Risk factors for anaemia in pregnancy in rural KwaZulu-Natal, South Africa: Implication for health education and health promotion

Hoque, Monjurul; Hoque, Ehsanul; Kader, Suriya Bibi

doi:10.1080/20786204.2009.10873811

Cited by 25 publications

(24 citation statements)

References 18 publications

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“…Our finding was in agreement with different studies conducted in different parts of Ethiopia and other country that reported higher odds of anemia among hookworm-infected women [ 31 , 17 , 32 ]. Additionally, similar studies also showed higher odds of anemia among those having co-infection of hookworm with other intestinal parasites [ 33 , 34 , 35 ]. The worm in the intestine may cause intestinal necrosis and blood loss as a result of the attachment to the intestinal mucosa and chronic infections lead to iron deficiency and anemia resulting from the excessive loss of iron [ 3 ].…”

Section: Discussionmentioning

confidence: 87%

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Lebso¹,

2017

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BackgroundAnemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia.MethodsCommunity based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia.ResultsThe prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11–3.69), trimester second (AOR = 3.09, 95%CI: 1.41–6.79) and third (AOR = 3.68, 95% CI: 1.67–8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03–3.07) and six and above (AOR = 2.59, 95%CI: 1.37–4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02–2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37–7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34–5.39).ConclusionAnemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors.

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Section: Discussionmentioning

confidence: 87%

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Lebso¹,

2017

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“…A local study based in KZN at the Empangeni Hospital indicated similar findings, where HIV infection was observed to increase the likelihood of anaemia during pregnancy and was more common among cases (56%) than among controls (37%) (OR = 2.11; 95% CI = 1.123, 3.21; p ≤ 0.005). 16 Upon initiation of ANC, screening for HIV is of great importance. This would help in the attitude, a fear of HIV testing, health system barriers, a lack of knowledge and financial barriers hinder an adolescent's access to ANC services.…”

Section: Discussionmentioning

confidence: 99%

Obstetric outcomes and antenatal access among adolescent pregnancies in KwaZulu-Natal, South Africa

Govender

Reddy

Ghuman

2017

South African Family Practice

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Background: Pregnancy among adolescents in South Africa is a growing concern as it may be associated with adverse socioeconomic and health impacts. Timeous initiation and optimal utilisation of antenatal care (ANC) services is imperative to ensure positive pregnancy outcomes. However, this is not always possible owing to various challenges. Methods: A multi-method study design using both retrospective record review and qualitative interviews was undertaken at a district hospital on the North Coast of KwaZulu-Natal, South Africa. Data on ANC attendance trends and obstetric/perinatal outcomes for all recorded adolescent pregnancies (13-16 years) at the district hospital under study was collected over 3 years (2011-2013) (n = 314). Qualitative interviews with randomly selected pregnant adolescents were conducted to assess experiences of ANC access and utilisation. Results: Late ANC booking and reduced ANC visits were common for adolescent pregnancies. Under-utilisation of ANC (i.e. less than 4 visits) was significantly associated with lower gestational age (< 37 weeks) (OR = 2.64; 95% CI = 1.04; 6.74; p < 0.05). Low birthweight, low Apgar scores as well as the incidence of maternal anaemia and pregnancy-induced hypertension (PIH) were found to be related to late ANC booking. In-depth interviews suggested that teenagers suffered emotional vulnerability linked to family, partner and financial support. They discussed various barriers linked with accessing ANC while acknowledging perceived benefits. Conclusion: Adolescent pregnancy was associated with late booking and reduced ANC visits, which was a risk for adverse maternal health outcomes. In-depth interviews suggested numerous challenges associated with ANC access including; financial barriers, attitude of healthcare workers (HCWs), long queues, distance travelled to access ANC services, human immunodeficiency virus (HIV) status and a lack of knowledge.

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“…The tool uses 10 criteria to assess both internal and external validity of studies based on participant selection criteria as a representation of overall population, how information is collected, and whether parameters used to determine prevalence was consistent in each study amongst participants (10). An overall risk of bias will then be determined based on the individual scores obtained for each of the 10 items and graded according to the number of high risks found: low (≤ 2), moderate (3)(4), and high (≥ 5). Where information related to the 10 items is not available, it will be captured as high risk.…”

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

The Prevalence, Risk factors and Outcomes of Anaemia in South African Pregnant Women: A Protocol for a Systematic Review and Meta-analysis

Dorsamy

Bagwandeen

Moodley

2020

Preprint

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Background A significant cause of morbidity and mortality during pregnancy is maternal anaemia. The causes of anaemia and the sequelae are varied, and the prevention and management are public health challenges, especially in resource limited settings and certain geographic locations. South Africa is plagued by a quadruple burden of disease, with high maternal mortality rates affected by hypertensive disorders of pregnancy, HIV, tuberculosis and neglected tropical diseases. This is most prevalent in people of lower socio-economic status. Poor nutrition, chronic infections, lack of access to health care facilities and poor compliance with micronutrient supplementation all contribute to maternal anaemia. The aim of this study is to systematically map the literature to ascertain the pooled prevalence and associated causes of anaemia in the South African pregnant population, which will enable health care workers and other key stakeholders to more pertinently address Sustainable Development Goal 3 focussing on good health and reducing maternal mortality.Methods PubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS will be searched, using the keywords ‘anaemia’, ,’haemoglobin’, ‘pregnancy’, ‘South Africa’, to conduct a systematic review and meta-analysis to explore, describe and map literature on the distribution and burden of anaemia in pregnant women in South Africa. The reference list of articles selected for review will be scanned for other articles of interest to our study question. Studies published in any language will be included in this review. As there may be differences in sampled populations in South Africa based on geography and sociodemographic factors, a weighted inverse-variance meta-analysis using a random-effects model will be carried out to generate a pooled prevalence estimate. A Funnel plot and Egger’s regression test will be conducted to assess publication bias. Heterogeneity among studies will be checked using I2 to determine dispersion and meta-regression analysis will be performed to investigate the source of heterogeneity. The articles obtained by these searches will be analysed for causative factors, severity and outcomes by a parallel and independent review team, using suitable eligibility criteria. Screening, data extraction, and quality appraisal will be conducted independently by two authors. Disagreement will be resolved by independent assessment by a third reviewer. Sub group analysis by region, stage of pregnancy, socio-economic status, severity and cause of anaemia will be conducted if sufficient data is available. Data will be analysed using statistical software, and presented in evidence tables and in meta-analytic forest plots.Discussion This protocol is developed to systematically review the literature on the prevalence and severity of anaemia, risk factors and outcomes in pregnant women in South Africa. Correlation of factors contributing to the development of anaemia and other disorders during pregnancy will facilitate exploration of appropriate medical and behavioural change interventions implemented within other countries or regions that mitigate risk. This study will assist local health systems to inform public health policies and practises for more favourable maternal and fetal outcomes.

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Risk factors for anaemia in pregnancy in rural KwaZulu-Natal, South Africa: Implication for health education and health promotion

Cited by 25 publications

References 18 publications

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Obstetric outcomes and antenatal access among adolescent pregnancies in KwaZulu-Natal, South Africa

The Prevalence, Risk factors and Outcomes of Anaemia in South African Pregnant Women: A Protocol for a Systematic Review and Meta-analysis

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