Agulu Gangtaba Gilbert, Ahissou Noudéhouénou Crédo Adelphe, Kamiya Yasuhiko, Baiden Frank, Matsui Mitsuaki
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 1076 Kiyuna, Nishihara, Okinawa, 901-2027, Japan.
Trop Med Health. 2025 Aug 27;53(1):118. doi: 10.1186/s41182-025-00792-8.
Despite extensive global and national efforts to reduce anaemia, it remains a major public health concern among Women of Reproductive Age (WRA). However, community-based studies that compare the prevalence and risk factors of anaemia using nationally representative samples are limited in Ghana. This study examines and compares anaemia prevalence and associated risk factors between nonpregnant and pregnant WRA in Ghana.
This study utilized cross-sectional data from the 2022 Ghana Demographic and Health Survey (GDHS). A total of 15,014 WRA were recruited, of whom 7,557 were screened for anaemia including 7004 nonpregnant and 553 pregnant women. Anaemia was defined as haemoglobin levels below 12 g/dL for nonpregnant and below 11 g/dL for pregnant women. Pearson chi-square and Fisher's exact tests were used to compare anaemia prevalence across groups. Poisson regressions were applied to identify risk factors for anaemia. All analyses were conducted using Stata version SE.18.
The prevalence of anaemia was 40.4% among nonpregnant women and 51.4% among pregnant women. Aside from self-reported health status and toilet facilities being significant determinants for nonpregnant women, common factors affecting both groups included parity, BMI, wealth status, and geographic zone. Multiparous women had a higher risk of anaemia, with nonpregnant and pregnant women experiencing 23% and 43% increased risk, respectively. Underweight nonpregnant women had an 11% higher risk, while overweight pregnant women had a 34% lower risk of anaemia. In terms of wealth, women in the poorest quintile had a significantly higher risk of anaemia 36% among nonpregnant women (APR: 1.36, 95% CI 1.01-1.83, p = 0.049) and 32% among pregnant women (APR: 1.32, 95% CI 1.01-1.76, p = 0.049). Additionally, women residing in the northern zone had a higher anaemia risk compared to those in the southern zone. Among nonpregnant women, those reporting poor health status had a 51% increased risk of anaemia, while those with improved toilet facilities had a 10% lower risk (APR: 0.90, 95% CI 0.83-0.96, p = 0.004).
The prevalence of anaemia, particularly among pregnant women, remains high in Ghana and constitutes a significant public health threat. Addressing this issue requires holistic and tailored public health strategies that improve access to healthcare, nutrition, sanitation, and economic equity.
尽管全球和各国都在为减少贫血症做出广泛努力，但贫血症仍是育龄妇女（WRA）面临的主要公共卫生问题。然而，在加纳，使用具有全国代表性样本比较贫血症患病率和风险因素的社区研究有限。本研究调查并比较了加纳未怀孕和怀孕育龄妇女的贫血症患病率及相关风险因素。
本研究利用了2022年加纳人口与健康调查（GDHS）的横断面数据。共招募了15,014名育龄妇女，其中7,557人接受了贫血筛查，包括7,004名未怀孕妇女和553名怀孕妇女。贫血的定义为未怀孕妇女血红蛋白水平低于12g/dL，怀孕妇女低于11g/dL。使用Pearson卡方检验和Fisher精确检验比较各组之间的贫血患病率。应用泊松回归来确定贫血的风险因素。所有分析均使用Stata版本SE.18进行。
未怀孕妇女中贫血患病率为40.4%，怀孕妇女中为51.4%。除了自我报告的健康状况和厕所设施是未怀孕妇女贫血的重要决定因素外，影响两组的共同因素包括胎次、体重指数、财富状况和地理区域。经产妇患贫血的风险更高，未怀孕和怀孕妇女的风险分别增加23%和43%。体重过轻的未怀孕妇女患贫血的风险高11%，而超重的怀孕妇女患贫血的风险低34%。在财富方面，最贫困五分之一的妇女患贫血的风险显著更高，未怀孕妇女中为36%（调整患病率：1.36，95%置信区间1.01-1.83，p = 0.049），怀孕妇女中为32%（调整患病率：1.32，95%置信区间1.01-1.76，p = 0.049）。此外，居住在北部地区的妇女比南部地区的妇女患贫血的风险更高。在未怀孕妇女中，报告健康状况差的人患贫血的风险增加51%，而厕所设施有所改善的人患贫血的风险低10%（调整患病率：0.90，95%置信区间0.83-0.96，p = 0.004）。
在加纳，贫血症的患病率，尤其是孕妇中的患病率仍然很高，构成了重大的公共卫生威胁。解决这一问题需要全面且量身定制的公共卫生策略，以改善医疗保健、营养、卫生设施和经济公平性的可及性。
