10.1371/journal.pone.0091252PLoS ONE93-POLN

AA Lover

Ali Montazeri

Andrew A. Lover

BA Haider

C Luxemburger

David L. Heymann

DI Pritchard

DS Nurdia

EM McClure

GA Stevens

J Deen

J Pulford

JA Noronha

JF Friedman

K Tolentino

KE Agho

Kee Seng Chia

KJ Archer

L Muhangi

M Boel

M Mayxay

M Morrow

Mikael Hartman

ML Dreyfuss

N Senn

N Van den Broek

NM Douglas

PH Nguyen

PJ Hotez

RJ Soares Magalhães

S Tatala

T Shamah-Levy

ZA Bhutta

PLoS ONE

PubMed

Lover Andrew A.

Hartman Mikael

Chia Kee Seng

Heymann David L.

Public Library of Science (PLOS)

Demographic and Spatial Predictors of Anemia in Women of Reproductive Age in Timor-Leste: Implications for Health Program Prioritization

Anemia is a significant risk factor for poor health outcomes for both the mother and neonate; however, the determinants of anemia in many epidemiological settings are poorly understood. Using a subset of a nationally representative cluster survey (2010 Demographic and Health Survey) in combination with other non-contemporaneous survey data, the epidemiology of anemia among women of reproductive age in Timor-Leste has been explored. Logistic regression was used to identify risk factors, population-level impacts were estimated as population attributable fractions and spatial analytics were used to identify regions of highest risk. The DHS survey found that ∼21% of adult women in Timor-Leste are anemic (49,053; 95% CI: 37,095 to 61,035), with hemoglobin \u3c12.0 g/dL. In this population, the main risk factors (adjusted odds ratio; 95% CI) are: currently abstaining from sex for any reason (2.25; 1.50 to 3.38); illiteracy (2.04; 1.49 to 2.80); giving birth within the previous year (1.80; 1.29 to 2.51); consumption of fruits/vegetables low in vitamin A (1.57; 1.13 to 2.20); and the district-level confirmed malaria incidence (1.31; 1.15 to 1.49). A review of prior soil-transmitted helminth surveys in Timor-Leste indicates low-to-moderate prevalence with generally low egg counts, suggesting a limited impact on anemia in this setting, although comprehensive survey data are lacking. Examination of the population-level effects highlights the impacts of both recent births and malaria on anemia, with more limited impacts from diet; the evidence does not suggest a large contribution from geohelminths within Timor-Leste. These patterns are divergent from some other settings in the Asia-Pacific region and highlight the need for further focused research. Targeting high-burden districts and by increasing access to pre/postnatal care, raising literacy levels, increasing access to family planning, and improving malaria control should be prioritized to maximize inherently limited health budgets in reaching these populations

Lover, Andrew A.

Hartman, Mikael

Chia, Kee Seng

Heymann, David L.

ScholarWorks@UMass Amherst

Anemia is a significant risk factor for poor health outcomes for both the mother and neonate; however, the determinants of anemia in many epidemiological settings are poorly understood. Using a subset of a nationally representative cluster survey (2010 Demographic and Health Survey) in combination with other non-contemporaneous survey data, the epidemiology of anemia among women of reproductive age in Timor-Leste has been explored. Logistic regression was used to identify risk factors, population-level impacts were estimated as population attributable fractions and spatial analytics were used to identify regions of highest risk. The DHS survey found that ∼ 21% of adult women in Timor-Leste are anemic (49,053; 95% CI: 37,095 to 61,035), with hemoglobin <12.0 g/dL. In this population, the main risk factors (adjusted odds ratio; 95% CI) are: currently abstaining from sex for any reason (2.25; 1.50 to 3.38); illiteracy (2.04; 1.49 to 2.80); giving birth within the previous year (1.80; 1.29 to 2.51); consumption of fruits/vegetables low in vitamin A (1.57; 1.13 to 2.20); and the district-level confirmed malaria incidence (1.31; 1.15 to 1.49). A review of prior soil-transmitted helminth surveys in Timor-Leste indicates low-to-moderate prevalence with generally low egg counts, suggesting a limited impact on anemia in this setting, although comprehensive survey data are lacking. Examination of the population-level effects highlights the impacts of both recent births and malaria on anemia, with more limited impacts from diet; the evidence does not suggest a large contribution from geohelminths within Timor-Leste. These patterns are divergent from some other settings in the Asia-Pacific region and highlight the need for further focused research. Targeting high-burden districts and by increasing access to pre/postnatal care, raising literacy levels, increasing access to family planning, and improving malaria control should be prioritized to maximize inherently limited health budgets in reaching these populations

Lover, Andrew A

Heymann, David L

LSHTM Research Online

Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization.

Andrew A Lover

David L Heymann

Directory of Open Access Journals

Crossref

Lover, A.A.

Hartman, M.

Chia, K.S.

Heymann, D.L.

ScholarBank@NUS

Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: Implications for health program prioritization

http://scholarbank.nus.edu.sg/bitstream/10635/108903/1/2014_Demographic%20and_Spatial_Predictors_of_Anemia-published.PDF

Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: Implications for health program prioritization

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