Arinda Ivan Kato, Sserwanja Quraish, Kamara Kassim, Mukunya David, Agnes Napyo, Edirisa Juniour Nsubuga, Christinah Nuwahereza, Kagali Anitah, Lee Seungwon
Department of Nutrition Research, Nutri-worth International, Kampala, Uganda.
Programmes Department, GOAL, Khartoum, Sudan.
Nutr Metab Insights. 2022 Jun 16;15:11786388221105732. doi: 10.1177/11786388221105732. eCollection 2022.
Anemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual's physiological needs. The prevalence of anemia among women of reproductive age is high in Sub-Saharan Africa (SSA), including Sierra Leone. However, data on anemia among lactating women in Sierra Leone are scarce. Therefore, this study was conducted to estimate the prevalence of anemia and determine its associated factors among lactating women in Sierra Leone.
The 2019 Sierra Leone Demographic and Health Survey (SLDH) data were used of which 1543 lactating women aged 15 to 49 years old had hemoglobin measurements. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariate binary logistic regression was used to determine factors associated with anemia among lactating women in Sierra Leone.
The general prevalence of anemia among lactating women in Sierra Leone was 52.9% (95% CI = 50.9-55.8). Almost a quarter, 23.8% (95% CI = 22.1-26.3) of the lactating women had mild anemia, 27.4% (95% CI = 25.3-29.7) had moderate anemia and 1.7% (95% CI = 1.1-2.5) had severe anemia. The use of modern contraceptives (aOR = 1.64, 95% CI = 1.09-2.47), not being visited by a field worker in the past year (aOR = 1.51, 95% CI = 1.12-2.03) and being Muslim (aOR = 1.46, 95% CI = 1.11-1.91), were associated with higher odds of being anemic. Being given and having bought iron supplements during pregnancy (aOR = 0.46, 95% CI = 0.25-0.87) was associated with less odds of being anemic.
More than half of the lactating mothers in our study were anemic. The risk factors for anemia in our study included: use of modern contraceptives, not being visited by a field worker in the past year and being Muslim. Receiving iron supplements during pregnancy was protective against anemia. According to the results from this study, the recommendation for lactating women was to maintain routine interface with the healthcare system which includes being visited by a field worker who should prescribe and issue iron supplements to them. Lactating women especially Muslims should receive routine nutrition education by the health workers at the health facilities during antenatal care visits or postnatal care in regard to anemia and means of prevention and treatment. Community stakeholders should also work in collaboration to establish scalable methods to correctly identify pregnant women with risk factors, inform them about anemia with caution, and apply appropriate measures as trained or instructed.
贫血是一种血红蛋白（Hb）浓度和/或红细胞（RBC）数量低于正常水平且不足以满足个体生理需求的病症。在撒哈拉以南非洲（SSA），包括塞拉利昂，育龄妇女贫血患病率很高。然而，塞拉利昂哺乳期妇女贫血的数据稀缺。因此，本研究旨在估计塞拉利昂哺乳期妇女贫血患病率并确定其相关因素。
使用2019年塞拉利昂人口与健康调查（SLDH）数据，其中1543名年龄在15至49岁的哺乳期妇女进行了血红蛋白测量。采用多阶段分层抽样选择研究参与者，并使用经过验证的问卷收集数据。采用多变量二元逻辑回归确定塞拉利昂哺乳期妇女贫血的相关因素。
塞拉利昂哺乳期妇女贫血的总体患病率为52.9%（95%置信区间=50.9-55.8）。近四分之一，即23.8%（95%置信区间=22.1-26.3）的哺乳期妇女患有轻度贫血，27.4%（95%置信区间=25.3-29.7）患有中度贫血，1.7%（9实%置信区间=1.1-2.5）患有重度贫血。使用现代避孕方法（调整后的比值比=1.64，95%置信区间=1.09-2.47）、过去一年未接受现场工作人员访视（调整后的比值比=1.51，95%置信区间=1.12-2.03）以及为穆斯林（调整后的比值比=1.46，95%置信区间=1.11-1.91）与贫血几率较高相关。孕期接受并购买铁补充剂（调整后的比值比=0.46，95%置信区间=0.25-0.87）与贫血几率较低相关。
我们研究中超过一半的哺乳期母亲患有贫血。我们研究中贫血的风险因素包括：使用现代避孕方法、过去一年未接受现场工作人员访视以及为穆斯林。孕期接受铁补充剂可预防贫血。根据本研究结果，对哺乳期妇女的建议是与医疗保健系统保持常规接触，包括接受现场工作人员访视，现场工作人员应为她们开处方并发放铁补充剂。哺乳期妇女尤其是穆斯林妇女应在产前检查或产后护理期间，由医疗机构的卫生工作者就贫血及其预防和治疗方法接受常规营养教育。社区利益相关者也应合作建立可扩展的方法，以正确识别有风险因素的孕妇，谨慎地告知她们有关贫血的情况，并按照培训或指示采取适当措施。
