Burden Of Anemia Research Articles

Impact of Fortified Infant Cereals on the Burden of Iron Deficiency Anemia in 6- to 23-Month-Old Indonesian Infants and Young Children: A Health Economic Simulation Model.

Iron deficiency and iron deficiency anemia (IDA) are highly prevalent among Indonesian infants and young children (IYC). Severe IDA hampers mental development in young children and is linked to lower quality of life and lower productivity as adults. The consumption of fortified infant cereals (FIC) increases iron intake during the weaning period, thus reducing the social burden of IDA. In this manuscript, we aimed to assess the impact of FIC on the burden of IDA on IYC in Indonesia. We analyzed data for IYC aged 6–23 months from the fifth wave (2014–2015) of the Indonesia Family Life Survey (IFLS) and the Indonesia Demographic and Health Survey 2017 (IDHS-17). We adapted a health economic simulation model to estimate the impact of FIC that accounted for lifetime health and cost consequences in terms of reduced future income and DALYs. The mean Hb level was 10.5 ± 1.4 g/dL. Consumers of FIC had a reduced burden of disease (43,000 DALYs; USD 171 million) compared with non-consumers. The consumption of fortified infant cereals plays an important role in reducing the burden of IDA, and it might complement the available strategy of nutritional interventions to address this problem in Indonesian IYC.

Perinatal outcomes in anemic pregnant women in public hospitals of eastern Ethiopia.

Anemia is a worldwide problem with serious effects for mothers and their babies. Although efforts have been made to lessen the burden of anemia, it has remained a problem. Moreover, there is a paucity of information regarding the perinatal outcomes of anemia in the study area. Thus this study aimed to assess the perinatal outcomes in anemic pregnant women in eastern Ethiopia. A facility-based cross-sectional study was conducted among 407 systematically selected pregnant women. Data were collected by interview and entered into EpiData version 3.1 and then exported into SPSS for Windows version 20 for analysis. Bivariate and multivariate analyses were employed to determine the association between independent variables and the outcome variable. Among pregnant women, 61.9% had an adverse perinatal outcome. The most common reported adverse perinatal outcomes were preterm birth, congenital anomalies and stillbirths. Furthermore, variables such as educational status (adjusted odds ratio [AOR] 2.11 [95% confidence interval {CI} 1.245 to 3.58]), antenatal care follow-up (AOR 2.75 [95% CI 1.47 to 5.18]) and hemoglobin level (AOR 4.1 [95% CI 2.609 to 6.405]) were significantly associated with perinatal outcomes. Nearly three-fourths of anemic pregnant women experienced adverse perinatal outcomes. In general, this study identified that educational status, antenatal follow-up and hemoglobin level were associated with perinatal outcomes among anemic pregnant women. To prevent adverse perinatal outcomes, efforts must be made to ensure that all pregnant women receive antenatal care and have adequate maternal nutritional status.

Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini.

BackgroundAnaemia is a global health problem affecting about a third of the world’s population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy.AimThis study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini.SettingThis study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital.MethodsThis cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15–49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis.ResultsA total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15–19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19–2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15–18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27–25.4) and second trimester (OR: 1.62; CI: 1.02–2.60).ConclusionAnaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country’s burden of anaemia.

