Prevalence of Anaemia, Deficiencies of Iron and Folic Acid and Their Determinants in Ethiopian Women

A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR)=1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR=0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR=0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micronutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses

Gender differences in household headship and level of awareness on anaemia among Ethiopian women: Evidences from a nationwide cross-sectional survey

Background: Information on gender difference in household headship in relation to awareness and practice related to anaemia is limited. This study has examined the issue under caption and provides evidence-based information for some program initiatives.Methods: Data from 970 Ethiopian women of reproductive age was extracted from a large data set collected as part of a nation-wide micronutrient programmes surveillance to examine the association between gender difference in household-headship and anaemia awareness. Data were analysed in SPSS version 20.0 for Windows. Proportional differences on some selected variables were determined using χ2 test, and a p-value less than 0.05 was considered statistically significant.Results: Males were found to head more than two third of the households. Significantly lower number of respondents were less educated with just 140 (14.4%) having primary cycle education (grades 1-6th) (P=0.001). About half of the respondents (50.2%) were aware of anaemia, with at least two thirds of the respondents from male-headed households aware of its symptoms (p=0.004) and treatment (p=0.003), and the difference was significant. Fewer women received iron supplementation in female-headed households (28.6%) than male-headed households (71.4%), though the difference was not significant (p=0.9). Unexpectedly, significant number of respondents with low awareness was among those with primary education with some regional variations (p=0.001).Conclusion: Anaemia awareness and treatment seeking behaviour was markedly lower in female-headed households than male-headed households which can be attributed to low levels of education. Thus, to narrow the observed gap, targeted education programs for women headed household is recommended. [Ethiop. J. Health Dev. 2018; 32(2):75-81]Key words: Gender, education, anaemia, iron supplementation, women, Ethiopi

The magnitude and determinants of anaemia among refugee preschool children from the Kebribeyah refugee camp, Somali region, Ethiopia

Background: Anaemia is a global public health problem affecting children from both industrialised and developing countries with major consequences for health, social and economic development. Although the burden of anaemia is high among refugee children due to their living conditions, its determinants are not yet clearly identified and documented in Ethiopia.Objective: To assess the magnitude and contributing factors of anaemia among refugee preschool children of the Kebribeyah refugee camp.Methodology: A cross-sectional study with an analytic component was conducted in the Kebribeyah refugee camp during March 2010. A total of 399 refugee children aged between 6 and 59 months were randomly selected and assessed for anaemia status using HemoCue® devices.Results: The prevalence of anaemia was 52.4%. Most of the anaemic children, 36.6%, were classified as having moderate (Hb 7–9.9 gm/dL), followed by severe, 10.5%, (Hb < 7 gm/dL) while the remaining 5.3% had mild anaemia (Hb 10–10.9 gm/dL). The age of the child, paternal educational level, number of children younger than five years of age in the household, sharing/selling part of ration, inadequacy of ration stock, presence of diarrhoea, personal hygiene of the child, stunting and underweight were significantly associated with anaemia.Conclusion: The purpose of this study was to demonstrate that anaemia is a severe public health problem among young refugee children and to document its major predisposing factors. In the Kebribeyah refugee camp, these included inadequate food rations, insufficient micronutrient composition, lack of provision of non-food items, selling and sharing of food rations, poor environmental sanitation, poor housing conditions, lack of nutrition/health education and disease (diarrhoea). A comprehensive nutrition service together with a holistic public health-focused approach to empower refugees to prevent the onset of anaemia by engaging in homestead small-scale food production for income generation and improving the integration and collaboration between beneficiaries, food donors and humanitarian aid organisations would be crucial in addressing the consequences of anaemia in the Kebribeyah refugee camp.Keywords: anaemia, determinants, Ethiopia, Kebribeyah, magnitude, preschool, refuge

Food security status and vulnerability to anemia among women of reproductive age in pastoralist communities of Somali regional state, Ethiopia: a comparative, community-based, cross-sectional study

