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加纳上东部地区孕妇贫血的风险因素:一项横断面研究。

Risk factors for anaemia among pregnant women: A cross-sectional study in Upper East Region, Ghana.

机构信息

School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.

Kassena Nankana West District Health Directorate, Ghana Health Service, Paga, Upper East Region, Ghana.

出版信息

PLoS One. 2024 Nov 14;19(11):e0301654. doi: 10.1371/journal.pone.0301654. eCollection 2024.

Abstract

BACKGROUND

Anaemia in pregnancy (AIP) is a public health concern due to its devastating effects on women and their unborn babies, resulting in increased maternal and neonatal deaths in developing countries. Despite several Ghanaian health policies to combat AIP, AIP is still on the rise. It becomes imperative to identify geographic-specific factors for developing appropriate interventions for the management of AIP. However, Kassena Nankana West District (KNWD) in the Upper East Region of Ghana lacks a study on anaemia risk factors, therefore, this study estimated the prevalence and risk factors for anaemia among pregnant women in the district.

METHODS

A cross-sectional study was conducted from February to March 2023 in the KNWD. Approximately 376 pregnant women in their third trimester were randomly selected from 10 health facilities by utilizing the antenatal register as the sampling frame. Anthropometric, obstetric, sociodemographic, and health facility resource characteristics were collected using structured questionnaires and from antenatal records. Mixed-effect logistic regression was used to identify independent factors of anaemia at 95% confidence interval.

RESULTS

Prevalence of AIP was 53.9% (95%CI:48.5%-58.8%). Mild, moderate, and severe anaemia prevalence was 16.9%, 35.3%, and 1.7% respectively. Malaria infection during pregnancy (aOR = 1.64; 95%CI:1.03-2.62) and accessing health facilities without trained laboratory personnel (aOR = 5.49; 95%CI:1.67-18.00) were associated with increased odds of AIP. Belonging to the major ethnic group (aOR = 0.52; 95%CI:0.28-0.85), accessing health facilities without laboratory services (aOR = 0.14; 95%CI:0.04-0.47), and accessing health facilities without sulphadoxine-pyrimethamine drugs (aOR = 0.22; 95%CI:0.06-0.86) in KNWD were also associated with decreased odds of AIP.

CONCLUSION

KNWD has a severe burden of AIP. Maternal and health facility-related factors were associated with AIP in the district. These factors are preventable. Therefore, the provision of functional laboratory services with dedicated technical personnel, regular supply of sulphadoxine-pyrimethamine drugs to the health facilities, and enhanced community education on malaria prevention are recommended for anaemia control in the district.

摘要

背景

妊娠贫血(AIP)是一个公共卫生问题,因为它对妇女及其未出生婴儿有毁灭性影响,导致发展中国家的产妇和新生儿死亡增加。尽管加纳有几项卫生政策来应对 AIP,但 AIP 仍在上升。因此,有必要确定特定于地理位置的因素,以便为 AIP 的管理制定适当的干预措施。然而,加纳上东部地区的卡萨纳南库西韦区(KNWD)缺乏关于贫血危险因素的研究,因此,本研究旨在估计该地区孕妇贫血的患病率和危险因素。

方法

这是一项 2023 年 2 月至 3 月在 KNWD 进行的横断面研究。从 10 个卫生机构中,利用产前登记册作为抽样框架,随机选择了大约 376 名处于孕晚期的孕妇。使用结构化问卷和产前记录收集了人体测量学、产科、社会人口统计学和卫生机构资源特征。使用混合效应逻辑回归模型在 95%置信区间内确定贫血的独立因素。

结果

AIP 的患病率为 53.9%(95%CI:48.5%-58.8%)。轻度、中度和重度贫血的患病率分别为 16.9%、35.3%和 1.7%。怀孕期间感染疟疾(优势比[OR] = 1.64;95%CI:1.03-2.62)和到没有训练有素实验室人员的卫生机构就诊(OR = 5.49;95%CI:1.67-18.00)与 AIP 的患病风险增加相关。属于主要少数民族(OR = 0.52;95%CI:0.28-0.85)、到没有实验室服务的卫生机构就诊(OR = 0.14;95%CI:0.04-0.47)和到没有磺胺多辛-乙胺嘧啶药物的卫生机构就诊(OR = 0.22;95%CI:0.06-0.86)也与 KNWD 地区 AIP 的患病风险降低相关。

结论

KNWD 的 AIP 负担严重。孕产妇和卫生机构相关因素与该地区的 AIP 相关。这些因素是可以预防的。因此,建议为该地区提供具有专业技术人员的功能实验室服务,定期向卫生机构供应磺胺多辛-乙胺嘧啶药物,并加强社区疟疾预防教育,以控制贫血。

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