was 44.4% (95%CI: 39.5-49.3%), where severe and moderate anemia were 11.8 and 47.0% respectively. In addition all anaemic cases were microcytic hypochromic anemia. Young maternal age, low Family income, fewer/zero parity, being at third or second trimesters, lack of ANC attendance during pregnancy, lack of iron supplementation during pregnancy, taking tea immediately after meal during pregnancy, lower/zero frequency of daily meat and vegetables consumption during pregnancy were associated risk factors of anemia. CONCLUSION The anemia prevalence from this study was severe public health problem. Several factors were found to be associated with anemia during pregnancy. Measures has to be taken to curb the problem by including them mass iron supplementation and health education towards identified risk factors.
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Affiliation(s)
| | | | | | - Sowdo Nuur Iyow
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia
| | - Maryan Abdulahi
- Obstetrics and Gynaecology Department, Dr Sumait Hospital, Mogadishu, Somalia
- Faculty of Medicine & Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Lul Mohamud Mohamed
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia
- Paediatric Department, Jazeera University Hospital, Mogadishu, Somalia
| | - Mohamed Hayir Tahlil Mohamud
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia.
- Research Unit, Jazeera University, Mogadishu, Somalia.
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Fite MB, Assefa N, Mengiste B. Prevalence and determinants of Anemia among pregnant women in sub-Saharan Africa: a systematic review and Meta-analysis. Arch Public Health 2021; 79:219. [PMID: 34861892 PMCID: PMC8643002 DOI: 10.1186/s13690-021-00711-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/17/2021] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public health, Institute of Health Science, Wollega University, Nekemte, Ethiopia.
| | - Nega Assefa
- Department of Public health, School of public health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bizatu Mengiste
- Department of Public health, School of public health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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21
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Khani Jeihooni A, Rakhshani T, Harsini PA, Layeghiasl M. Effect of educational program based on theory of planned behavior on promoting nutritional behaviors preventing Anemia in a sample of Iranian pregnant women. BMC Public Health 2021; 21:2198. [PMID: 34852814 PMCID: PMC8638108 DOI: 10.1186/s12889-021-12270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is one of the most common problems during pregnancy. The aim of this research was to determine the effect of educational program based on Theory of Planned Behavior (TPB) on promoting nutritional behaviors preventing anemia in a pregnant woman in Shiraz city, Iran. METHODS This quasi-experimental study was done on 150 pregnant women (75 experimental and 75 control groups) who were selected using randomly sampling method in in Shiraz city, Iran, in 2020-2021. The educational intervention for the experimental group included six educational sessions for 50 or 55 min-based TPB model. A questionnaire consisted of items about demographic information, TPB constructs (attitude, perceived behavioral control, subjective norms and behavioral intention) was used to measure the nutritional behaviours preventing iron deficiency anemia in pregnancy women before and 3 months after the intervention. RESULTS The results showed that before the educational intervention, there was no significant difference between the two groups in terms of knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance; however, three months after the educational intervention, the experimental group showed a significant increase in each of the mentioned variables. For example the mean and standard deviation score of behavioral intention after intervention in the experimental group was significantly increased (25.57 ± 1.66, P = 0.001),and the mean and standard deviation score of performance after intervention in the experimental group was significantly increased (31.03 ± 2.19, P = 0.001), (P < 0.05). CONCLUSIONS After the educational intervention, the experimental group showed a significant increase in of the knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance. Therefore the results of the study showed positive effect of nutrition educational intervention program base on TPB model on improvement of iron deficiency anemia preventive behaviours in the pregnancy women.
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Affiliation(s)
- Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tayebeh Rakhshani
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Layeghiasl
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Pregnant Women Attending Antenatal Care in Yifag Health Center, Northwest Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:7291199. [PMID: 34721748 PMCID: PMC8553486 DOI: 10.1155/2021/7291199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023]
Abstract
Background A cross-sectional study was conducted from November 2019 to March 2020 to determine the prevalence and associated risk factors of intestinal parasitic infections (IPIs) among pregnant women attending antenatal care (ANC) at Yifag Health Center. Methods The data were collected by a questionnaire interview technique and collecting the stool samples from each pregnant woman. Wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 25, and P-values < 0.05 were considered statistically significant. Results Out of the total 280 pregnant women who were selected using a simple random sampling technique, 277 participated in the questionnaire survey and gave stool samples (a response rate of 98.9%). The prevalence of IPIs among pregnant women was 53.4% (95% CI: 47.37, 59.42). Taenia species (18.1%) was the predominant parasite followed by Giardia lamblia (12.6%), Entamoeba histolytica/dispar (9.4%), hookworms (9%), Ascaris lumbricoides (4%), Schistosoma mansoni (3.2%), Hymenolepis nana (0.7%), Strongyloides stercoralis (0.4%), and Enterobius vermicularis (0.4%). Eating raw vegetables (AOR = 2.721; 95% CI: 1.266, 5.849; P=0.010) and poor personal hygiene (AOR = 4.015; 95% CI: 1.456, 11.07; P=0.007) were associated risk factors for G. lamblia, while eating raw meat (AOR = 2.477; 95% CI: 1.252, 4.902; P=0.009) for Taenia species infections. The prevalence of intestinal parasites was high and still a health burden to the pregnant women in the study area. We recommend avoiding eating raw meat, strengthening sanitation and hygiene programs, and routine deworming of pregnant mothers to reduce the burden of IPIs among pregnant women.
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Adjei-Banuah NY, Aduah VA, Ziblim SD, Ayanore MA, Amalba A, Mogre V. Nutrition Knowledge is Associated With the Consumption of Iron Rich Foods: A Survey Among Pregnant Women From a Rural District in Northern Ghana. Nutr Metab Insights 2021; 14:11786388211039427. [PMID: 34483667 PMCID: PMC8411617 DOI: 10.1177/11786388211039427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/26/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Iron deficiency anaemia is an international public health concern and pregnant women are at an increased risk. We investigated the consumption of iron rich foods and associated factors among pregnant women in a rural district from Ghana. METHODS Following a cross-sectional design, dietary intake of iron rich foods was obtained from 252 pregnant women using a 24-hour recall food check list. Nutrition knowledge, attitudes and socio-demographic characteristics were also assessed. FINDINGS Participants had a mean (SD) knowledge score of 54.66 (22.74)%. About 73% of the participants had heard about iron-deficiency anaemia. Only 16.3% of the participants knew foods that help the body to absorb and use iron while 9.1% knew beverages that decrease iron absorption. About 71% of the participants ate fish and/or seafood while 67.1% of them ate green leafy vegetables. Only 4.4% of the participants ate organ meat, and 29% took flesh meat. Only 22.4% of the study participants usually drank coffee or tea while 78.2% ate vitamin C-rich foods. With regards to attitudes, 88.5% of the participants perceived anaemia to be a serious disease. Nutrition knowledge was significantly associated with the consumption of iron rich foods (β = .02; 95% CI = 0.01-0.02). CONCLUSION Nutrition knowledge may be an important determinant of the consumption of iron rich foods among pregnant women making it necessary for healthcare providers to continue to provide nutrition education to pregnant women during routine antenatal care.
