Dietary Diversity and Its Contribution in the Etiology of Maternal Anemia in Conflict Hit Mount Cameroon Area: A Cross-Sectional Study

Abstract

Background: In the Mount Cameroon area, maternal anemia remains a major public health concern. We hypothesized that nutrient inadequacy may account for the level of anemia in pregnancy. Thus, this study examined the relative effect of dietary diversity on maternal anemia in the study area.Methods: A total of 1,014 consenting pregnant women were enrolled in this cross-sectional study. Information on socio-demographic, antenatal characteristics, malaria and anemia control measures were documented. Dietary diversity (DD) was evaluated using the 24-h recall method and hemoglobin (Hb) levels (g/dl) measured using a portable Hb meter. Malaria parasitaemia was diagnosed by blood microscopy. Anemia status was trimester specific. Logistic regression analysis was used determine predictors of maternal anemia.Results: Among the pregnant women enrolled, the mean DD score was 3.5±0.8 SD and only 10.4% had adequate dietary diversity. Anemia prevalence was 40.9%. Majority of the women consumed starchy staples (99.3%) while least consumed foods were dairy (4.5%), eggs (8.3%), fruits and vegetable (vitamin A-rich) (8.6%). A significant lower prevalence of anemia was associated with intake of dairy (P < 0.001), animal protein (P = 0.006), vitamin A-rich fruits and vegetables (P < 0.001). Furthermore, mean Hb levels were higher (P < 0.001) among women with diverse diets (12.39 ± 1.34) than in those with less diverse diets (10.85 ± 1.33). Predictors of anemia were as follows: study setting [Odd Ratio (OR) = 1.4, 95% CI: 1.07-1.94], occupation (OR = 1.9, 95% CI: 1.16-3.43), number of clinic visits (OR = 1.9, 95% CI: 1.27-2.91), trimester of pregnancy (OR = 3.2, 95% CI: 1.45-7.38), malaria parasitaemia (OR = 1.8, 95% CI: 1.33-2.68), out of home eating (OR = 1.4, 95% CI: 1.03-2.13), and DD (OR = 9.8, 95% CI: 4.56-20.80). The attributable risk of anemia due to dietary diversity was 82.9%.Conclusion: In the study area, DD is a major risk factor for maternal anemia. This finding underscores the importance of content specific nutrition education during clinic visits to improve intake of protein and iron-rich food in anemia prevention.

Prevalence and factors associated with anaemia among pregnant women attending reproductive and child health clinics in Mbeya region, Tanzania

“…Only two components of PDQS were significantly associated with anaemia in pregnant women, in multivariate analysis: eating dark green leafy vegetables and consumption of vegetable oils were strongly associated with protection from anaemia. These findings are comparable with studies conducted in the Morogoro and Dodoma Regions of Tanzania, which found that women who consumed dark green leafy vegetables resulted had higher hemoglobin and overall iron status [37], as well as with research conducted in Cameroun which found that consumption of vegetables and dark green leafy vegetables were significantly associated with lower prevalence of anaemia in pregnant women [38]. It is evident that these findings call for national programs to enhance the knowledge and skills of pregnant women in terms of use of green leafy vegetables, methods of cooking, processing of greens and growing kitchen garden.…”

Anaemia among adolescent girls, pregnant and lactating women in south coastal region of Bangladesh: prevalence and associated factors

“…In the present study, women in second and third pregnancy trimester were more likely to be anaemic which aligns with earlier studies conducted in Bangladesh [17], Cameroon [31], Ethiopia [32]. The current study found that pregnant and lactating women who received antenatal care (ANC) four or more times during their pregnancy had a lower risk of being anemic, which is consistent with earlier studies [31,33]. This may be due to routine diagnosis of anaemia during the ANC visit, scheduled counselling on nutrition related knowledge, supplementation and treatment [31].…”

“…Inappropriate eating habits may contribute to the development of anaemia where low dietary diversity plays a signi cant role. In our study, anaemia among pregnant and lactating women was linked to the consumption of low-diversi ed diet which was consistent with earlier study [31,32]. The physiological state of high demanding nutrient during pregnancy and lactation period suggested women to consume a diversi ed diet to achieve nutrient adequacy to prevent the development of micronutrient de cient anaemia [32].…”

Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta‐analysis

“…After a full‐text review, 42 studies were excluded for several reasons, including lack of full text, being outside the scope of the study, not presenting outcome measures, having different reference categories, and a high risk of bias. After a thorough review, 13 articles for the association between inadequate dietary diversity and anemia (Abriha et al, 2014; Agbozo et al, 2020; Ayensu et al, 2020; Delil et al, 2018; Deriba et al, 2020; Gibore et al, 2021; Jugha et al, 2021; Lebso et al, 2017; Ngimbudzi et al, 2021; Samuel et al, 2020; Vanié et al, 2021; Zerfu et al, 2016, 2019) and nine articles for determining the strength of the association between inadequate dietary diversity and low birth weight (Adem et al, 2020; Ahmed et al, 2018; Alemu & Gashu, 2020; Bekela et al, 2020; Berhe et al, 2021; Girma et al, 2019; Quansah & Boateng, 2020; Saaka et al, 2017; Zerfu et al, 2016) were included in the final meta‐analysis (Figure 1). One study was discarded after quality assessment (Vanié et al, 2021).…”