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Osman MM, Keles E, Bektemur G, Eker HH, Karaketir Ş, Ozer O. Determinants of anemia among pregnant women attending a tertiary hospital, Mogadishu, Somalia: unmatched case-control study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231376. [PMID: 38775531 PMCID: PMC11101180 DOI: 10.1590/1806-9282.20231376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE The objective of this study was to identify the factors associated with anemia among pregnant women attending a tertiary referral hospital in Mogadishu, Somalia. METHODS An unmatched case-control study was conducted on pregnant women who visited the antenatal clinics of a tertiary referral hospital between March and July 2021. The study recruited pregnant women who had a hemoglobin level of <11 g/dL into the anemic group, while those with hemoglobin levels ≥11 g/dL were included in the non-anemic group. Demographics, clinical, obstetrics, nutrition-related, hygiene- and sanitation-related, and parasitic infection-related data were collected. RESULTS A total of 449 pregnant women (399 anemic and 50 non-anemic) participated in the study. A total of 224 (56.7%) in the anemic group and 31 (62.0%) in the non-anemic group did not consume any dark green, leafy vegetables such as spinach, bukurey, cagaar, and koomboow (p=0.040). Notably, 255 (63.9%) in the anemic group and 21 (42.0%) in the non-anemic group had a middle-upper arm circumference <23 cm. More than half of anemic [335 (84%)] and non-anemic [46 (92.0%)] were classified under low dietary diversity score. Majority of the study participants, 288 (72.4%) of the anemic and 39 (78%) of the non-anemic groups, used pit toilets in dwellings, and 70.2% (134/191) of the anemic and 64.4% (246/382) of the non-anemic groups disposed of solid waste in open fields. CONCLUSION This study demonstrated that women who consumed green vegetables such as spinach, bukurey, cagaar, and koomboow in their diet had middle-upper arm circumference less than 23 cm, and those with low dietary diversity significantly developed anemia during pregnancy.
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Affiliation(s)
- Marian Muse Osman
- Somalia National Institute of Health, Research Department – Mogadishu, Somalia
| | - Esra Keles
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Public Health – İstanbul, Turkey
- University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Department of Gynaecologic Oncology – İstanbul, Turkey
| | - Guven Bektemur
- University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Department of Gynaecologic Oncology – İstanbul, Turkey
| | - Hasan Huseyin Eker
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Public Health – İstanbul, Turkey
- University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Public Health – Mogadishu, Somalia
| | - Şeyma Karaketir
- Istanbul University, Istanbul School of Medicine, Department of Public Health, Occupational Health Training Programme – İstanbul, Turkey
| | - Ozgur Ozer
- University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Obstetrics and Gynecology – Mogadishu, Somalia
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Nuwabaine L, Kawuki J, Kamoga L, Sserwanja Q, Gatasi G, Donkor E, Mutisya LM, Asiimwe JB. Factors associated with anaemia among pregnant women in Rwanda: an analysis of the Rwanda demographic and health survey of 2020. BMC Pregnancy Childbirth 2024; 24:328. [PMID: 38678175 PMCID: PMC11055334 DOI: 10.1186/s12884-024-06528-6] [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: 11/22/2022] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda. METHODS Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value < 11 g/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26). RESULTS Of the 435 pregnant women, 24.6% (95%CI: 21.1-29.3) were anaemic (1 in 4 pregnant women). Not working (AOR = 2.45; 95%CI: 1.14-5.26), being unmarried (AOR = 1.23; 95%CI: 1.24-3.57), low wealth index (AOR = 9.19; 95%CI: 1.64-51.56), having difficulty accessing a nearby health facility (AOR = 5.40; 95%CI: 2.21-13.23), and normal body mass index (AOR = 3.33; 95%CI: 1.46-7.59) were associated with higher odds of being anaemic. However, not taking iron supplements (AOR = 0.16; 95% CI: 0.04-0.67), having no exposure to television (AOR = 0.35; 95%CI: 0.14-0.91), being from the southern region (AOR = 0.14; 95% CI: 0.03-0.66), and low husband/partner's education (AOR = 0.08; 95% CI: 0.01-0.59) were associated with lower odds of being anaemic. CONCLUSIONS The study findings indicate a high prevalence of anaemia in pregnancy, which was associated with several socio-demographics. There is a need for setting up mobile clinics and health facilities in hard-to-reach areas for easy accessibility to early anaemia screening services. Conducting mass screening for anaemia targeting pregnant women who are not working, the unmarried, and those with a low wealth index would also be beneficial. The intake of locally available iron rich foods and/ or bio-fortified foods is also recommended.