Background: Although the impact of food insecurity and anemia has been shown to be more common among women of reproductive age, there is little information available on the issue in relation to women in Fafan Zone, Somali Region, Ethiopia.Objectives: To compare the levels of anemia among women of reproductive age in food-secure versus food-insecure households in Fafan Zone.Methods: A community-based, cross-sectional study design was employed in rural Ethiopia from February to April 2017. In total, 142 women from food-insecure households and 287 women from food-secure households were recruited and their levels of anemia were measured using a HemoCue spectrophotometer, and then compared. Food insecurity was measured using a modified household food insecurity access scale. Data were entered using Epi data 3.1 and analyzed using Stata version 14.0. Bivariate and multivariate logistic regression analyses with 95% confidence intervals were used to examine the association between anemia and food security. A p-value of less than 0.05 was statistically significant.Results: The prevalence of anemia among women in food-insecure households was 79.53% and ranged from 42.0% to 90.0%; among women in food-secure households, the prevalence was 20.47% and ranged from 12% to 34%. The observed difference between Food Security (FS) and Food Insecurity (FI) was statistically significant indicating a correlation between the two groups. Women who reported food insecurity were about 1.4 times more likely to suffer from anemia than their food-secure counterparts (AOR=1.4; 95% CI=1.02-2.10).Conclusions and recommendations: It appears that four in five women in food-insecure households had anemia, and that there was an overall positive relationship between food insecurity and anemia. To address the level of anemia in food-insecure households, more nutritional support is required, in addition to implementing a poverty alleviation program and weekly iron folic acid supplementation. . [Ethiop.J. Health Dev. 2019; 33(1):28-37]Key words: Food insecurity, anemia in women, Somali Region, Ethiopi

Xerophthalmia in children of Torbayo village, West Hararghe

Abstract: A cross-sectional study was conducted in children below the age of 14 years in Torbayo village, West Hararghe, during the month of February 1991 to determine the prevalence of Xerophthalmia. Every third household with children below 14 years (n=373, 32.3%) was randomly selected and the children were convened in a central place for examination of the signs and symptoms of Xerophthalmia, morbidity and nutritional status. A total of 132 children were found to have xerophthalmia, of which 70(18.8%) had night blindness and 55(14.7%) had Bitot's spots. According to WHO, this appears to be of public health significance. Males were affected slightly more than females(4.2% vs 3.9%), and school children were noted to be affected more than preschool children. Though the levels of wasting and stunting which were 39(10.5%) and 133(35.7%), respectively, appear to be high, no significant association was observed with the clinical manifestation of vitamin A deficiency. In conclusion, the prevalence rate of X1B of 14.7% is amongst the highest rates reported in the world and, therefore, we recommend periodic vitamin A supplementation until dietary intervention takes place.[Ethiop. J. Health Dev. 1998;12(1):39-43

Prevalence of anaemia, deficiencies of iron and folic acid and their determinants in Ethiopian women

A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR)=1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR=0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR=0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micro-nutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses

Factors contributing to positive and negative deviances in child nutrition

Abstract: A cross sectional study investigating factors leading to positive and negative deviance in child nutrition, was conducted between March and April 1996 at Zigbaboto, Gurage Zone. Among 400 children aged 6-59 months, 231 children were randomly selected and categorized into negative deviants (lower tercile), median growers (middle tercile) and positive deviants (upper tercile) based on local distribution of height for age. Over 20 variables presumed to affect nutritional status of children were then collected and analyzed to see their associations to each category. The prevalence of malnutrition was also determined using the NCHS standard. The results indicated that 46.8% were stunted, 44.2% were under-weight and 13.0% were wasted. Of the over 20 variables, only nine variables showed significant differences at least among two categories. Religion, maternal education, maternal age, and income distinguished negative deviants from median growers. Prenatal follow-up, age of the child, and duration of breast feeding distinguished median growers from positive deviants. Only two variables, maternal body mass index and maternal height differentiated both positive and negative deviants from median growers. In conclusion our study revealed that factors responsible for positive and negative deviances are not necessarily the converse of each other implying that indepth assessment of factors leading to optimum nutrition is required before intervention strategies are considered. [Ethiop. J. Health Dev. 1998;12(2):69-73

The association of children’s nutritional status to maternal education in Zigbaboto, Guragie Zone, Ethiopia