Anemia Burden among Hospital Attendees in Makkah, Saudi Arabia

Background Anemia is a major health problem in Saudi Arabia and has multiple etiologies. Many studies have been conducted in Saudi Arabia in specific population groups like school children, adolescents, university students, and females in the reproductive age group, and most have reported high prevalence of anemia. This study was conducted in a specialist hospital in Makkah city and includes all outpatients aged 15 years and above. Objective To study the burden of anemia among hospital attendees, its stratification based on gender and age, and its severity along with the morphological types of anemia. Methods This is a study conducted at a specialist hospital in Makkah city and one-month data were collected retrospectively from the laboratory database and include demographic and routine hematological results of complete blood count (CBC). Results A total of 21,524 patients were included, out of which 9444 (43.9%) were males and 12020 (56.1%) were females. The overall prevalence of anemia was 38.7% (8339). Prevalence was very high in females, accounting for 68.2% (5689), whereas it was 31.8% (2650) in males. There were 39.6% (3301), 43.9% (3657), and 16.6% (1381) cases of mild, moderate, and severe anemia, respectively. In females, anemia was more prevalent in the age group of 15 to 49, which is considered as the reproductive age group. Microcytic anemia was the most prevalent type observed in this age group, accounting for 40.7% of all anemia cases. Normocytic anemia was more prevalent in the males, accounting for 52%. Conclusion Our study showed high prevalence of anemia among the patients attending outpatient departments in a specialist hospital. Females have high prevalence of anemia when compared to male population. Microcytic anemia was the most common anemia type among females and was seen in the 15–49 age group. There is an increase in prevalence of anemia with age for males, whereas, in females, increased prevalence is observed in the reproductive age groups and the anemia prevalence maintained a steady decrease towards the 5th to the 9th decades. Normocytic anemia was more prevalent in the 5th to the 9th decades, indicating that there are more etiologies other than iron deficiency in the causation of anemia. Macrocytic anemia was the least reported anemia type. Anemia of mild and moderate severity was predominant in both genders, although severe anemia showed higher prevalence in females as compared to males. Conclusion Our study showed high prevalence of anemia among the patients attending outpatient departments in a specialist hospital. Females have high prevalence of anemia when compared to male population. Microcytic anemia was the most common anemia type among females and was seen in the 15–49 age group. There is an increase in prevalence of anemia with age for males, whereas, in females, increased prevalence is observed in the reproductive age groups and the anemia prevalence maintained a steady decrease towards the 5th to the 9th decades. Normocytic anemia was more prevalent in the 5th to the 9th decades, indicating that there are more etiologies other than iron deficiency in the causation of anemia. Macrocytic anemia was the least reported anemia type. Anemia of mild and moderate severity was predominant in both genders, although severe anemia showed higher prevalence in females as compared to males. Conclusion. Anemia is highly prevalent in adolescents, adults, and the elderly in Makkah region. The most common cause is thought to be iron deficiency, although other causes are not uncommon. The authorities need to address the problem of prevention and reduction in anemia prevalence by taking effective measures and interventions.

Longitudinal trends in the health outcomes among children of the North Eastern States of India: a comparative analysis using national DHS data from 2006 to 2020.

Background/ObjectivesNortheastern Indian region has a high density of marginalised populations with a concerning quality of health services. We observed the trends in prevalence of infectious diseases and nutritional disorders among children under-five years from 2006 to 2020 in the Northeastern states. We also assessed the distribution of their burden by place of residence.MethodsA secondary data analysis of select indicators on infectious diseases and nutritional disorders in seven Northeastern states across three rounds of the National Family Health Survey (2005–06, 2015–16, 2019–20) was undertaken. We calculated outcome indicator mean prevalence, relative change and average annual rates of reduction of the indicators.ResultsA significant relative reduction between 2006–2020 in the prevalence of diarrhoea (0.4 [95CI:0.7,0.1]) at p < 0.05; acute respiratory illness (ARI) (0.7 [95CI:0.1,0.4]), stunting (0.3 [95CI: 0.3,0.12]) and underweight (0.3 [95CI:0.5,0.2]) at p < 0.001 were noted. However, overweight prevalence increased (10.1[95CI:4.3,16.0, p < 0.001]) due to a low annual reduction rate. The highest annual reduction rates were observed in Sikkim and Tripura for diarrhoea and ARI respectively (>10.0%), and in Meghalaya for wasting and severely wasting (6.3%). Rural areas had a higher burden of stunting, wasting (including severe), underweight, anaemia and diarrhoea; overweight was seen in both rural and urban settings.ConclusionSignificant reductions were observed in ARI, diarrhoea, stunting and underweight prevalence between 2006–2020, with sub-regional variations and a greater burden in rural areas. During this period, overweight prevalence worsened; and anaemia showed a large increase from 2016. To reduce the equity-gap, programmes should be adapted to meet the differential needs of the Northeastern states.

Shooting shadows: India's struggle to reduce the burden of anaemia.