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Affiliation(s)
- Nhyira Yaw Adjei-Banuah
- Department of Community Health and
Family Medicine, School of Medicine, University for Development Studies, Tamale,
Ghana
| | - Victor Abugah Aduah
- Department of Community Health and
Family Medicine, School of Medicine, University for Development Studies, Tamale,
Ghana
| | - Shamsu-Deen Ziblim
- Department of Health Policy Planning
and Management, School of Public Health, University of Health and Allied Sciences,
Ho-Ghana
| | - Martin Amogre Ayanore
- Department of Population and
Reproductive Health, School of Public Health, University for Development Studies,
Tamale, Ghana
| | - Anthony Amalba
- Department of Health Professions
Education and Innovative Learning, School of Medicine, University for Development
Studies, Tamale, Ghana
| | - Victor Mogre
- Department of Health Professions
Education and Innovative Learning, School of Medicine, University for Development
Studies, Tamale, Ghana
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24
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Andarge SD, Areba AS, Kabthymer RH, Legesse MT, Kanno GG. Is Indoor Air Pollution From Different Fuel Types Associated With the Anemia Status of Pregnant Women in Ethiopia? J Prim Care Community Health 2021; 12:21501327211034374. [PMID: 34328038 PMCID: PMC8327257 DOI: 10.1177/21501327211034374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.
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Affiliation(s)
| | - Abriham Sheferaw Areba
- College of Health and Medical Science, School of public health, Dilla University, Dilla, Ethiopia
| | - Robel Hussen Kabthymer
- College of Health and Medical Science, School of public health, Dilla University, Dilla, Ethiopia
| | - Miheret Tesfu Legesse
- College of Health and Medical Science, School of public health, Dilla University, Dilla, Ethiopia
| | - Girum Gebremeskel Kanno
- College of Health and Medical Science, School of public health, Dilla University, Dilla, Ethiopia
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25
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Kare AP, Gujo AB. Anemia among Pregnant Women Attending Ante Natal Care Clinic in Adare General Hospital, Southern Ethiopia: Prevalence and Associated Factors. Health Serv Insights 2021; 14:11786329211036303. [PMID: 34376992 PMCID: PMC8327009 DOI: 10.1177/11786329211036303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Assefa Philipos Kare
- Department of Social and Population Health, Yirgalem Hospital Medical College, Ethiopia
| | - Amelo Bolka Gujo
- Department of Social and Population Health, Yirgalem Hospital Medical College, Ethiopia
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Animaw Z, Melese A, Demelash H, Seyoum G, Abebe A. Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:474. [PMID: 34210260 PMCID: PMC8252203 DOI: 10.1186/s12884-021-03908-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.
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Affiliation(s)
- Zelalem Animaw
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Addisu Melese
- Department of Medical Microbiology, College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habtamu Demelash
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Girma Seyoum
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Abebe
- Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Taghipour A, Ghodsian S, Jabbari M, Olfatifar M, Abdoli A, Ghaffarifar F. Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 115:457-470. [PMID: 33007067 DOI: 10.1093/trstmh/traa101] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/04/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Sahar Ghodsian
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Jabbari
- Department of Microbiology, Faculty of Basic Science, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
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Chelkeba L, Melaku T, Lemma D, Mekonnen Z. Burden of intestinal parasitic infections among pregnant women in Ethiopia: a systematic review and meta-analysis. Infection 2021; 49:1091-1105. [PMID: 34110569 DOI: 10.1007/s15010-021-01635-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Legese Chelkeba
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegaye Melaku
- School of Pharmacy, Institute of Health, Jimma University, P.O. Box: 378, Jimma, Ethiopia.
| | - Dereje Lemma
- Department of Obstetrics and Gynecology, College Health Sciences, Ambo University, Ambo, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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29
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Debella A, Dheresa M, Geda B, Tiruye G, Fage SG. A Third of Pregnant Women are Affected by Anemia in Eastern Ethiopia: A Facility-Based Study. J Blood Med 2021; 12:299-306. [PMID: 34040474 PMCID: PMC8140923 DOI: 10.2147/jbm.s305567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/13/2021] [Indexed: 01/17/2023] Open
Abstract
Background Although it is a public health problem of pregnant women in low, middle and high-income countries, the highest prevalence rate of anemia is found among pregnant women of low-income countries, particularly in Africa. Therefore, this study has aimed to determine the magnitude of the anemia and its associated factors among pregnant women admitted to labor wards of public hospitals in eastern Ethiopia. Methods and Materials A health facility-based cross-sectional study was conducted among 405 pregnant women admitted to labor wards in four public hospitals of Harar town and Dire Dawa City Administration. A systematic random sampling technique was used to select the study participants. Data were collected through an interview using a structured questionnaire. The hemoglobin level was measured for each study participant. Binary and multivariable logistic regression models were fitted and statistical significance was declared at P<0.05. Results The magnitude of anemia was 33.1% (95% CI: 28.4%, 37.8%). Being from rural areas (AOR: 3.8; 95% CI: 1.81, 7.94), no antenatal care (ANC) follow-up (AOR: 3.4; 95% CI: 1.34, 8.79), a habit of drinking milk with tea after meals (AOR: 2.8; 95% CI: 1.48, 5.61), taking a meal only 1–2 times per day (AOR: 3.9; 95% CI: 1.69, 8.97), experiencing no blood loss in the current pregnancy (AOR: 0.25; 95% CI: 0.06, 0.96) and a habit of eating leafy vegetables (AOR: 0.12; 95% CI: 0.06, 0.24) were significantly associated with anemia. Conclusion About one in three pregnant women were anemic and anemia was a moderate public health problem in the study settings. Interventions targeting reducing or preventing anemia should focus on pregnant women in rural areas, promoting the benefits of ANC follow-up, reducing the habit of drinking milk with tea after meals, enhancing the consumption of leafy vegetables and increasing meal frequency per day to minimize or prevent anemia and its consequences during pregnancy.
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Affiliation(s)
- Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, College of Health and Medical Sciences, Meda Welabu University, Bale-Robe, Ethiopia
| | - Getahun Tiruye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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30
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Pervin J, Sarker BK, Nu UT, Khatun F, Rahman AMQ, Venkateswaran M, Rahman A, Frøen JF, Friberg IK. Developing targeted client communication messages to pregnant women in Bangladesh: a qualitative study. BMC Public Health 2021; 21:759. [PMID: 33879108 PMCID: PMC8056650 DOI: 10.1186/s12889-021-10811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 04/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Timely and appropriate evidence-based practices during antenatal care improve maternal and neonatal health. There is a lack of information on how pregnant women and families perceive antenatal care in Bangladesh. The aim of our study was to develop targeted client communication via text messages for increasing antenatal care utilization, as part of an implementation of an electronic registry for maternal and child health. Methods Using a phenomenological approach, we conducted this qualitative study from May to June 2017 in two sub-districts of Chandpur district, Bangladesh. We selected study participants by purposive sampling. A total of 24 in-depth interviews were conducted with pregnant women (n = 10), lactating women (n = 5), husbands (n = 5), and mothers-in-law (n = 4). The Health Belief Model (HBM) was used to guide the data collection. Thematic analysis was carried out manually according to the HBM constructs. We used behavior change techniques to inform the development of targeted client communication based on the thematic results. Results Almost no respondents mentioned antenatal care as a preventive form of care, and only perceived it as necessary if any complications developed during pregnancy. Knowledge of the content of antenatal care (ANC) and pregnancy complications was low. Women reported a variety of reasons for not attending ANC, including the lack of information on the timing of ANC; lack of decision-making power; long-distance to access care; being busy with household chores, and not being satisfied with the treatment by health care providers. Study participants recommended phone calls as their preferred communication strategy when asked to choose between the phone call and text message, but saw text messages as a feasible option. Based on the findings, we developed a library of 43 automatically customizable text messages to increase ANC utilization. Conclusions Pregnant women and family members had limited knowledge about antenatal care and pregnancy complications. Effective health information through text messages could increase awareness of antenatal care among the pregnant women in Bangladesh. This study presents an example of designing targeted client communication to increase antenatal care utilization within formal scientific frameworks, including a taxonomy of behavior change techniques. Trial registration ISRCTN69491836. Registered on December 06, 2018. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10811-y.