Abstract: A cross-sectional study intended to assess the association of the nutritional status of children aged 6-59 months in relation to the literacy status of their mothers was undertaken in Zigbaboto village, Guragie Zone, Southern Ethiopia, during March-April, 1996. The study was based on 231 children and the overall prevalences of stunting, underweight and wasting were 46.7%, 44.2%, and 13.0%, respectively. A bivariate analysis based on height-for-age showed a high prevalence of stunting in children of illiterate mothers (52.2%) than children of literate mothers (22.2%). This difference is noted to be statistically significant (P<0.05). A multivariate analysis also demonstrated that within the given literacy status, income (that is mainly based on possessions of agricultural products and livestock), prenatal follow-up of the mother, and household size did not show any statistical significance on the nutritional status of the study children. The findings underscored the importance of maternal education for a better achievement of nutritional status than any other variable and has important implications for policy and for further investigation in a similar community. [Ethiop. J. Health Dev. 1999;13(1):55-61

Vitamin A status in three woredas of Kambatta, Alaba, and Timbaro Zone, Southern Peoples’s Region

Abstract: As a part of comprehensive evaluative study on various strategies to control Vitamin A Deficiency (VAD), a baseline survey was conducted in three woredas of Kambatta, Alaba, and Timbaro Zone (KAT) in Southern Nations, Nationalities and People’s Region in 1996. A total of 4123 children from randomly selected peasant associations were clinically examined for signs of xerophthalmia while blood samples were collected from a systematically selected 197 children for serum retinol analysis. Results indicate that 1.2% (51) of the children had a history of night blindness and 0.2% (8) had bitot’s spots. Most cases of bitot’s spots (6 out of 8) were in the age range of 36-72 months. The prevalence of bitot’s spots was higher in male children compared to female children (5 and 3 respectively). Over a quarter of children (27.9%) had low serum retinol concentrations, while 4.6% had deficient serum retinol concentrations. Nearly equal numbers of male and female children (4 and 5 respectively) had deficient levels of serum retinol concentrations while more male children had low serum retinol levels compared to female children (28 and 17, respectively). The high prevalence of night blindness (WHO’s cut-off point of 1%) and serum retinol levels (WHO’s cut-off point of 20% less than or equal to 0.70 umole/1) indicates that VAD is emerging as a public health problem in an area previously considered free of VAD. These findings justify the need to strengthen the intervention strategies underway in the area. [Ethiop. J. Health Dev. 1998;12(3):225-229

Vitamin A deficiency status in Tigray Region, Ethiopia, 1996

Abstract: A survey was conducted to determine the prevalence of xerophthalmia in Alaje and Samre weredas of Tigray Region, Northern Ethiopia, where EPI-plus and Wereda Integrated Basic Service (WIBS) approaches are being launched to prevent and control vitamin A deficiency. A total of 5,253 preschool children (PSC) were clinically examined between October and November, 1996 for ocular signs of xerophthalmia. Blood samples were drawn from 248 PSC for serum retinol levels(SRL). The overall prevalence rates of night blindness (XN) and Bitot's spot (X B) for both weredas were 1 0.9% and 1.5%, respectively, with a higher prevalence rate in males than females (53 vs 26). Alaje wereda(EPI-plus) had XN=21(0.8%) and X B=38(1.4%), and Samre wereda (WIBS) had 1 XN=25(1.0%) and X B=41(1.7%). No sex difference was seen in the prevalence rate of corneal 1 xerosis and keratomalacia (0.4%). The most affected age groups were children between five and six years of age. Both weredas showed the distribution of serum retinol levels to be deficient in 21(16.7%) in Samre and 19(15.5%) in Alaje, and low in 60(47.6%) in Samre and 57(46.7%) in Alaje. Low SRL is found to be highest among children between five and six years of age in males and between two to three years of age in females in both weredas. The high prevalence rate of X B 1 (three times higher than the WHO cut-off point), and the low level of serum retinol value found in this study indicates the need and urgency for the continuation of the aforementioned strategies of vitamin A deficiency control program launched in the Region until their impact is further evaluated. [Ethiop. J. Health Dev. 1999;13(2):87-91