Despite several efforts by the Government of India, the national burden of anaemia remains high and its growing prevalence (between 2015-2016 and 2019-2021) is concerning to India's public health system. This article reviews existing food-based and clinical strategies to mitigate the anaemia burden and why they are premature and insufficient. In a context where multiple anaemia control programmes are in play, this article proposes a threefold strategy for consideration. First, except the Comprehensive National Nutrition Survey, 2016-2018, which measured Hb concentration among children and adolescents aged 1-19 years using venous blood samples, all national surveys use capillary blood samples to determine Hb levels, which could be erroneous. The Indian government should prioritise conducting a nationwide survey for estimating the burden of anaemia and its clinical determinants for all age groups using venous blood samples. Second, without deciding the appropriate dose of Fe needed for an individual, food fortification programmes that are often compounded with layering of other micronutrients could be harmful and further research on this issue is needed. Same is true for the pharmacological intervention of Fe tablet or syrup supplementation programmes, which is given to individuals without assessing its need. In addition, there is a dire need for robust research to understand both the long-term benefit and side effects of Fe supplementation programmes. Third and final, the WHO is in process of reviewing the Hb threshold for defining anaemia, therefore the introduction of new anaemia control programmes should be restrained.

A Survey of Anemia Burden and its Predictors Among the Undergraduates Enrolled in a Government Medical College of Delhi

Background: Anemia in developing countries is a major public health challenge whose burden is influenced primarily by dietary factors, physiological characteristics, and cultural practices. Objectives: The objectives of this study were to estimate the prevalence of anemia among medical students and find its associated sociodemographic, dietary, or clinical correlates, if any. Methods: A cross-sectional study was conducted among 665 medical undergraduate students, who were screened for anemia via a camp-based approach, with estimation by an automated hemoglobinometer and participant recruitment by an opt-in option. Analysis was done using IBM SPSS version 25.0. Results: The prevalence of anemia was 19.8%, with a significantly higher prevalence among females (40.9%) compared to males (5.6%). All males and majority of female anemics (56.4%) belonged to mild category. On bivariate analysis, female sex, hostel residence, and frequent consumption of meat or poultry were significant predictors of anemia. On adjusted analysis, female students were 11 times more likely to have anemia compared to male students (P &lt; 0.001). Furthermore, menstrual irregularities were more frequently reported by the female students with anemia. Conclusions: A high burden of anemia exists among female medical students. These findings emphasize the need for regular and periodic screening activities, supplemented with health education activities for awareness generation to control this neglected public health problem.

KNOWLEDGE, ATTITUDE AND PRACTICE OF ANEMIA: A CROSS-SECTIONAL STUDY

BACKGROUND: Anemia is one among serious public health problems, particularly, in a developing nation like India. To find out situation analysis of any public health condition or to assess effectiveness of implemented public health program, study of gap analysis has significant role. Nutritional knowledge related gap is one among major causes for nutritional problems. Moreover, intergenerational impact results due to uptake of improper practices. OBJECTIVES: To assess the burden of anemia and to study knowledge, attitude and practice among young women for the use of Iron Folic Acid (IFA) tablets relate to anemia. MATERIAL AND METHODS: This cross-sectional study was conducted in a North Gujarat region. A total of 1000 young women were included in this study. A predesigned, pretested, questionnaire was used to assess objective of the study. RESULTS: According to NFHS-V, 2019-20, prevalence of anemia among non-pregnant women is 65.1 % in Gujarat. The present study found that 40-60% of respondents could identify the major symptoms, causes and consequences of anemia. Least knowledge was found about inhibitors and enhancers. 54% of respondents like to consume iron-rich food. Only 32.6% of respondents had a positive attitude towards IFA tablets. 39% knew the importance of complementary food along breastfeeding. 32% of respondents used to consume citric food. 28.7% of school going girls used to consume IFA tablets weekly and only 26% of girls used to go for deworming annually. In non-going school girls, only 16% of young women used to consume IFA tablets. Only 10.4% of respondents used to/preferred to consume iron enhancers with IFA tablet. CONCLUSION: Young women depicted intermediate knowledge towards anemia but not adequate attitude and practice. Initial uptake and adherence to IFA tablets is extremely low among young women. Along with KAP, social and environmental factors need to address to disseminate misperceptions around IFA use and low-risk perception.