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Affiliation(s)
- Jesmin Pervin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. .,University of Bergen, Bergen, Norway.
| | - Bidhan Krishna Sarker
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - U Tin Nu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fatema Khatun
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,Norwegian Institute of Public Health, Oslo, Norway
| | - A M Quaiyum Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahima Venkateswaran
- University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Anisur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - J Frederik Frøen
- University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Ingrid K Friberg
- Norwegian Institute of Public Health, Oslo, Norway.,Tacoma-Pierce County Health Department, Tacoma, WA, USA
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Gebere YF, Bimerew LG, Malko WA, Fenta DA. Hematological and CD4+ T- cell count reference interval for pregnant women attending antenatal care at Hawassa University Comprehensive Specialized Hospital, Hawassa Southern Ethiopia. PLoS One 2021; 16:e0249185. [PMID: 33831053 PMCID: PMC8031454 DOI: 10.1371/journal.pone.0249185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pregnancy is a state characterized by physiological, hematological, and immunological changes. However, the reference intervals (RI) being used in clinical practice in Ethiopia are derived from non-local general populations. Therefore; this study was aimed to determine the reference interval of hematological and immunological profiles among healthy pregnant mothers attending Hawassa University Hospital. METHODS A cross-sectional study in a total of 360 healthy pregnant women was enrolled from January to April 2019, at Hawassa University hospital. Sociodemographic and obstetric data were collected using a structured questionnaire. Blood samples collected from each participant were used to define the hematological parameters. The median and 95% intervals were calculated for the immunological and hematological profiles. P-value 0.05 was considered statistically significant. RESULT A total of 360 healthy pregnant women were enrolled in this study. The age range of the participants was 18-45 years. 342(95%) were married and 270 (75%) of the participants were multigravida. The overall median CD4+ T-cell and total WBC counts (cells/mm3) were 602 and 7.58 respectively. The overall median value for lymphocytes, neutrophils, monocytes, eosinophils, and basophil count was (cells/mm3) was 2.21, 6.74, .63, .53, and 0.09 respectively. Whereas the median RBC and platelet count was 4.48×106/μLand 212×106/μL. The median value of hematological profiles in the first, second, and third trimesters was TWBC (103/μL) (7.90, 8.30, 8.65), RBC (106/μL) (4.5, 4.6, 4.62), and PLT (103/μL) (210, 209,161) respectively. The CD4 T cell count median value was (600, 598, and 591) in the first, second, and third trimesters. Significant changes were observed in hematological and immunological parameters between trimesters (P < 0.05). CONCLUSION Significant changes were observed in hematological and immunological parameters between trimesters (P < 0.05). Considerable differences were also seen between the values in this study and other studies from Ethiopia and other countries, indicated the need for the development of local reference intervals for pregnant women.
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Affiliation(s)
- Yidnekachew Fiseha Gebere
- Department of Medical Laboratory, College of Medicine and Health Science, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Sidama Region, Ethiopia
| | - Lealem Gedefaw Bimerew
- School of Medical Laboratory Sciences, Institute of Health Faculty of Health, Jimma University, Jimma, Oromiya Region, Ethiopia
| | - Wondimagegn Adissu Malko
- School of Medical Laboratory Sciences, Institute of Health Faculty of Health, Jimma University, Jimma, Oromiya Region, Ethiopia
| | - Demissie Assegu Fenta
- School of Medical Laboratory Science, College of Medicine and Health Science, Hawassa University, Hawassa, Sidama Region, Ethiopia
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Adam I, ALhabardi NA, Al-Wutayd O, Khamis AH. Prevalence of schistosomiasis and its association with anemia among pregnant women: a systematic review and meta-analysis. Parasit Vectors 2021; 14:133. [PMID: 33653391 PMCID: PMC7923606 DOI: 10.1186/s13071-021-04642-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 02/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review and meta-analysis of schistosomiasis during pregnancy. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in international databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar), from their inception until May 31, 2020. The retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale. OpenMeta Analyst software was used for the statistical analysis. RESULTS Thirty-two studies enrolling 21024 pregnant women were included in this meta-analysis. All 32 of these studies were conducted in Africa. Of these studies, 19, 11, and 2 investigated S. mansoni, S. haematobium, and combined S. mansoni and S. haematobium infections, respectively. The pooled prevalence estimate of schistosomiasis during pregnancy was 13.2% (95 CI 11.0-15.4). A random model was used because of high heterogeneity (Q = 99.14; P < 0.001). In subgroup analyses, the pooled prevalence estimate of S. haematobium was significantly higher than the pooled prevalence estimates of S. mansoni [22.5% (95% CI 1.6-43.5) vs 8.7% (95% CI 6.0-11.3, P = 0.016), respectively]. The results of meta-regression analyses showed a non-significant difference in the prevalence of schistosomiasis during pregnancy according to the study sample sizes and year of publication. Only six studies evaluated the association between schistosomiasis during pregnancy and anemia. Schistosomiasis was associated with anemia in these six studies (OR = 3.02, 95% = 1.25‒7.28, P = 0.014). CONCLUSION The present meta-analysis suggests that schistosomiasis during pregnancy is an existing health problem. This meta-analysis also highlights the lack of data on the determinants and outcomes of schistosomiasis during pregnancy. Preventive measures are needed and could be part of antenatal care in areas endemic with schistosomiasis.
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Affiliation(s)
- Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Nadiah A. ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Ammar H. Khamis
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Bongomin F, Olum R, Kyazze AP, Ninsiima S, Nattabi G, Nakyagaba L, Nabakka W, Kukunda R, Ssekamatte P, Kibirige D, Cose S, Nakimuli A, Baluku JB, Andia-Biraro I. Anemia in Ugandan pregnant women: a cross-sectional, systematic review and meta-analysis study. Trop Med Health 2021; 49:19. [PMID: 33648575 PMCID: PMC7919073 DOI: 10.1186/s41182-021-00309-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/19/2021] [Indexed: 12/26/2022] Open
Abstract
Background Anemia in pregnancy represents a global public health concern due to wide ranging maternal and neonatal adverse outcomes in all peripartum periods. We estimated the prevalence and factors associated with anemia in pregnancy at a national obstetrics and gynecology referral hospital in Uganda and in addition performed a systematic review and meta-analysis of the overall burden of anemia in pregnancy in Uganda. Methods We conducted a cross-sectional study among 263 pregnant women attending the antenatal care clinic of Kawempe National Referral Hospital, Kampala, Uganda, in September 2020. Anemia in pregnancy was defined as a hemoglobin level of < 11.0 g/dl and microcytosis as a mean corpuscular volume (MCV) of < 76 fL. We also performed a systematic review (PROSPERO Registration ID: CRD42020213001) and meta-analysis of studies indexed on MEDLINE, Embase, African Journal Online, ClinicalTrials.gov, ICTRP, and the Cochrane Library of systematic review between 1 January 2000 and 31 September 2020 reporting on the prevalence of anemia in pregnancy in Uganda. Results The prevalence of anemia was 14.1% (n= 37) (95%CI 10.4–18.8), of whom 21 (56.8%) had microcytic anemia. All cases of anemia occurred in the second or third trimester of pregnancy and none were severe. However, women with anemia had significantly lower MCV (75.1 vs. 80.2 fL, p<0.0001) and anthropometric measurements, such as weight (63.3 vs. 68.9kg; p=0.008), body mass index (25.2 vs. 27.3, p=0.013), hip (98.5 vs. 103.8 cm, p=0.002), and waist (91.1 vs. 95.1 cm, p=0.027) circumferences and mean systolic blood pressure (BP) (118 vs 125 mmHg, p=0.014). Additionally, most had BP within the normal range (59.5% vs. 34.1%, p=0.023). The comparison meta-analysis of pooled data from 17 published studies of anemia in pregnancy in Uganda, which had a total of 14,410 pregnant mothers, revealed a prevalence of 30% (95% CI 23–37). Conclusions Despite our study having a lower prevalence compared to other studies in Uganda, these findings further confirm that anemia in pregnancy is still of public health significance and is likely to have nutritional causes, requiring targeted interventions. A larger study would be necessary to demonstrate potential use of basic clinical parameters such as weight or blood pressure as screening predictors for anemia in pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-021-00309-z.