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Affiliation(s)
- Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Livingstone Kamoga
- Department of Nursing, Makerere University College of Health Sciences, Makerere, Uganda
| | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
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Getnet M, Sisay WS, Alem AZ. Spatial distribution and associated factors of co-occurrence of overweight/obesity and Anemia among women in the reproductive age in sub-Saharan Africa: A multilevel analysis, DHS 2016-2021. PLoS One 2024; 19:e0299519. [PMID: 38635643 PMCID: PMC11025742 DOI: 10.1371/journal.pone.0299519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Overweight/obesity is one of the major public health problems that affect both developed and developing nations. The co-occurrence of overweight/obesity and anemia is thought to be largely preventable if detected early. To date, no spatial analyses have been performed to identify areas of hotspots for the co-occurrence of overweight/obesity and anemia among reproductive women in sub-Saharan Africa. Therefore, this study aimed to assess the spatial distribution and associated factors of the co-occurrence of overweight/obesity and anemia among women of reproductive age. METHODS Data for the study were drawn from the Demographic and Health Survey, a nationally representative cross-sectional survey conducted in the era of Sustainable Development Goals, in which the World Health Assembly decided and planned to cease all forms of malnutrition by 2030. Seventeen sub-Saharan African countries and a total weighted sample of 108,161 reproductive women (15-49 years) were included in our study. The data extraction, recoding and analysis were done using STATA V.17. For the spatial analysis (autocorrelation, hot-spot and interpolation), ArcGIS version 10.7 software, and for the SaTScan analysis, SaTScan version 10.1 software was used. Descriptive statistics were presented using frequency tables and percentages. We employed multilevel logistic regression to investigate associated factors. In the multivariable analysis, variables with a p-value of ≤0.05 are considered as a significant factor associated with co-occurrence of overweight/obesity and anemia among women aged 15-49 years. RESULTS The overall co-occurrence of overweight/obesity and anemia among women in sub-Saharan Africa was 12% (95%CI: 9-14%). The spatial analysis revealed that the co-occurrence of overweight/obesity and anemia among women significantly varied across sub-Saharan Africa. (Global Moran's I = 0.583163, p<0.001). In the spatial window, the primary-cluster was located in Liberia, Guinea, Gambia, Sira Leon, Mauritania, Mali, Cameron and Nigeria with a Log-Likelihood Ratio (LRR) of 1687.30, and Relative Risk (RR) of 2.58 at a p-value < 0.001. In multilevel analysis, women aged 25-34 years (AOR = 1.91, 95%CI: 1.78, 2.04), women aged 35-49 years (AOR = 2.96, 95% CI: 2.76, 3.17), married (AOR = 1.36, 95% CI: 1.27, 1.46), widowed (AOR = 1.22, 95%CI: 1.06, 1.40), divorced (AOR = 1.36, 95% CI: 1.23, 1.50), media exposure (AOR = 1.31, 95%CI: 1.23, 1.39), middle income (AOR = 1.19, 95%CI: 1.11, 1.28), high income/rich (AOR = 1.36, 95%CI: 1.26, 1.46), not working (AOR = 1.13, 95% CI:1.07, 1.19), traditional contraceptive utilization (AOR = 1.39, 95%CI: 1.23, 1.58) and no contraceptive use (AOR = 1.27, 95%CI: 1.20, 1.56), and no health insurance coverage (AOR = 1.36, 95%CI: 1.25, 1.49), were individual level significant variables. From community-level variables urban residence (AOR = 1.61, 95%CI: 1.50, 1.73), lower middle-income country (AOR = 2.50, 95%CI: 2.34, 2.66) and upper middle-income country (AOR = 2.87, 95%CI: 2.47, 3.34), were significantly associated with higher odds of co-occurrence of overweight/ obesity and anemia. CONCLUSION AND RECOMMENDATIONS The spatial distribution of the co-occurrence of overweight/obesity and anemia was significantly varied across the sub-Saharan African country. Both individual and community-level factors were significantly associated with the co-occurrence of overweight/obesity and anemia. Therefore, public health programmers and other stalk holders who are involved in maternal healthcare should work together and give priority to hotspot areas of co-occurrence in sub-Saharan Africa.
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Affiliation(s)
- Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wullo Sisay Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tirore LL, Areba AS, Tamrat H, Habte A, Abame DE. Determinants of severity levels of anemia among pregnant women in Sub-Saharan Africa: multilevel analysis. Front Glob Womens Health 2024; 5:1367426. [PMID: 38655396 PMCID: PMC11035794 DOI: 10.3389/fgwh.2024.1367426] [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: 01/18/2024] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
Background Anemia is a severe public health problem affecting 54% of pregnant women in SSA Yet, only a limited number of studies have provided a partial assessment of the pooled prevalence and related determinants of the severity levels of anemia in pregnant women in SSA. Therefore, this study provides the most recent estimates of anemia severity levels and related determinants. Methods The most recent Demographic Health Survey (DHS) dataset of 21 Sub-Saharan African countries which were collected between 2015 and 2022 were used. A total of 14,098 pregnant women were included. Multilevel ordinal logistic regression was used. Results The pooled prevalence of anemia was 51.26%. Pregnant women who were in the old age groups, and who have attended secondary and higher education were less likely to be at higher levels of anemia. Those women who have given birth to >1 children in the last 5 years, pregnant women in second and third trimester and living in poorest households had greater odds of being at higher levels of anemia. Conclusion In Sub-Saharan Africa, anemia is a severe public health concern for pregnant mothers. When developing and implementing strategies for the prevention and control of anemia, it is imperative to take into account the individual and community circumstances. Programs for the prevention and control of anemia should incorporate the economic and educational empowerment of women.
