Medical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand.
Centre for Research and Development of Medical Diagnostic Laboratories (CMDL), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
BMC Public Health. 2020 Jan 28;20(1):102. doi: 10.1186/s12889-020-8248-1.
Anaemia and iron deficiency (ID) affect women of reproductive age globally and considered to be a major public health problem in developing countries. This study determines the prevalence of anaemia and ID among women of reproductive age in urban northeast Thailand and examined the relative contribution of various risk factors to anaemia and ID in this population.
Three hundred ninety-nine non-pregnant women, aged 18-45 years, from three universities in northeast Thailand participated in this cross-sectional study. Selected socio-demographic, history of blood loss, usual consumption of red meat and tea/coffee, and anthropometric data were collected. Complete blood count including haemoglobin (Hb) concentration, serum ferritin (SF), C-reactive protein (CRP), and thalassemia were determined. Multiple logistic regressions were applied to identify the risk factors of anaemia and ID.
Overall, 370 participants were included for data analyses after excluding women with severe/intermedia thalassemia diseases and/or those with positive serum CRP. The prevalence of anaemia, ID, and iron deficiency anaemia (IDA) were 28.4, 28.4, and 13.2%, respectively. Women with thalassemia had a higher prevalence of anaemia but a lower prevalence of ID than the women without thalassemia. By multiple regression analysis, ID [adjusted OR (AOR) = 4.9, 95% CI = 2.8-8.3], two α-gene defects (AOR = 8.0, 95% CI = 3.0-21.3) and homozygous Hb E (AOR = 8.5, 95% CI = 3.0-24.3) were identified as the potential risk factors of anaemia. Further, the odds of ID were significantly higher among women who donated blood within the past 3 months (AOR = 6.7, 95% CI = 2.8-16.3), and had moderate to a high amount of blood loss during menstruation (AOR = 2.2, 95% CI = 1.3-3.9).
This study found a relatively high but differential prevalence of anaemia and ID among women of reproductive age with or without thalassemia. Only homozygous Hb E and two α-gene defects of thalassemia types and ID were the main factors contributing to anaemia. Recent blood donation, and moderate to a high amount of blood loss during menstruation were potential risk factors of ID in this population.
贫血和缺铁（ID）影响全球育龄妇女，被认为是发展中国家的一个主要公共卫生问题。本研究旨在确定泰国东北部城市育龄妇女的贫血和 ID 患病率，并研究该人群中各种危险因素对贫血和 ID 的相对贡献。
本横断面研究纳入了来自泰国东北部三所大学的 399 名非妊娠育龄妇女。收集了选定的社会人口统计学、失血史、常食红肉和茶/咖啡以及人体测量学数据。检测了全血细胞计数，包括血红蛋白（Hb）浓度、血清铁蛋白（SF）、C 反应蛋白（CRP）和地中海贫血。应用多因素逻辑回归分析确定贫血和 ID 的危险因素。
排除严重/中间型地中海贫血疾病和/或血清 CRP 阳性的妇女后，共有 370 名妇女纳入数据分析。贫血、ID 和缺铁性贫血（IDA）的患病率分别为 28.4%、28.4%和 13.2%。患有地中海贫血的妇女贫血患病率较高，但 ID 患病率较低。多因素回归分析显示，ID[调整比值比（AOR）=4.9，95%可信区间（CI）=2.8-8.3]、两个α-珠蛋白基因突变（AOR=8.0，95%CI=3.0-21.3）和纯合子 Hb E（AOR=8.5，95%CI=3.0-24.3）是贫血的潜在危险因素。此外，过去 3 个月内献血（AOR=6.7，95%CI=2.8-16.3）和月经期间中等至大量失血（AOR=2.2，95%CI=1.3-3.9）的妇女 ID 发病风险显著升高。
本研究发现，患有或不患有地中海贫血的育龄妇女贫血和 ID 的患病率相对较高，但存在差异。只有纯合子 Hb E 和两种α-珠蛋白基因突变的地中海贫血类型和 ID 是导致贫血的主要因素。在该人群中，近期献血和月经期间中等至大量失血是 ID 的潜在危险因素。