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Affiliation(s)
- Felix Bongomin
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda. .,Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
| | - Ronald Olum
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Andrew Peter Kyazze
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sandra Ninsiima
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Gloria Nattabi
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Lourita Nakyagaba
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Winnie Nabakka
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Rebecca Kukunda
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Phillip Ssekamatte
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Davis Kibirige
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Directorate of Programs, Mildmay Uganda, Wakiso, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics & Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Baruch Baluku
- Directorate of Programs, Mildmay Uganda, Wakiso, Uganda.,Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - Irene Andia-Biraro
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Department of Clinical Research, Faculty of Infectious and Tropical Disease (ITD), London School of Hygiene and Tropical Medicine, London, UK
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Assefa E. Multilevel analysis of anemia levels among reproductive age groups of women in Ethiopia. SAGE Open Med 2021; 9:2050312120987375. [PMID: 33552512 PMCID: PMC7841667 DOI: 10.1177/2050312120987375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/17/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Anemia is a condition in which the hemoglobin concentration falls below 11 g/dL. It impairs health and well-being in women and increases the risk of maternal and neonatal adverse outcomes. The availability of local information on the magnitude and associated factors has a major role in the management and control of anemia in women contributing to reduction in maternal morbidity and mortality. Methods The purpose of this study was to see regional impacts and influencing factors related to the anemia among women in Ethiopia using the 2016 Ethiopia Demographic and Health Survey data. The anemia level among women aged 15-49 years (n = 5133) using the multilevel ordinal logistic regression model was analyzed. Results In the study, 37.4% of women in Ethiopia had no anemia, above one-third percent (34.4%) of women had moderate anemia, and approximately 4% women's anemia level was severe. The 27.1% of variation of anemia was due to between-region variations. The odds of being normal weight in the greater category of anemia level were 0.59 times less likely as compared to underweight women. The higher levels of anemia were increased by 2.31 for pregnant women as compared to non-pregnant women. Having work being in greater anemia levels was 0.88 times less likely as compared to had no work. Older women (35-49 years) in higher anemia levels were 2.1 times more likely as compared to younger women. The women living in the rural area being in the greater category anemia levels were 1.53 times more likely as compared to women living in the urban area. The higher level of anemia in the rich quintile was 0.72 times less likely to the higher level of anemia as compared in the poor quintile women. Conclusion Pregnant women in Ethiopia are more exposed for the higher anemia level and women live in rural area have the greater anemia level.
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Affiliation(s)
- Enyew Assefa
- Department of Statistics, Wollo University, Dessie, Ethiopia
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Mishra A, Marwah S, Divedi P, Dewan R, Ahluwalia H. A Cross-Sectional Study of Barriers in Prevention of Anemia in Pregnancy. Cureus 2021; 13:e12802. [PMID: 33628671 PMCID: PMC7894214 DOI: 10.7759/cureus.12802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Anemia in pregnancy is a significant health challenge in India and other developing countries. Various health programs aiming anemia prevention are existing in India for many decades. Despite that, anemia affects more than half of pregnant women. Our objective for performing this study was to evaluate the barriers in the prevention of anemia and to evaluate the perceptions and practices of anemic women towards their condition. Methods A cross-sectional questionnaire-based study, including 210 anemic women, was conducted in a tertiary care center in Delhi, India. In-depth interviews were conducted with 50 participants. Results Our important observations were that anemia was more prevalent in multigravida, and 43.80% of anemic patients were not taking iron supplements at the time of diagnosis. Chronic diseases were associated with 28.2% (n=59) of anemic women. Only 19% (n=40) of women sought antenatal care in the first and second trimester; the rest all booked themselves in the third trimester only. Twenty-two percent (n=48) of women reached our hospital after 36 weeks. Ignorance to anemia symptoms and the importance of consistent intake of the oral iron supplements was seen in 35.2% (n=74). One hundred and sixty-five (74.8%) women accepted that healthcare provider had informed them about iron-rich and high protein diet, but only 47.1% (n=98) actually made dietary modifications. Only 9.5% (n=20) of women were consistent in iron intake. Side effects of iron were reported by 30% (n=64) of women, and 15% (n=32) were intolerant to oral iron. Non-availability, change of residence, and forgetfulness were the main reasons behind non-compliance to oral iron. Conclusion We emphasize motivation for early registration, regular antenatal care, adequate iron supplement supply, and persistent counseling to ensure compliance to iron supplements by the antenatal care provider. Behavior-changing communication is needed at a societal level for antenatal mothers and their families aiming to prevent anemia in pregnancy instead of focussing on treatment.
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Affiliation(s)
- Archana Mishra
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Sheeba Marwah
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Pragati Divedi
- Department of Obstetrics and Gynecology, Rama Medical College and Hospital, Hapur, IND
| | - Rupali Dewan
- Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Himani Ahluwalia
- Department of Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Kushitor SB, Owusu L, Kushitor MK. The prevalence and correlates of the double burden of malnutrition among women in Ghana. PLoS One 2020; 15:e0244362. [PMID: 33370352 PMCID: PMC7769247 DOI: 10.1371/journal.pone.0244362] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 12/08/2020] [Indexed: 01/23/2023] Open
Abstract
Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15-49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.
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Affiliation(s)
- Sandra Boatemaa Kushitor
- Food Security Initiative and Centre for Complex Systems in Transition, Stellenbosch University, Stellenbosch, South Africa
| | - Lily Owusu
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Mawuli Kobla Kushitor
- Department of Health Policy, Planning and Management, University of Health and Allied Sciences, Hohoe, Ghana
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Determinants of Anemia among Pregnant Women at Public Hospitals in West Shewa, Central Ethiopia: A Case-Control Study. Anemia 2020. [DOI: 10.1155/2020/2865734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Anemia is highly dominant among pregnant women due to the need for iron for women themselves and their fetuses. Nearly half a billion globally and around one-third in Ethiopia of pregnant women were affected by anemia which has both health and economic impact. Therefore, this study aimed to identify the determinants of anemia among pregnant women attending antenatal care at public hospitals in the West Shewa zone, Oromia regional state, Central Ethiopia, 2019. Methods. An unmatched case-control study was conducted at public hospitals in the West Shewa zone, Ethiopia, from February to April 2019. A consecutive sampling was used to select study participants. Data were collected by a structured questionnaire, and the collected data were entered into Epi Info version 7 and SPSS version 23 for analyses. Descriptive statistics such as tables, graphs, and proportions were used to present the data. Binary and multiple logistic regression analyses were computed to identify the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and
value <0.05 were used to determine the presence of an association. Result. A total of 426 women (142 cases and 284 controls) participated in this study with a 95.3% response rate. Family size >5 (AOR = 2.95, 95% CI: 1.34–6.50), peptic ulcer diseases (PUD) (AOR = 2.85, 95% CI: 1.14–7.13), having the previous history of abortion (AOR = 2.84, 95% CI: 1.08–7.47), birth interval <2 years (AOR = 2.61, 95% CI: 1.20–5.70), antepartum hemorrhage (APH) (AOR = 6.05, 95% CI: 1.95–18.81), and not using latrine (AOR = 3.45, 95% CI: 1.30–9.24) were the identified determinants of anemia. Conclusions. Family size, PUD, abortion, birth interval, APH, and unable to use latrine were the determinants of anemia among pregnant women. Therefore, the intervention on anemia prevention should consider the promotion of family planning methods and counseling on latrine utilization.