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Affiliation(s)
| | | | - Habtamu Tamrat
- Department of Orthopedic Surgery, Wachemo University, Hossana, Ethiopia
| | - Aklilu Habte
- Department of Public Health, Wachemo University, Hossana, Ethiopia
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Mare KU, Aychiluhm SB, Sabo KG, Tadesse AW, Kase BF, Ebrahim OA, Tebeje TM, Mulaw GF, Seifu BL. Determinants of anemia level among reproductive-age women in 29 Sub-Saharan African countries: A multilevel mixed-effects modelling with ordered logistic regression analysis. PLoS One 2023; 18:e0294992. [PMID: 38019840 PMCID: PMC10686498 DOI: 10.1371/journal.pone.0294992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Despite the implementation of different nutritional and non-nutritional interventions, 43% of reproductive-age women in Africa suffer from anemia. Recent evidence also shows that none of the Sub-Saharan African (SSA) countries are on the track to achieve the nutrition target of 50% anemia reduction by 2030. To date, information on the level of anemia and its determinants among reproductive-age women at the SSA level is limited. Thus, this study aimed to estimate the pooled prevalence of anemia level and its determinants in SSA countries. METHODS We used a pooled data of 205,627 reproductive-age women from the recent demographic and health surveys of 29 SSA countries that were conducted between 2010-2021. A multilevel mixed-effects analysis with an ordered logistic regression model was fitted to identify determinants of anemia level and the deviance value was used to select the best-fitted model. First, bivariable ordinal logistic regression analysis was done and the proportional odds assumption was checked for each explanatory variable using a Brant test. Finally, in a multivariable multilevel ordinal logistic regression model, a p-value<0.05 and AOR with the corresponding 95% CI were used to identify determinants of anemia level. All analyses were done using Stata version 17 software. RESULTS The pooled prevalence of anemia among women of reproductive age in SSA was 40.5% [95% CI = 40.2%-40.7%], where 24.8% [95% CI: 24.6%-25.0%], 11.1% [95% CI = 10.9%-11.2%], and 0.8% [95% CI = 0.7%-0.8%] had mild, moderate, and severe anemia, respectively. The prevalence significantly varied from the lowest of 13% in Rwanda to the highest of 62% in Mali, and anemia was found as a severe public health problem (prevalence of ≥ 40%) in 18 countries. The regression result revealed that polygamous marriage, women and husband illiteracy, poor household wealth, shorter birth interval, non-attendance of antenatal care, underweight, unimproved toilet and water facilities, and low community-level women literacy were positively linked with high anemia level. Additionally, the likelihood of anemia was lower in women who were overweight and used modern contraception. CONCLUSIONS Overall results showed that anemia among women of reproductive age is a severe public health problem in SSA countries, affecting more than four in ten women. Thus, enhancing access to maternal health services (antenatal care and contraception) and improved sanitation facilities would supplement the existing interventions targeted to reduce anemia. Moreover, strengthening women's education and policies regulating the prohibition of polygamous marriage are important to address the operational constraints.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Epidemiology & Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bizunesh Fentahun Kase
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Oumer Abdulkadir Ebrahim
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Getahun Fentaw Mulaw
- School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Nyarko SH, Boateng ENK, Dickson KS, Adzrago D, Addo IY, Acquah E, Ayebeng C. Geospatial disparities and predictors of anaemia among pregnant women in Sub-Saharan Africa. BMC Pregnancy Childbirth 2023; 23:743. [PMID: 37864203 PMCID: PMC10588187 DOI: 10.1186/s12884-023-06008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/19/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Anaemia has become a major public health concern among women in Sub-Saharan Africa (SSA). However, little is known about the spatial disparities in anaemia prevalence and their associated factors among pregnant women in the region. This study analysed the spatial disparities in anaemia and their associated factors among pregnant women in rural and urban settings in SSA. METHODS This is a secondary analysis of the most recent demographic and health surveys of 26 countries in SSA. Spatial autocorrelation and hotspot assessment were conducted, while a multivariate logistic regression model was used to identify demographic factors associated with anaemia. RESULTS Anaemia was reported among ~50% of pregnant women in urban and rural areas of SSA. The hotspot analysis identified the West African sub-region as having a higher concentration of anaemia cases in rural settings. In urban areas, the odds of anaemia were significantly higher among pregnant women in their second trimester (Adjusted OR = 2.39, CI = 1.99, 2.76). On the other hand, pregnant women in their third trimester (Adjusted OR = 1.98, CI = 1.77, 2.22) and those who had taken intestinal parasite drugs (Adjusted OR = 1.12 CI = 1.02, 1.23) had a higher likelihood of having anaemia in rural areas. Pregnant women aged 35-39 years (Adjusted OR = 0.52, CI = 0.33, 0.81) and those aged 40-44 years (Adjusted OR = 0.69, CI = 0.50, 0.95) had a lesser likelihood of having anaemia compared to women aged 15-19 years in urban and rural areas respectively. Compared to Congo DR, Benin (OR = 2.22, CI = 1.51, 3.28) and Mali (OR = 3.71, CI = 2.73, 5.05) had higher odds of anaemia in urban and rural areas respectively. CONCLUSIONS Spatial disparities in anaemia persist among pregnant women in rural and urban settings in SSA. Prevailing spatial variations in anaemia may be addressed by specialised interventions considering the contextual residential settings and socio-economic factors highlighted in this study.
