Liyew Alemneh Mekuriaw, Tesema Getayeneh Antehunegn, Alamneh Tesfa Sewunet, Worku Misganaw Gebrie, Teshale Achamyeleh Birhanu, Alem Adugnaw Zeleke, Tessema Zemenu Tadesse, Yeshaw Yigizie
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 Apr 27;16(4):e0250560. doi: 10.1371/journal.pone.0250560. eCollection 2021.
Anemia during pregnancy is a public health problem that leads to different life-threatening complications and poor pregnancy outcomes. So far, the evidence is scarce on pooled prevalence and determinants of anemia during pregnancy in East Africa for integrated intervention. Therefore, this study aimed to assess the prevalence and determinants of anemia among pregnant women in eastern Africa using recent Demographic and Health Surveys.
Secondary data analysis was conducted using data from recent Demographic and Health Survey datasets from 10 East African countries. A total of 8583 (weighted sample) pregnant women were included in the analysis. The multi-level mixed-effects generalized linear model (Poisson regression with robust error variance) was fitted to identify determinants of anemia. Finally, the adjusted prevalence ratio (aPR) with 95% CI and random effects for the multilevel generalized linear mixed-effects model was reported.
In this study, the overall prevalence of anemia among pregnant women was 41.82% (95% CI: 40.78, 42.87) with a large difference between specific countries which ranged from 23.36% in Rwanda to 57.10% in Tanzania. In the multi-level analysis, teenage pregnant women (aPR = 1.22;95%CI:1.02, 1.40), unmarried women (aPR = 1.14; 95% CI;1.02,1.28), pregnant women who had unimproved toilet facility (aPR = 1.17;95%CI:1.06,1.27), and those women from countries with high illiteracy level (aPR = 1.12;95%CI; 1.07,1.18) had a higher prevalence of anemia during pregnancy.
Anemia is still a public health problem in East Africa. Therefore, enabling the households to have improved toilet facilities by strengthening the existing health extension program, reducing teenage pregnancy, and improving the community literacy level is vital to reduce the prevalence of anemia during pregnancy in East Africa.
孕期贫血是一个公共卫生问题，会导致各种危及生命的并发症和不良妊娠结局。到目前为止，关于东非孕期贫血的综合患病率和决定因素的证据很少，难以进行综合干预。因此，本研究旨在利用最新的人口与健康调查评估东非孕妇贫血的患病率及其决定因素。
使用来自10个东非国家最近的人口与健康调查数据集进行二次数据分析。分析共纳入8583名（加权样本）孕妇。采用多水平混合效应广义线性模型（具有稳健误差方差的泊松回归）来确定贫血的决定因素。最后，报告多水平广义线性混合效应模型的调整患病率比（aPR）及其95%置信区间和随机效应。
在本研究中，孕妇贫血的总体患病率为41.82%（95%置信区间：40.78, 42.87），不同国家之间存在很大差异，从卢旺达的23.36%到坦桑尼亚的57.10%不等。在多水平分析中，青少年孕妇（aPR = 1.22；95%置信区间：1.02, 1.40）、未婚女性（aPR = 1.14；95%置信区间：1.02, 1.28）、厕所设施未改善的孕妇（aPR = 1.17；95%置信区间：1.06, 1.27）以及来自文盲率高的国家的女性（aPR = 1.12；95%置信区间：1.07, 1.18）孕期贫血患病率较高。
贫血在东非仍然是一个公共卫生问题。因此，通过加强现有的健康推广项目，使家庭拥有改善的厕所设施，减少青少年怀孕，并提高社区识字水平，对于降低东非孕期贫血患病率至关重要。