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Nutritional-Related Predictors of Anemia among Pregnant Women Attending Antenatal Care in Central Ethiopia: An Unmatched Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8824291. [PMID: 33294455 PMCID: PMC7691012 DOI: 10.1155/2020/8824291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/24/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022]
Abstract
Background Anemia is a major public health problem in both developed and developing countries especially among pregnant women. Nearly half of pregnant women in Ethiopia have anemia which has both health and economic impacts. Therefore, this study is aimed at identifying nutritional-related predictors of anemia among pregnant women attending antenatal care in Central Ethiopia, 2019. Methods An unmatched case-control study was conducted at public hospitals in Central Ethiopia from February to April 2019. The consecutive sampling technique was used to select study participants. Data were collected by a structured questionnaire, and the collected data were entered into Epi Info version 7 and SPSS version 23 for analysis. Binary and multiple logistic regression analyses were computed to identify predictors of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 was used to determine the presence of an association. Result A total of 426 pregnant women (142 cases and 284 controls) had participated in this study. Taking tea/coffee immediately after food (AOR = 2.35, 95% CI: 1.39-3.99), mid-upper arm circumference (MUAC) of mothers of <23 centimeters (AOR = 3.83, 95% CI: 2.26-6.49), the presence of forbidden food during pregnancy (AOR = 2.21, 95% CI: 1.24-3.88), not taking additional food (AOR = 1.99, 95% CI: 1.17-3.40), unable to take fruit (AOR = 4.05, 95% CI: 1.3-15.47), loss of appetite (AOR = 2.28, 95% CI: 1.28-4.09), low dietary diversity score (DDS) (AOR = 3.29, 95% CI: 1.83-5.90), and medium DDS (AOR = 2.88, 95% CI: 1.46-5.70) were found to be determinants of anemia. Conclusions Taking tea or coffee immediately after food, MUAC of mothers, the presence of forbidden food, not taking additional food, frequency of taking fruit, and dietary diversity were predictors of anemia among pregnant women. Therefore, interventions targeted at prevention of anemia among pregnant mothers should emphatically consider those identified determinants. This finding also highlights the need for strong nutritional counseling to prevent anemia among pregnant mothers during antenatal care follow-ups along with other interventions.
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Kejela G, Wakgari A, Tesfaye T, Turi E, Adugna M, Alemu N, Jebessa L. Prevalence of anemia and its associated factors among pregnant women attending antenatal care follow up at Wollega University referral hospital, Western Ethiopia. Contracept Reprod Med 2020; 5:26. [PMID: 33062297 PMCID: PMC7547419 DOI: 10.1186/s40834-020-00130-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/20/2020] [Indexed: 11/26/2022] Open
Abstract
Background Even if anemia is a worldwide public health problem affecting numerous people in all age groups, particularly the burden of the problem is higher among pregnant women. Anemia is estimated to contribute to more than 115,000 maternal deaths and 591,000 prenatal deaths globally per year. Maternal mortality is the prime health indicator in any society. Therefore, determining the prevalence of anemia and assessing its associated factors among pregnant women might help for the intervention of the problem. Objective The objective of this study was to determine the prevalence of anemia and its associated factors among pregnant women attending Antenatal Care (ANC) at Wollega University Referral Hospital, Western Ethiopia. Methods and materials Institution based cross-sectional study was conducted at antenatal care (ANC) departments of Gynecology and Obstetrics, and MCH at Wollega University Referral Hospital from July 15–22, 2019. A systematic random sampling technique was used to select the study unit. The data were collected using questionnaires, physical examination, and laboratory investigation. After collection, the data were entered using Epi Data version 3.1 and analyzed using SPSS version 20 statistical software. Bivariate and multivariate logistic regression analysis was performed to identify predictors of anemia. Finally, the result was presented using text, tables, and charts. Results The overall prevalence of anemia using a cut off level of hemoglobin < 11 g/dl (< 33% Haematocrit) was 51 (17.8%). Out of all anemic pregnant women, 19 (37.25%) were mildly anemic, 24 (47%) were moderately anemic and 8 (15.68%) were severely anemic. Multivariable logistic regression analysis revealed that Birth interval of less than 2 years (AOR = 2.56 CI [2.84–4.52]), history of malarial attack in the past 12 months (AOR = 2.585 CI [1.181–5.656]) and engaging into daily laborer occupation (AOR = 8.33 CI [2.724–25.497]) showed significant association with maternal anemia. Conclusions The prevalence of anemia among pregnant women in this study is high. Having a birth interval of < 2 years, having a history of malarial attack in the past 12 months, and being engaged in daily laborer occupation were factors associated with anemia among pregnant women. Thus, contraceptive methods and information to space children, information, and services to prevent malaria and economically empowering women is needed to prevent anemia among pregnant women in the study area.
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Affiliation(s)
- Gemechu Kejela
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Aga Wakgari
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tariku Tesfaye
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Moa Adugna
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Netsanet Alemu
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Latera Jebessa
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Nyamu GW, Kihara JH, Oyugi EO, Omballa V, El-Busaidy H, Jeza VT. Prevalence and risk factors associated with asymptomatic Plasmodium falciparum infection and anemia among pregnant women at the first antenatal care visit: A hospital based cross-sectional study in Kwale County, Kenya. PLoS One 2020; 15:e0239578. [PMID: 33031456 PMCID: PMC7544053 DOI: 10.1371/journal.pone.0239578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
Background Prevalence of Prevalence of malaria in pregnancy (MiP) in Kenya ranges from 9% to 18%. We estimated the prevalence and factors associated with MiP and anemia in pregnancy (AiP) among asymptomatic women attending antenatal care (ANC) visits. Methods We performed a cross-sectional study among pregnant women attending ANC at Msambweni Hospital, between September 2018 and February 2019. Data was collected and analyzed in Epi Info 7. Descriptive statistics were calculated and we compared MiP and AiP in asymptomatic cases to those without either condition. Adjusted prevalence Odds odds ratios (aPOR) and 95% confidence intervals (CI) were calculated to identify factors associated with asymptomatic MiP and AiP. Results We interviewed 308 study participants; their mean age was 26.6 years (± 5.8 years), mean gestational age was 21.8 weeks (± 6.0 weeks), 173 (56.2%) were in the second trimester of pregnancy, 12.9% (40/308) had MiP and 62.7% had AiP. Women who were aged ≤ 20 years had three times likelihood of developing MiP (aPOR = 3.1 Cl: 1.3–7.35) compared to those aged >20 years old. The likelihood of AiP was higher among women with gestational age ≥ 16 weeks (aPOR = 3.9, CI: 1.96–7.75), those with parasitemia (aPOR = 3.3, 95% CI: 1.31–8.18), those in third trimester of pregnancy (aPOR = 2.6, 95% CI:1.40–4.96) and those who reported eating soil as a craving during pregnancy (aPOR = 1.9, 95%CI:1.15–3.29). Conclusions Majority of the women had asymptomatic MiP and AiP. MiP was observed in one tenth of all study participants. Asymptomatic MiP was associated with younger age while AiP was associated with gestational age parasitemia, and soil consumption as a craving during pregnancy.