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Affiliation(s)
- Samuel H Nyarko
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Ebenezer N K Boateng
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Kwamena S Dickson
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - David Adzrago
- Center for Health Promotion and Prevention Research (CHPPR), School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Isaac Y Addo
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Evelyn Acquah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health, and Allied Sciences, Ho, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
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Abbas G, Hussain A, Hussain A, Ahmed Z, Abbas Y, Nemat A. Geostatistical analysis for spatial distribution of anemia (Hb level) among women of reproductive age and determinant factors. Food Sci Nutr 2023; 11:4183-4190. [PMID: 37457163 PMCID: PMC10345706 DOI: 10.1002/fsn3.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/18/2023] Open
Abstract
The study was designed to assess the geostatistical spatial distribution of anemia and determinant factors among the women of reproductive age group (RAG) in Gilgit district, Pakistan. The Hb levels for 15-25 RAG, 26-35 RAG, and 36-45 group showed 10.22 g/dL, 10.41 g/dL, and 9.90 g/dL levels, respectively, while the Hb level showed a nugget/sill ratio of 0.21 inferring strong for the 15-25 group, weak for the 26-36, and moderate for 36-45 spatial dependence. Furthermore, 15-25 RAG showed 8% severe and 33.34% sufficient cases and 26-35 showed 12% severe and 29.33% sufficient results in their Hb level, whereas 36-45 had 9.34% severe and 29.33% sufficient.
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Affiliation(s)
- Ghulam Abbas
- Department of Biological SciencesKarakoram International UniversityGilgitPakistan
| | - Azhar Hussain
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Abid Hussain
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Zahoor Ahmed
- School of Food & Biological EngineeringJiangsu UniversityZhenjiangChina
- Department of Human Nutrition and Dietetics, School of Food and Agricultural SciencesUniversity of Management and Technology LahoreLahorePakistan
| | - Yasir Abbas
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
| | - Arash Nemat
- Kabul University of Medical SciencesKabulAfghanistan
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Seid A, Dugassa Fufa D, Weldeyohannes M, Tadesse Z, Fenta SL, Bitew ZW, Dessie G. Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta-analysis. Food Sci Nutr 2023; 11:3706-3717. [PMID: 37457158 PMCID: PMC10345738 DOI: 10.1002/fsn3.3388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/02/2023] [Accepted: 04/11/2023] [Indexed: 07/18/2023] Open
Abstract
Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta-analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random-effects meta-analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta-analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66-2.65), while that for low birth weight was 2.04 (95% CI, 1.46-2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68-17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95-3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19-4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29-2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food-based dietary guidelines, should be strengthened.
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Affiliation(s)
- Awole Seid
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
| | - Desta Dugassa Fufa
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Haramaya Institute of Technology, Haramaya UniversityDire DawaEthiopia
| | | | - Zuriyash Tadesse
- Department of Nutrition and DieteticsMekelle UniversityMekelleEthiopia
| | - Selamawit Lake Fenta
- Department of MidwiferyCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
| | - Zebenay Workneh Bitew
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- St. Paul Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Getenet Dessie
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- National Center for Epidemiology and Population HealthAustralian National University, College of Health and MedicineAustralian Capital TerritoryCanberraAustralia
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Azinge IE, Ogunyemi A, Ogamba CF, Jimoh RO. Prevalence of anemia and associated factors among adults in a select population in Lagos, Southwest Nigeria. J Public Health Afr 2023; 14:2224. [PMID: 37347070 PMCID: PMC10280247 DOI: 10.4081/jphia.2023.2224] [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: 05/14/2022] [Accepted: 08/08/2022] [Indexed: 06/23/2023] Open
Abstract
Background Anemia is a public health problem affecting people in both the developed and developing world and has serious consequences on health. Objective This study determines the prevalence of anemia amongst people of different socioeconomic levels, associated factors, and the prevalence of anemia in populations other than children or pregnant women. Methods This is a descriptive cross-sectional study using a pretested interviewer-administered questionnaire to collect data from 387 residents. A multi-stage random sampling technique was used. Analysis of blood samples using the HemoCue301 system and data analysis using SPSS 20. Chi-square test and binary logistic regression were used to test association and determine predictors of anemia respectively, with P<0.05 considered statistically significant. Results The mean age of respondents was 35±11.8 years, with 28.9% of respondents being anemic. Female respondents (52.7%) were more than male respondents (47.3%). Female respondents (39.2%) had a higher prevalence of anemia than male respondents (17.5%). There was a significant association between sex, level of education, and anemia status. Being female, having no formal education, or only having a primary school level of education were significant predictors of anemia [odds ratio (OR)=2.55; 95% confidence interval (CI)=1.54, 4.23; P=0.00; OR=12.57; 95%CI=2.39, 66.27; P=0.00; and OR=2.54; 95%CI=1.16, 5.58; P=0.02 respectively]. Conclusion There was a higher prevalence of anemia among women, younger people, and those with no or only primary levels of formal education. Awareness programs targeted at women and people with lower levels of education are necessary to reduce the overall prevalence of anemia in this region.