Health state utilities for beta-thalassemia: a time trade-off study

BackgroundBeta-thalassemia (BT) is an inherited blood disorder characterized by reduced levels of functional hemoglobin resulting in phenotypes ranging from clinically asymptomatic to severely anemic. Patients with BT may require lifelong regular blood transfusions supported by appropriate iron chelation therapy (ICT). This study aimed to determine how the UK general population values BT health states associated with differing transfusion burden and ICT.MethodsComposite time trade-off (cTTO) methodology was employed to elicit health state utilities in BT. Relevant BT literature related to symptom and quality-of-life impact, including physical, functional, and emotional well-being, and safety profiles of BT treatments were considered when drafting health state descriptions. Eleven health state descriptions were developed and validated by hematologists and patient advocates for clinical accuracy and completeness. 200 individuals from the UK general population participated in the cTTO interviews.ResultsThe mean age of participants was 41.50 years (SD 16.01, range 18–81); 88 (46.8%) were female. Utility values ranged from 0.78 (SD 0.34) for non-transfusion dependent BT with oral ICT to 0.37 (SD 0.50) for high transfusion burden with subcutaneous ICT in transfusion-dependent BT.ConclusionsThis study provides health utilities for a range of BT health states from the UK general population perspective. Importantly, lower transfusion burden and lower burden of anemia were associated with higher utilities. To a lesser extent, differential modes of ICT were found to impact utility valuations in patients with BT. The utilities obtained in this study can be employed as inputs in cost-effectiveness analyses of BT therapies.

The burden and types of anaemia among HIV infected, ART-naive injection substance users in Kenya.

Illicit substance use and HIV infection cause haematological derangements. Anaemia characterized by a reduction in the quality and quantity erythrocytes is the most common disorder in both HIV-positive persons and illicit substance users. To describe anaemia burden, types, and its association with HIV in injectable substance users in Mombasa, Kenya. This descriptive case-control study evaluated red cell indices and morphology in 494 adults. The primary outcome was anaemia. The association of anaemia with HIV in injection substance users was determined using the chi-square test. The participants included 275 injection substance users (ISU), (HIV-positive, n=62 and HIV-negative, n=213); and 219 non-injection substance users (nonISU), (HIV-positive, n=33 and HIV-negative, n=186). Overall, 49% were anaemic with anaemia burden significantly differing across the groups, X2(3, N=494) =12.1, p=0.0070. Anaemia burden was higher in HIV-positive ISU compared to HIV-negative ISU (odds ratio (OR) = 1.59, 95% confidence interval (CI): 0.85, 2.96); and HIV-positive nonISU compared to HIV-negative nonISU (OR = 0.37, 95% confidence interval (CI): 0.17, 0.79). Most of the anaemia was dimorphic in both HIV-positive (ISU, 67% and nonISU, 52%) and HIV-negative (ISU, 43% and nonISU, 55%) participants. Infection with HIV is associated with increased risk of anaemia in injectable and non-injectable substance users. Majority of the anaemia was dimorphic suggestive of multiple aetiologies. Establishing the related aetiologies is essential for the effective treatment of anaemia. The accurate evaluation of thin blood films remains an essential tool in diagnosing an array of haematologic disorders and as a reference for further tests and patient management.

Prevalence of Anaemia among Adolescent Girls on Weekly Iron and Folic Acid Supplementation (WIFS) and Non WIFS Group in Rural Schools of Mangalore, Karnataka; a Comparative Study

Background: Weekly Iron and Folic Acid Supplementation (WIFS) Programme is an initiative to decrease the burden of anaemia among adolescents studying in Government schools.&#x0D; Objective: To assess the difference in prevalence of anaemia among Government school-going adolescents girls on WIFS as compared to private school girls not on WIFS.&#x0D; Methods: Cross-sectional study was conducted among adolescent girls, 7th to 10th standard in Government schools (on WIFS) and private schools (not on WIFS). The sample size in each group was 104, selected by multi-stage sampling. Data was collected using semi-structured questionnaire, clinical examination and haemoglobin estimation. Chi-square test and Unpaired t test used to compare the categorical and continuous variables respectively.&#x0D; Results: The prevalence of anaemia among the school children in government schools was 51% and in the private schools it was 64.4%. The mean haemoglobin was 11.77 ± 1.41 and 11.34 ± 1.49 in government and private school girls, respectively, which was statistically significant (p=0.013).&#x0D; Conclusions: The prevalence of anaemia among the government school girls was lesser as compared to the private schools girls, suggesting the role of WIFS in the reduction of prevalence of anemia. WIFS programme may be extended to private schools as well.

Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study.

