Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2022 May 9;17(5):e0268129. doi: 10.1371/journal.pone.0268129. eCollection 2022.
Anemia is a disorder by which the body's red blood cells are inadequate to fulfill The physiological needs of the body. The World Health Organization (WHO) defines anemia as having a hemoglobin (Hb) level of less than 120 g/l for nonpregnant women and 110 g/l for pregnant women. It has serious implications for human health as well as negative social and economic consequences like decreased workforce, impaired learning, and stunted child development. As these women are highly vulnerable to different micro and macro-nutritive deficiency associated with rapid physical, mental and psychological development, particular attention should be given to a young woman (15-24). Therefore this study assesses the magnitude and determinants of anemia among young women in sub-Saharan Africa (SSA).
This was a secondary data analysis based on the Demographic and Health Surveys (DHS) data conducted in sub-Saharan Africa. We pooled the most recent DHS surveys done in 31 sub-Sahara Africa and a total weighted sample of 88, 832 young women (15-24 years) were included. At bivariable analysis, variables with a p-value of ≤0.2 were selected for multivariable analysis, and at the multivariable analysis variables with a p-value of ≤0.05 were considered as a significant factor associated with anemia among young women (15-24 years).
The pooled prevalence of anemia among young women (15-24) in sub-Sahara Africa was 42.17% [95%CI: 41.85, 42.50]. Young women of aged 20-24 years [AOR = 0.92, 95%CI: 0.89-0.95], women from rich household [AOR = 0.83, 95%CI: 0.80-0.87], young women with primary [AOR = 0.7, 95%CI: 0.67-0.72], secondary [AOR = 0.72, 95%CI: 0.69-0.75] and higher educational status [AOR = 0.58, 95%CI: 0.53-0.64], married women [AOR = 1.12, 95%CI: 1.08-1.17], divorced/separated/widowed women [AOR = 1.16, 95%CI: 1.08-1.25], women who use modern contraceptive [AOR = 0.65, 95%CI: 0.62-0.67], young women who ever had terminated pregnancy [AOR = 1.22, 95%CI: 1.14-1.29], overweight young woman [AOR = 0.79, 95%CI: 0.76-0.82] and young women from female-headed household [AOR = 0.94, 95%CI: 0.91-0.97] were the individual-level factors that significantly associated with anemia of young women. Meanwhile, being a rural dweller [AOR = 0.82, 95%CI: 0.79-0.85] and high community educational level [AOR = 0.87, 95%CI: 0.70-0.97] were the community level determinant of anemia. Interclass correlation coefficient (ICC), Median Odds Ratio (MOR) and Percentage change in variance (PCV) were done for the assessment of the random effect model of the multilevel analysis. The ICC value in the null model was 0.05, which indicates that 5% of the variation in anemia among young women in sub-Saharan Africa was attributed to community-level factors.
The prevalence of anemia among young women in this study was higher compared with reports from the previous studies. Divorced/separated/widowed women, married women and women with ever terminated pregnancy, young women with primary, secondary and higher educational achievement, being rural dwellers, young women aged 20-24 years, being from rich households and women who used modern contraceptives were factors that significantly associated with anemia among young women. Therefore, particular attention should be given to those higher-risk women including, young women with a history of a terminated pregnancy, those from rural areas and young women aged 15-19 years to reduce the burden of anemia among these young women as the continuity of the future generation depends on the health of young women.
贫血是一种人体红细胞不足以满足生理需求的疾病。世界卫生组织（WHO）将非孕妇的血红蛋白（Hb）水平定义为低于 120g/l，孕妇的血红蛋白水平定义为低于 110g/l。贫血对人类健康有严重影响，也会带来负面的社会和经济后果，如劳动力减少、学习能力受损和儿童发育迟缓。由于这些女性在快速的身体、心理和心理发展过程中极易受到各种微量和宏量营养素缺乏的影响，因此应特别关注年轻女性（15-24 岁）。因此，本研究评估了撒哈拉以南非洲（SSA）年轻女性贫血的程度和决定因素。
这是一项基于人口与健康调查（DHS）数据的二次数据分析。我们汇总了在撒哈拉以南非洲进行的最近的 31 项 DHS 调查，共纳入了 88832 名年龄在 15-24 岁的年轻女性。在单变量分析中，选择 p 值≤0.2 的变量进行多变量分析，在多变量分析中，选择 p 值≤0.05 的变量作为与年轻女性（15-24 岁）贫血相关的显著因素。
撒哈拉以南非洲年轻女性（15-24 岁）贫血的总患病率为 42.17%[95%CI：41.85，42.50]。20-24 岁的年轻女性[AOR=0.92，95%CI：0.89-0.95]、来自富裕家庭的女性[AOR=0.83，95%CI：0.80-0.87]、接受过小学[AOR=0.7，95%CI：0.67-0.72]、中学[AOR=0.72，95%CI：0.69-0.75]和高等教育的女性[AOR=0.58，95%CI：0.53-0.64]、已婚女性[AOR=1.12，95%CI：1.08-1.17]、离婚/分居/丧偶的女性[AOR=1.16，95%CI：1.08-1.25]、使用现代避孕药具的女性[AOR=0.65，95%CI：0.62-0.67]、曾经终止妊娠的年轻女性[AOR=1.22，95%CI：1.14-1.29]、超重的年轻女性[AOR=0.79，95%CI：0.76-0.82]和来自女性为户主家庭的女性[AOR=0.94，95%CI：0.91-0.97]是与年轻女性贫血显著相关的个体水平因素。同时，居住在农村地区[AOR=0.82，95%CI：0.79-0.85]和社区教育水平较高[AOR=0.87，95%CI：0.70-0.97]是贫血的社区水平决定因素。本研究还进行了组间相关系数（ICC）、中位数优势比（MOR）和方差百分比变化（PCV）评估，零模型中的 ICC 值为 0.05，这表明撒哈拉以南非洲年轻女性贫血的 5%变异归因于社区水平因素。
与之前的研究报告相比，本研究中年轻女性贫血的患病率较高。离婚/分居/丧偶的妇女、已婚妇女和曾经终止妊娠的妇女、接受过小学、中学和高等教育的年轻妇女、居住在农村地区的年轻妇女、20-24 岁的年轻妇女、来自富裕家庭的妇女和使用现代避孕药具的妇女是与年轻女性贫血显著相关的因素。因此，应特别关注那些高风险的年轻女性，包括有过终止妊娠史的女性、来自农村地区的女性以及 15-19 岁的年轻女性，以降低这些年轻女性贫血的负担，因为未来一代的延续取决于年轻女性的健康。