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Affiliation(s)
- Ifeoma Elaine Azinge
- Department of Community Health and Primary Care, College of Medicine, University of Lagos
| | - Adedoyin Ogunyemi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos
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Hassen AE, Agegnehu AF, Admass BA, Temesgen MM. Preoperative anemia and associated factors in women undergoing cesarean section at a comprehensive specialized referral hospital in Ethiopia. Front Med (Lausanne) 2023; 10:1056001. [PMID: 37081836 PMCID: PMC10110839 DOI: 10.3389/fmed.2023.1056001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundAnemia is a common public health burden during pregnancy. Severe maternal and fetal complications have been associated with anemia. Despite many studies on anemia during pregnancy have been conducted in Ethiopia at any time of antenatal care visits, the prevalence of preoperative anemia among women awaiting cesarean delivery and its contributing factors have not been determined. The aim of this study was to determine the prevalence and associated factors of preoperative anemia in women awaiting cesarean section at a comprehensive specialized hospital in Ethiopia.MethodsAn institution-based cross-sectional study was done from April to June 2022 to determine preoperative anemia in women undergoing cesarean delivery. Data were obtained using a standardized questionnaire that included the women’s background characteristics. Bi-variable and multi-variable logistic regression analyses were performed to identify variables related to preoperative anemia. With a 95% confidence level, the estimated crude odds ratio and adjusted odds ratio were calculated. In a multivariate analysis, variables were considered statistically significant if their p-value was less than 0.05.ResultsA total of 424 pregnant women with a 100% response rate were included in this study. The prevalence of preoperative anemia among women awaiting cesarean delivery was 28.3% (95% CI: 23.8–32.5%). Previous history of abortion, lack of iron supplementation, human immunodeficiency virus infection, previous cesarean section, and American Society of Anesthesiology class III were significantly associated with preoperative anemia among women awaiting cesarean section.Conclusion and recommendationPreoperative anemia was diagnosed in a significant proportion of women awaiting cesarean-delivery. Anemia was linked to a lack of iron supplementation, American Society of Anesthesiology class III, previous history of abortion, human immunodeficiency virus infection, and previous cesarean section. Therefore, early detection of high-risk pregnancies, iron supplementation, prevention of HIV infection and due attention to people living with HIV/AIDs are paramount.
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Affiliation(s)
| | - Abatneh Feleke Agegnehu
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Biruk Adie Admass,
| | - Mamaru Mollalign Temesgen
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Determinants And Spatial Patterns of Anaemia And Haemoglobin Concentration Among Pregnant Women In Nigeria Using Structured Additive Regression Models. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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12
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Tesfa D, Azanaw MM, Gebremariam AD, Engidaw MT, Tiruneh M, Zemene MA, Anley DT, Dessie AM. Women's independent decision-making power and determinants on not to use contraceptives among currently married women in Ethiopia using demographic and Health Survey data: Multilevel Analysis. BMC Womens Health 2022; 22:541. [PMID: 36550498 PMCID: PMC9773615 DOI: 10.1186/s12905-022-02051-y] [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: 03/31/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Evidence suggests that couples frequently dispute regarding the desirability of pregnancy, as well as whether or not to employ family planning measures. There are numerous unmet needs owing to partner or family objections, according to a scares study that illustrates women's independent decision-making capacity on whether or not to use a contraceptive. As a result, the purpose of this study was to analyze women's independent decision-making power and determinants of not using contraceptives. METHODS Reproductive age group women aged (15-49 years) currently married who are not pregnant and are currently not using family planning preceding five years the survey was included from the individual record (IR file) file using standard demographic and health survey datasets of Ethiopia. Using multilevel logistic regression models, we investigated the relationship between several independent factors and women's independent decision-making not to use contraception. The adjusted odds ratios were evaluated using 95% confidence intervals. RESULTS A total of 5,598 currently married women were included in this study. Individual level factors significantly associated with women independent decision making on not to use contraceptive were female-led households (AOR = 2.11; 95% CI = 1.60-2.78), being orthodox ( AOR = 1.84; 95% CI = 1.39-2.44 ) and protestant ( AOR = 1.62; 95% CI = 1.17-2.23), and belonging to more than one union (AOR = 1.48; 95% CI = 1.12-1.95). Whereas, low community education (AOR = 1.19; 95%= 1.00-1.49) and regions: in Tigray (AOR = 2.19; 95%CI = 1.51-3.16), Afar (AOR = 1.74; 95% CI = 1.14-2.64), Amhara (AOR = 2.45; 95% CI = 1.71-3.500), South Nations Nationality (AOR = 1.87; 95% CI = 1.32-2.65), Gambela (AOR = 2.58; 95% CI = 1.73-3.84), Hareri (AOR = 3.93; 95% CI = 2.62-5.88), and Dre DDewa (AOR = 1.66; 95% CI = 1.12-2.45) were community-level factors. CONCLUSION Women's independent decision-making power not to use contraceptives was low and greatly affected by both individual and community-level factors. Therefore, it is necessary to develop policies and create programs that promote women's empowerment by incorporating their partners in each region of the nation to encourage women's independent decision-making authority to use or not to use a contraceptive.