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Affiliation(s)
- Gibson Waweru Nyamu
- Technical University of Mombasa, Mombasa, Kenya
- Department of Health, Kwale County, Kwale County, Kenya
- * E-mail:
| | | | - Elvis Omondi Oyugi
- Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
| | - Victor Omballa
- Center for Global Health Research—Kenya Medical Research Institute, Nairobi, Kenya
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Fondjo LA, Addai‑Mensah O, Annani-Akollor ME, Quarshie JT, Boateng AA, Assafuah SE, Owiredu EW. A multicenter study of the prevalence and risk factors of malaria and anemia among pregnant women at first antenatal care visit in Ghana. PLoS One 2020; 15:e0238077. [PMID: 32822409 PMCID: PMC7444479 DOI: 10.1371/journal.pone.0238077] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Malaria in pregnancy remains a major public health problem in Africa and Ghana and has been associated with a variety of pregnancy-related adverse complications. The development of effective and timely health policies for the prevention and control of malaria and anemia in pregnancy; requires current and consistent data on the prevalence and risk factors. We report the prevalence and risk factors of malaria and anemia from three major hospitals across three regions in Ghana. METHODS This multicenter cross-sectional study comprising a total of 628 pregnant women was conducted at the antenatal care units of the Achimota Hospital in the Greater Accra Region (n = 199), St. Michael's Hospital in the Ashanti Region (n = 221), and Effia Nkwanta Regional Hospital in the Western Region (n = 211). Questionnaires were administered to obtain socio-demographic, obstetrics and clinical data. Venous blood, stool and urine samples were collected for hematological profile and parasite identification using microscopy. Risk factors were evaluated using logistic regression models. RESULTS The overall prevalence of P. falciparum malaria was 8.9%. Factors independently associated with malaria were self-reported mosquito exposure (moderate exposure: aOR = 3.11, 95% CI (1.12-8.61) and severe exposure: aOR = 10.46, 95% CI (3.86-28.34)) and non-use mosquito repellents (aOR = 3.29, 95% CI (1.70-6.39)). Multiparty (parity of 2: aOR = 0.19, 95% CI (0.05-0.70) and parity ≥3: aOR = 0.11, 95% CI (0.03-0.45)) and age (20-30 years old: aOR = 0.22, 95% CI (0.09-0.56)) reduced the odds of infection. The overall prevalence of anemia was 42.4%. The prevalence of mild, moderate and severe anemia were 35.7%, 6.1% and 0.6%, respectively. The use of water other than purified water (tap water: aOR = 3.05, 95% CI (2.06-4.51) and well water: aOR = 2.45, 95% CI (1.35-4.44)), increasing gestational age (second trimester: aOR = 2.05, 95% CI (1.41-2.97) and third trimester: aOR = 7.20, 95% CI (3.06-16.92)) and malaria (aOR = 2.40, 95% CI (1.27-4.53)) were independent risk factors for anemia. CONCLUSIONS Although the prevalence of malaria is relatively low, that of anemia remains high. We recommend increasing efforts to make ITNs more available to strengthen malaria prevention. Public health education programs could help improve uptake and proper use of ITNs. To help reduce anemia in pregnancy, women should be empowered economically and interventions that reduce malnutrition should be encouraged. Women should be educated on early initiation of antenatal care to enhance surveillance, identification and treatment of anemia.
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Affiliation(s)
- Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai‑Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jude Tetteh Quarshie
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adwoa Abrafi Boateng
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Ernest Assafuah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Osman MO, Nour TY, Bashir HM, Roble AK, Nur AM, Abdilahi AO. Risk Factors for Anemia Among Pregnant Women Attending the Antenatal Care Unit in Selected Jigjiga Public Health Facilities, Somali Region, East Ethiopia 2019: Unmatched Case-Control Study. J Multidiscip Healthc 2020; 13:769-777. [PMID: 32848406 PMCID: PMC7428401 DOI: 10.2147/jmdh.s260398] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby. Objective To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia. Methods An institution-based unmatched case–control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p<0.05. Results Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1–2 times a month [AOR=7.245; 95% CI=(2.007–26.151)] or not at all [AOR=8.690; 95% CI=(1.795–42.072)]), and insufficient consumption of green vegetables (i.e. 1–2 times a week [AOR=2.970; 95% CI=(1.012–8.716)] or 1–2 times a month [AOR=8.057; 95% CI=(2.358–27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240–51.526)] with anemia. Conclusion This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries.
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Affiliation(s)
- Mohamed Omar Osman
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Tahir Yousuf Nour
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Hodan Mahamed Bashir
- Department of Food Science and Nutrition, College of Dryland Agriculture, Jigjiga University, Jigjiga, Ethiopia
| | - Abdurahman Kedir Roble
- Department of Midwifery, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Abdikani Mawlid Nur
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Abdilahi Omer Abdilahi
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
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Parasitic infections among pregnant women at first antenatal care visit in northern Ghana: A study of prevalence and associated factors. PLoS One 2020; 15:e0236514. [PMID: 32706826 PMCID: PMC7380595 DOI: 10.1371/journal.pone.0236514] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023] Open
Abstract
Background Parasitic infections remain widespread in developing countries and constitute a major public health problem in many parts of sub-Saharan Africa. It is prevalent among children under 5 years and pregnant women; however, studies among the later high risk group is limited in the northern part of Ghana. Here, we evaluated the prevalence and associated factors of parasitic infections among pregnant women at first antenatal care visit in northern Ghana. Methods This was a cross-sectional study conducted at the Department of Obstetrics and Gynecology, Bolgatanga Regional Hospital, Upper East Region-Ghana. A total of 334 consecutive consenting pregnant women were included. Questionnaires were administered to obtain socio-demographic data. Venous blood, stool and urine samples were collected for parasite identification using microscopy. Factors associated with parasitic infections were evaluated using regression models. Statistical analysis was performed using R. Results Parasitic infections identified were giardiasis (30.5%), P. falciparum malaria (21.6%) and schistosomiasis (0.6%). Polyparasitic infection was identified in 6.6% of the population. Increasing age [Age of 20–29 years: AOR = 0.16, 95% CI (0.06–0.38); Age of 30–39 years: AOR = 0.21, 95% CI (0.08–0.50); Age >39 years: AOR = 0.30, 95% CI (0.11–0.83)] was associated with lower odds whiles presence of domestic animals [AOR = 1.85, 95% CI (1.01–3.39)], being in the second trimester of pregnancy [AOR = 2.21, 95% CI (1.17–4.19)], having no formal education [AOR = 3.29, 95% CI (1.47–7.35)] and basic education as the highest educational level [AOR = 6.03, 95% CI (2.46–10.81)] were independent predictors of increased odds of giardiasis. Similarly, having no formal education [AOR = 2.88, 95% CI (1.21–8.79)] was independently associated with higher odds of P. falciparum malaria. The use of insecticide treated net (ITN) [AOR = 0.43, 95% CI (0.21–0.89)] and mosquito repellent [AOR = 0.09, 95% CI (0.04–0.21)] were independent predictors of lower odds of P. falciparum malaria. Conclusion Giardiasis and P. falciparum malaria are common among pregnant women in northern Ghana. The major associated factors of giardiasis are lack of or low level of formal education, the presence of domestic animals and being in the second trimester of pregnancy. Increasing age confers protection against giardiasis. Likewise, lack of formal education is an associated factor for P. falciparum malaria among pregnant women in northern Ghana. The use of ITN and mosquito repellents reduce the risk of P. falciparum malaria. Given the possible role of parasitic infections in adverse pregnancy outcomes, our findings highlight the need for regular screening and treatment of infected women in the northern parts of Ghana. Public health education and improving socio-economic status could help reduce the risk of parasitic infections among pregnant women in the region.