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Affiliation(s)
- Desalegn Tesfa
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Melaku Tadege Engidaw
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulu Tiruneh
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- grid.510430.3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Ogbuabor DC, Ogbuabor AO, Ghasi N. Determinants of anaemia prevalence in women of reproductive age in Nigeria: A cross-sectional study using secondary data from Nigeria Demographic and Health Survey 2018. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142961. [PMID: 36515440 PMCID: PMC9756372 DOI: 10.1177/17455057221142961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anaemia disproportionately affects women of reproductive age in sub-Saharan Africa including Nigeria. Yet, community-based studies on the prevalence and determinants of anaemia among women of reproductive age are scarce in Nigeria. DESIGN A cross-sectional community-based survey using a nationally representative sample. OBJECTIVES This study described anaemia prevalence and its associated factors among women of reproductive age, pregnant women, and non-pregnant women in Nigeria. METHODS We analysed data from the 2018 Nigeria Demographic and Health Survey. Pregnant women with a haemoglobin level less than 11 g/dL and non-pregnant women with a haemoglobin level less than 12 g/dL were considered anaemic. Anaemia was also categorized as mild, moderate, and severe. Pearson's chi-square test was used to evaluate the association between anaemia status and independent variables. All variables with ρ ⩽ 0.25 in bivariate analyses were further analysed using complex sample logistic regression. RESULTS Anaemia prevalence was 57.8%, 57.4%, and 61.1% for women of reproductive age, non-pregnant women, and pregnant women, respectively. The prevalence of severe anaemia was 1.6%, 1.5%, and 2.3% for overall women of reproductive age, non-pregnant women, and pregnant women, correspondingly. The southern regions, rural residence, low education, unemployment, low wealth index, and non-use of modern contraceptives significantly increased the likelihood of anaemia and severe anaemia among women of reproductive age and non-pregnant women. The likelihood of being anaemic was significantly increased by large family size among women of reproductive age and by being underweight among non-pregnant women. The South-East region, rural residence, low education, and unemployment were significantly associated with anaemia among pregnant women. The South-South region and unemployment increased the likelihood of severe anaemia among pregnant women. Short stature significantly reduced the odds of being anaemic and severely anaemic among pregnant women. CONCLUSIONS Anaemia prevalence among all categories of women of reproductive age is high in Nigeria. Predictors of anaemia prevalence and severity should be considered in policies intended to reduce anaemia among women of reproductive age in Nigeria.
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Affiliation(s)
- Daniel Chukwuemeka Ogbuabor
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria,Daniel Chukwuemeka Ogbuabor, Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria.
| | | | - Nwanneka Ghasi
- Department of Management, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Zhang J, Li Q, Song Y, Fang L, Huang L, Sun Y. Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis. Front Public Health 2022; 10:1041136. [PMID: 36311562 PMCID: PMC9615144 DOI: 10.3389/fpubh.2022.1041136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 01/29/2023] Open
Abstract
Background Anemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial. Methods PubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers. Results A total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference < 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy. Conclusions Prevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.
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Affiliation(s)
- Jing Zhang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China,Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Quanhong Li
- Kunming Children's Hospital, Kunming, China,Department of Pharmacy, Children's Hospital of Kunming Medical University, Kunming, China
| | - Ying Song
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China,Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Liping Fang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China,Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Lei Huang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China,Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Yu Sun
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China,Kunming Municipal Service Center for Maternal and Child Health, Kunming, China,*Correspondence: Yu Sun
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Konje ET, Ngaila BV, Kihunrwa A, Mugassa S, Basinda N, Dewey D. High Prevalence of Anemia and Poor Compliance with Preventive Strategies among Pregnant Women in Mwanza City, Northwest Tanzania: A Hospital-Based Cross-Sectional Study. Nutrients 2022; 14:nu14183850. [PMID: 36145226 PMCID: PMC9505096 DOI: 10.3390/nu14183850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/29/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Anemia in pregnancy is prevalent in Tanzania despite the implementation of existing prevention strategies. This study aims to determine the level of compliance with anemia preventive strategies among pregnant women and the factors associated with poor compliance. A cross sectional study was conducted among 768 pregnant women who attended the Bugando Medical Center, Sekou-Toure Regional Hospital, Nyamagana District Hospital, and Buzuruga Health Center in Mwanza, Northwest Tanzania. The prevalence of anemia at term was 68.8% (95% CI, 65.5–72.0%). The average hemoglobin level at term was 10.0 g/dL (95% CI, 9.8–10.1). Only 10.9% of pregnant women complied fully with anemia-preventive strategies. A decrease in mean hemoglobin level was observed across levels of compliance, with women who were non-compliant displaying a significantly lower mean hemoglobin level (8.3 g/dL) compared to women who were fully compliant (11.0 g/dL). Poor compliance was associated with no formal or primary education and initiating antenatal care in the 2nd or 3rd trimester. Anemia in pregnancy was commonly associated with lack of compliance with preventive strategies among participants. There is a need for community-based health education on the importance of complying with anemia-preventive strategies in order to reduce the burden during pregnancy and the consequences of anemia to the unborn baby.
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Affiliation(s)
- Eveline T. Konje
- Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences—BUGANDO, Mwanza P.O. Box 1464, Tanzania
- Correspondence: or
| | - Bernadin Vicent Ngaila
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences—BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Albert Kihunrwa
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences—BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Stella Mugassa
- Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences—BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Namanya Basinda
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences—BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Deborah Dewey
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre at the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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Mengistu GT, Mengistu BK, Gudeta TG, Terefe AB, Habtewold FM, Senbeta MD, Sori SA, Jiru HD. Magnitude and factors associated with iron supplementation among pregnant women in Southern and Eastern Regions of Ethiopia: Further Analysis of mini demographic and health survey 2019. BMC Nutr 2022; 8:66. [PMID: 35850710 PMCID: PMC9295274 DOI: 10.1186/s40795-022-00562-3] [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: 04/08/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Anemia is a global public health problem that affects pregnant women. The most common cause of anemia is iron deficiency which is extremely common in developing countries. World health organization reported that 36.5% of pregnant women are anemic globally. In Ethiopia, 27.08% of women of the reproductive age group are anemic. Therefore, this study aimed to identify the magnitude and factors associated with iron supplementation during pregnancy in the southern and eastern regions of Ethiopia. Methods The data used in this analysis were extracted from Mini Demographic and Health Survey 2019. The survey was conducted in 9 regional states and two city administrations. The data used in the analysis were extracted from individual women datasets, and 1780 study participants were included in this study. The logistic regression analysis including bivariate and multivariable logistic regression at a 95% confidence interval and a p-value less than 0.05 was used. Result The finding of the study shows that iron supplementation during pregnancy in Southern and Eastern parts of Ethiopia was 50.06%. Among those who received iron, only about 20% took it for 90 days and more during their pregnancy. Iron supplementation among the pregnant women was affected by secondary education [AOR = 2.20, 95%CI (1.325, 3.638)], residing in urban [AOR = 1.75, 95%CI (1.192, 2.574)], having media at home [AOR = 1.41, 95%CI (1.022, 1.946)], having antenatal care follow up [AOR = 9.27, 95%CI (4.727, 18.169)], having 4 and more ANC follow up [AOR = 2.01, 95%CI (1.468,2.760], having antenatal care follow up at government health institutions [AOR = 3.40, 95%CI (1.934, 5.982)], and giving birth at governmental health institutions [AOR = 1.70, 95%CI (1.236, 2.336)]. Conclusion Only one in two pregnant women was supplemented with iron during their recent pregnancy. The supplementation was affected by women's education, place of residence, presence of media at home, antenatal care follow-up, the number of antenatal care follow up, antenatal care follows up at governmental health institutions, and giving birth at the governmental health institution. The availability and accessibility of maternal care services and their functionality in providing maternal care services improve the supplementation.