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Mahamoud NK, Mwambi B, Oyet C, Segujja F, Webbo F, Okiria JC, Taremwa IM. Prevalence of Anemia and Its Associated Socio-Demographic Factors Among Pregnant Women Attending an Antenatal Care Clinic at Kisugu Health Center IV, Makindye Division, Kampala, Uganda. J Blood Med 2020; 11:13-18. [PMID: 32021527 PMCID: PMC6980843 DOI: 10.2147/jbm.s231262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/07/2020] [Indexed: 12/05/2022] Open
Abstract
AIMS/OBJECTIVES This study sought to determine the prevalence, morphological characterization and associated socio-demographic factors of anemia among pregnant women attending Kisugu Health Centre IV, Makindye Division, Kampala, in Uganda. METHODS This was a cross-sectional study that employed laboratory analysis of blood samples to determine hemoglobin concentration, and a structured questionnaire to obtain socio-demographic factors associated with anemia during pregnancy. RESULTS We enrolled 345 pregnant women aged 15 to 43 years. The median, interquartile range, and mean Hb levels were 8.1g/dL, 6.4 ± 2.1g/dL and 7.9g/dL, respectively. There were 89 participants whose Hb levels were indicative of anemia, giving anemia prevalence of 25.8% (95% confidence interval: 21.6-29.8). Of these, 25 (28.1%) had mild anemia, 46 (51.7%) had moderate anemia, while 18 (20.2%) had severe anemia. Thin blood film examination showed normocytic-hypochromic (75.3%), then microcytic-hypochromic (21.6%), and macrocytic-hypochromic red blood cells (3.4%). The socio-demographic factors of gestational age, parity, and mother's occupation were significantly associated with the risk of anemia (p< 0.05). CONCLUSION We report a high prevalence of anemia among pregnant women; with a majority of hypochromic-microcytic anemia. This may necessitate more anemia awareness and it requires institution of nutritional interventions to avert fetal-maternal complications.
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Affiliation(s)
- Naimo Khalif Mahamoud
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Bashir Mwambi
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Caesar Oyet
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Farouk Segujja
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Fred Webbo
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
- Lancet Laboratories, Kampala, Uganda
| | - John Charles Okiria
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Ivan Mugisha Taremwa
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
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Berhe K, Fseha B, Gebremariam G, Teame H, Etsay N, Welu G, Tsegay T. Risk factors of anemia among pregnant women attending antenatal care in health facilities of Eastern Zone of Tigray, Ethiopia, case-control study, 2017/18. Pan Afr Med J 2019; 34:121. [PMID: 31934262 PMCID: PMC6945385 DOI: 10.11604/pamj.2019.34.121.15999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/24/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Worldwide the average prevalence of anemia among pregnant women is 38.2% and in Ethiopia, the average prevalence of anemia among pregnant women is 22%. The aim of this research was to identify risk factors of anemia among pregnant women in Eastern Zone of Tigray, Ethiopia. Methods A case-control study was conducted among 600 (150 cases and 450 controls) pregnant women in 2017/18. Pregnant women with a hemoglobin level below 11 g/dl were cases (anemic) and those with hemoglobin >11 g/dl were controls (non-anemic). Data were collected using structured questionnaire and SPSS version 20 was used for analysis. Bivariate and multivariate logistic regression model was used to identify the risk factors for anemia among pregnant women. P-value <0.05 and adjusted odds ratio with a 95% confidence interval were used to assess the association. Results Intestinal parasites (adjusted odds ratio (AOR)=3.4; 95% confidence interval (CI): 1.2, 17.9), farmer occupation (AOR=3, 95% CI: 1.4, 10.8), unprotected sources of drinking water (AOR=3; 95% CI: 1.7, 16.9), drinking coffee/tea with or immediately after meal daily (AOR=1.9; 95%CI: 1.04, 8.7) and diet diversity score (DDS) of less than 3 (AOR=3; 95% CI: 1.5, 5.5) were statistically significant for anemia among pregnant women. Conclusion In this study, the risk factors for anemia among pregnant women were intestinal parasites, mother farmer occupation, unprotected source of drinking water, drinking coffee or tea with a meal or immediately after meal and low diet diversification score. Therefore, nutritional intervention should consider the above-identified risk factors.
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Affiliation(s)
- Kidanemaryam Berhe
- Department of Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Berhane Fseha
- Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | | | - Hirut Teame
- Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | - Natnael Etsay
- Department of Midwifery, Adigrat University, Adigrat, Ethiopia
| | - Guesh Welu
- Department of Midwifery, Aksum University, Axum, Ethiopia
| | - Tesfay Tsegay
- Department of Nursing, Adigrat University, Adigrat, Ethiopia
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Hailu T, Kassa S, Abera B, Mulu W, Genanew A. Determinant factors of anaemia among pregnant women attending antenatal care clinic in Northwest Ethiopia. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:13. [PMID: 31360533 PMCID: PMC6637567 DOI: 10.1186/s40794-019-0088-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/01/2019] [Indexed: 12/19/2022]
Abstract
Background Anaemia is a low blood haemoglobin concentration and has been shown to be a public health problem affecting both developing and developed countries. Pregnant women are the most vulnerable groups to anaemia due to several factors, including parasitic infection and feeding habits during their pregnancy. The aim of this study was to assess the prevalence and determinant factors of anemia in pregnant women in Northwest Ethiopia. Methods A cross-sectional study was conducted among pregnant women from February, 2017 to June, 2017. The data on determinant factors were collected using a structured questionnaire. The hemoglobin level and intestinal parasites were determined using Hemocue HB 201 and formol ether concentration techniques, respectively. Data was entered and analyzed using SPSS version 23 statistical software. Bivariate and multivariate regressions were computed and odds ratio was determined at 95% confidence interval. Results The study consists of 743 participants with a median age of 25 years were included. The prevalence of anemia among pregnant women was 79 (10.6%). The prevalence of mild, moderate and severe anaemia were 78 (99.8%), 1 (0.1%) and 1 (0.1%), respectively. Pregnant women of rural dwellers (AOR = 3.72, CI =1.51-9.18), farmer in occupation (AOR = 3.51, CI = 1.75-7.01), and not educated (AOR = 2.25, CI = 1.13-4.48) were significantly associated with increased risk of anemia. Conclusion Anaemia is still a problem amongst pregnant women in the study area though much has been done to increase the hemoglobin level during pregnancy. Health education should be given on factors that aggravate anaemia during pregnancy.
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Affiliation(s)
- Tadesse Hailu
- 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar City, Ethiopia
| | - Simachew Kassa
- 2Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar City, Ethiopia
| | - Bayeh Abera
- 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar City, Ethiopia
| | - Wondemagegn Mulu
- 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar City, Ethiopia
| | - Ashenafi Genanew
- 3Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar City, Ethiopia
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Berhe B, Mardu F, Legese H, Gebrewahd A, Gebremariam G, Tesfay K, Kahsu G, Negash H, Adhanom G. Prevalence of anemia and associated factors among pregnant women in Adigrat General Hospital, Tigrai, northern Ethiopia, 2018. BMC Res Notes 2019; 12:310. [PMID: 31151463 PMCID: PMC6544916 DOI: 10.1186/s13104-019-4347-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/29/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Anemia remains a major public health problem in Ethiopia, which causes maternal and fetal severe consequences. In Tigrai, there are limited literatures on prevalence of anemia and associated factors among pregnant women. Thus, a hospital based cross-sectional study was conducted to determine the prevalence and associated factors of anemia in Adigrat General Hospital. Data was analyzed and computed using SPSS version 22. p value = 0.05 at 95% confidence interval was considered statistically significant. Results Overall prevalence of Anemia among the pregnant women attending Adigrat General Hospital was 7.9%. About 62.5% and 37.5% of the anemic women were with mild (Hgb: 10.0–10.9 g/d1) and moderate (Hgb: 7–9.9 g/dl) type respectively. Factors like, residing in rural areas increases risk of anemia by 6 times (AOR = 6, 95% CI 1.34, 27.6, p = 0.019), participants having current blood loss (AOR = 3.4, 95% CI 1.16, 10.2, p = 0.026), having history of recent abortion (AOR = 7.9, 95% CI 2.23, 28.1, p = 0.001) and gestational age in the third trimester (AOR = 4.9, 95% CI 1.39, 17.6, p = 0.013) were statistically associated with anemia. Generally, prevalence of anemia is found to be low in the study area. However, it should be given due attention. Therefore, strong endeavor is needed to control anemia among pregnant women by assessing different micronutrient deficiencies for further prevention.