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Affiliation(s)
- Girma Teferi Mengistu
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
| | - Bizunesh Kefale Mengistu
- Department of Statistics, College of Natural and Computational Science, Ambo University, Ambo, Ethiopia
| | - Tolesa Gemeda Gudeta
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Ayana Benti Terefe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | | | - Mebratu Demissie Senbeta
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Seboka Abebe Sori
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Hirut Dinku Jiru
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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Dennis K, Marera D, Were T. Determination of hematological response to iron and folic acid supplementation among the expectant mothers attending Kakamega County Referral Hospital, Kenya. THE EGYPTIAN JOURNAL OF HAEMATOLOGY 2022. [DOI: 10.4103/ejh.ejh_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Vasconcelos A, Sousa S, Bandeira N, Alves M, Papoila AL, Pereira F, Machado MC. Antenatal screenings and maternal diagnosis among pregnant women in Sao Tome & Principe-Missed opportunities to improve neonatal health: A hospital-based study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001444. [PMID: 36962895 PMCID: PMC10021443 DOI: 10.1371/journal.pgph.0001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
Newborn mortality and adverse birth outcomes (ABOs) in Sao Tome & Príncipe (STP) are overwhelmingly high, and access to quality-antenatal care (ANC) is one of the strategies to tackle it. This study aimed to fill the gaps in ANC screenings with a focus on how to improve neonatal outcomes. We conducted a retrospective hospital-based study in which ANC pregnancy cards were reviewed. Screenings were described and compared according to the total number of ANC contacts: 1-3 (inadequate), 4-7 (adequate), and ≥8 (complete). The collected data were entered into QuickTapSurvey and exported to SPSS version 25 for analysis. Statistical significance was considered at a p-value ≤0.05. A total of 511 ANC pregnancy cards were reviewed. Mothers' mean age was 26.6 (SD = 7.1), 51.7% had a first trimester early booking, 14.9% (76) had 1-3 ANC contacts, 46.4% (237) had 4-7 and 38.7% (198) ≥8. Screening absence was found in 24%-41%, lack of money was registered in 36%. Pregnant women had no screening performed for HIV in 4.5%, syphilis in 8.8%, HBV 39.3%, malaria 25.8%, hemoglobin 24.5%, blood glucose 45.4%, urine 29.7%, stool exams 27.8% and 41.1% had no ultrasound. Screening completion for blood group, HIV, malaria, urine, hemoglobin, and coproparasitological exam were found to have a statistically significant difference (p<0.001) for the complete ANC group when compared to other groups. Antenatal problems identified were: 1) bacteriuria (43.2%); 2) maternal anemia (37%); 3) intestinal parasitic infections (59.2%); 4) sickle cell solubility test positive (13%); and 5) a RhD-negative phenotype (5.8%). Missed-ANC treatments were up to 50%. This study reveals a coverage-quality gap in STP since no pregnant woman is left without ANC contact, although most still miss evidence-based screenings with an impact on neonatal outcomes. Strategies such as implementing a total free ANC screening package in STP would enhance maternal diagnosis and prompt treatments.
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Affiliation(s)
- Alexandra Vasconcelos
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Nelson Bandeira
- Hospital Dr. Ayres de Menezes, São Tomé, Sao Tome and Principe
| | - Marta Alves
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana Luísa Papoila
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Filomena Pereira
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maria Céu Machado
- Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
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Mamuye Azanaw M, Gebremariam AD, Teshome Dagnaw F, Yisak H, Atikilt G, Minuye B, Engidaw MT, Tesfa D, Abebe Zewde E, Abebaw Tiruneh S. Factors Associated with Numbers of Antenatal Care Visits in Rural Ethiopia. J Multidiscip Healthc 2021; 14:1403-1411. [PMID: 34140778 PMCID: PMC8203265 DOI: 10.2147/jmdh.s308802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/27/2021] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Antenatal care (ANC) is a medical care and procedure carried out for pregnant women. Data on ANC visits can help policymakers show gaps in service provision. Therefore, this study assessed the factors associated with the number of ANC visits among women in rural Ethiopia. METHODS We included a total of 6611 women who gave birth within 5 years preceding the survey from the 2016 Ethiopian Demographic and Health Survey. A multi-level negative binomial regression analysis was employed to consider the hierarchical nature of the data. In the multivariable analysis, variables with a p-value <0.05 were considered to be significantly associated with the number of ANC visits. RESULTS Overall, 27.3% (95% CI: 14.63, 15.76) of women had at least four ANC visits during pregnancy in rural Ethiopia. Among individual level factors, age group 25-29 years (adjusted incidence rate ratio (AIRR)=1.13,95% CI:1.02,1.26), household rich wealth status (AIRR=1.17, 95% CI:1.04,1.31), women's educational status (primary, AIRR=1.19,95% CI:1.08,1.32; secondary, AIRR= 1.30,95% CI:1.08,1.55; above secondary, AIRR=1.35, 95% CI:1.07,1.71), partner educational status (primary, AIRR=1.16, 95% CI:1.05,1.28; secondary, AIRR=1.22,95% CI:1.08,1.38), and autonomy to decision to their care (AIRR=1.25,95% CI:1.10,1.42) were positively associated factors whereas having a birth order of five or more (AIRR=0.80,95% CI: 0.69,0.94) was a negative associated with number of ANC visits. Among community-level variables, being in higher community level literacy (AIRR=1.35, 95% CI: 1.14, 1.59) and higher poverty level (AIRR=0.77, 95% CI: 0.64, 0.92) were significant factors with the number of ANC visits. CONCLUSIONS AND RECOMMENDATIONS Women's age, wealth status, women's educational status, partner educational status, autonomy to decision making in health care, and birth order were determinants of the number of ANC visits. Furthermore, poverty and literacy are also important factors at the community level. Addressing economic and educational interventions for rural women should be prioritized.
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Affiliation(s)
- Melkalem Mamuye Azanaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Fentaw Teshome Dagnaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hiwot Yisak
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getaneh Atikilt
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Binyam Minuye
- Department of Nursing, 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
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Edgeit Abebe Zewde
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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