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Affiliation(s)
- Brhane Berhe
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia.
| | - Fitsum Mardu
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Haftom Legese
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Aderajew Gebrewahd
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Guesh Gebremariam
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Kebede Tesfay
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Getachew Kahsu
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Hadush Negash
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Gebre Adhanom
- Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
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Bolka A, Gebremedhin S. Prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia: a cross-sectional study. BMC Infect Dis 2019; 19:483. [PMID: 31146689 PMCID: PMC6543579 DOI: 10.1186/s12879-019-4135-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies reported contradicting findings about the association between intestinal parasitosis and maternal anemia. In this study we aimed to determine the prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia. Methods This facility-based cross-sectional study was conducted in June and July 2018. Pregnant women (n = 352) were randomly drawn from five health centers using antenatal care follow-up lists. Trained data collectors administered the questionnaire. Capillary blood was collected and analyzed for hemoglobin using the HemoCue method. Stool sample was collected following standard procedure and analyzed for the presence and types of intestinal parasites using direct microscopy with Formalin-ether concentration technique. Association between intestinal parasitosis and anemia was measured using multivariable binary logistic regression analysis. The outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI). Results The overall prevalence of intestinal parasitic infection was 38.7% (95% CI: 33.6–43.8%). One-tenth (9.7%) of the pregnant women were infected with polyparasites. Ascaris lumbricoides was the predominant infection encountered in 24.9% of the women. The other infections identified were: hookworms (11.2%), Giardia lamblia (5.4%), Entamoeba histolytica (3.4%), Trichuris trichiura (2.9%) and Schistosoma mansoni (2.3%). The mean (± standard deviation) hemoglobin concentration was 12.3 (±1.9) g/dl and 31.5% (95% CI: 26.6–36.4%) women were anemic (hemoglobin < 11 g/dl). The prevalence of anemia among women infected with intestinal parasite (55.6%) was substantially higher than the prevalence in their counterparts (16.4%) (p < 0.001). In a multivariable model adjusted for multiple potential confounders including socio-economic status indicators, the odds of anemia were six times increased (AOR = 6.14, 95% CI: 2.04–18.45) among those affected by at least one intestinal parasite. Conclusion Strengthening the existing water, sanitation and hygiene programs and routine deworming of pregnant mothers may help to reduce the burden of both intestinal parasitic infection and anemia in pregnant women. Electronic supplementary material The online version of this article (10.1186/s12879-019-4135-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amelo Bolka
- Wonedo Genet Town Health Unit, Wondo Genet, Ethiopia
| | - Samson Gebremedhin
- Department of Public Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
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Delil R, Tamiru D, Zinab B. Dietary Diversity and Its Association with Anemia among Pregnant Women Attending Public Health Facilities in South Ethiopia. Ethiop J Health Sci 2019; 28:625-634. [PMID: 30607078 PMCID: PMC6308774 DOI: 10.4314/ejhs.v28i5.14] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Anemia is a major public health problem among pregnant women in developing countries like Ethiopia. Nutritional deficiency related to anemia is an important contributor to maternal mortality and poor fetal outcomes. Methods Institution based cross-sectional study was conducted among pregnant women to assess the prevalence of anemia and its association with dietary diversity in Hossana Town from March 15 to April 30, 2017. Systematic random sampling procedure was employed to select 314 study subjects. Data were collected using an interviewer administered semi-structured questionnaire supplemented with laboratory tests. Multivariable logistic regression was used to determine the independent predictors of anemia. Results The prevalence of mild to moderate anemia among pregnant women was 56.6% and 40.8% respectively. The mean dietary diversity and food variety score of study participants were 7 and 22 respectively. Maternal education (AOR=10.5; 95% CI:2.2, 27), occupation of spouse (AOR=9.3; 95% CI:1.6, 53), nutrition education (AOR=2.5; 95% CI:1.5, 6.4) and dietary diversity (AOR=18.6; 95% CI: 4.4, 28) were significantly associated with anemia. Conclusion Anemia was found to be a moderate public health problem in Hossana Town. Therefore, there is a need of nutrition education and promotion awareness on healthy diets to prevent anemia among pregnant women.
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Affiliation(s)
| | - Dessalegn Tamiru
- Jimma University, Department of Population and Family Health, Jimma, Ethiopia
| | - Beakal Zinab
- Jimma University, Department of Population and Family Health, Jimma, Ethiopia
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Gebremariam AD, Tiruneh SA, Abate BA, Engidaw MT, Asnakew DT. Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017. PLoS One 2019; 14:e0210086. [PMID: 30615646 PMCID: PMC6322725 DOI: 10.1371/journal.pone.0210086] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/17/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction Nutritional anemia is a major public health problem throughout the world, particularly in developing countries. Iron with folic acid supplementation (IFAS) is recommended to mitigate anemia and its resulting complications during pregnancy. There has been limited study on IFAS adherence of pregnant women in the study area. The aim of this study was to assess adherence to IFAS and its associated factors among pregnant women attending antenatal care service in Debre Tabor General Hospital, Ethiopia. Methods An institution-based cross-sectional study was conducted from January 9 to April 8, 2017, at Debre Tabor General Hospital. A total of 262 study participants were included and selected by systematic random sampling. The entire interviewed questionnaire was checked and entered into EpiData version 3.1 and then exported to SPSS version 20 for windows for analysis. IFAS adherence status was defined as, if pregnant mothers took 65% or more of the IFAS which is equivalent to taking IFAS at least 4 days a week during the 1-month period preceding the study. Regressions were fitted to identify independent predictors of IFAS adherence. A P-value of less than 0.05 was used to declare statistical significance. Results A total of 241 pregnant women were included (92% response rate), of which 107 (44%) were adherent to IFAS. Only 39% received IFAS counseling, and 52% had some knowledge of IFAS. Gravidity (AOR = 2.92 95% CI (1.61, 5.30)), gestational age at first ANC visit (AOR = 3.67, 95% CI (1.94, 6.97)), pregnant women who got advice about IFAS (AOR = 2.04, 95%CI (1.12, 3.75)), current anemia (AOR = 2.22, 95%CI (1.45, 4.29)), and had knowledge about IFAS (AOR = 3.27, 95% CI (1.80, 5.95)) were statistically associated with adherence to IFAS among pregnant women. Conclusion Overall, IFAS adherence among pregnant women was low. The associated factors with adherence of IFAS were counseling and knowledge, early ANC attendance, pregnancy history, and current anemia diagnosis. IFAS counseling by health workers was low but, when given, was associated with improved IFAS adherence. Health workers and health extension workers should consistently counsel on IFAS benefits during ANC visit, to improve IFAS adherence during the current and subsequent pregnancies.
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Affiliation(s)
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bedilu Abebe Abate
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa Asnakew
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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