So far, no comprehensive studies have been performed to assess burden and determinants of anemia in Iran. In the present study, we aimed to answer this query using the data obtained from the Prospective Epidemiological Research Studies in IrAN (PERSIAN). In this cross-sectional study, we included 161,686 adult participants (aged 35 years and older) from 16 provinces of Iran. Anemia was defined as a hemoglobin concentration of <13 g/dL in males and <12 g/dL in females. To evaluate the association between anemia and different factors, we used the multivariable Poisson regression analysis with robust variance by applying adjusted prevalence ratio (PR) with 95% confidence interval (CI). Of the total number of subjects, 72,387 (44.77%) were male and others were female. Mean age was 49.39±9.15 years old. The overall age- and sex-standardized prevalence of anemia was 8.83% (95% CI: 8.70-8.96%) in the included population. The highest and the lowest age- and sex-standardized prevalence of anemia pertained to Hormozgan (37.41%, 95% CI: 35.97-38.85%) and Kurdistan (4.57%, 95% CI: 3.87-5.27%) provinces, respectively. Being female (PR = 2.97), rural residence (PR = 1.24), being retired (PR = 1.53) and housewife (PR = 1.11), third and fourth wealth status quartiles (PR = 1.09 and PR = 1.11, respectively), being underweight (PR = 1.49), drug user (PR = 1.35), inadequate sleep (PR = 1.16), poor physical activity (PR = 1.15), diabetes (PR = 1.09), renal failure (PR = 2.24), and cancer (PR = 1.35) were associated with increased risk of anemia. On the other hand, illiteracy (PR = 0.79) and abdominal obesity (PR = 0.77) decreased the risk of anemia. According to the results, a variable prevalence of anemia was observed across the included provinces. We tried to provide an informative report on anemia prevalence for health professionals and authorities to take measures for identification and management of the cases of anemia in high-prevalence areas.

Prevalence of anemia among people living with HIV: A systematic review and meta-analysis.

SummaryBackgroundAnemia is the most frequent hematologic abnormality among people living with human immunodeficiency virus (HIV) (PLWHIV) and is associated with HIV disease progression and higher risk of mortality of the patients. However, there is a wide variation of the prevalence of anemia among PLWHIV in different clinical settings. We aimed to obtain more precise estimates of prevalence of anemia and severity of anemia among PLWHIV, which may be important for patients, caregivers, researchers and health policy-makers.MethodsWe systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library for original articles reporting the prevalence of anemia defined using age and sex-specific hemoglobin levels according to World Health Organization criteria among PLWHIV from inception to August 31, 2021. We used DerSimonian-Laird random-effects meta-analyses to obtain pooled prevalence and 95% confidence intervals (CIs) of anemia and severity of anemia among PLWHIV. A univariable meta-regression has been conducted to assess the association between anemia prevalence and study characteristics, including study design, median year of sampling, geographical region, World Bank Income level, and proportion of antiretroviral therapy (ART).FindingsWe included 63 observational studies covering 110,113 PLWHIV. The pooled prevalence of anemia was 39.7% (95% CI: 31.4%-48.0%) for children living with HIV aged <15 years, 46.6% (95% CI: 41.9%-51.4%) for adults (men and non-pregnant women) living with HIV aged ≥15 years, and 48.6% (95% CI: 41.6%-55.6%) for pregnant women living with HIV. Among adults living with HIV, the pooled prevalence of severity of anemia was 21.6% (95% CI: 19.9%-23.3%), 22.6% (95% CI: 14.8%-30.4%), and 6.2% (95% CI: 4.4%-8.1%) for mild, moderate and severe anemia, respectively. Compared with East Africa, anemia prevalence among adults living with HIV was higher in Southern Africa (p = 0.033).InterpretationAnemia is prevalent among PLWHIV. Thus, policies, strategies, and programs should be considered to identify the predictors of anemia among PLWHIV to reduce the burden of anemia among patients in the ART era.

Characterisation of anaemia amongst school going adolescent girls in rural Haryana, India.

High burden of anaemia exists amongst rural adolescent girls in India. The objective of this study was to characterise anaemia in school going adolescent girls in rural Haryana, India. Linear and multiple logistic regression analysis of data collected prior to an intervention trial was conducted. Participants were classified into anaemic (haemoglobin <12 g/dl) and non-anaemic group and were further classified into deficiencies of Fe, folate or vitamin B12, mixed, anaemia of other causes and inflammation. Three schools in Ballabgarh block of Faridabad District, Haryana, India. One hundered and ninety-eight non-anaemic and 202 anaemic adolescent girls (12-19 years). Anaemic girls had 29·6 % Fe deficiency, 28·1 % folate or vitamin B12 deficiency, 15·8 % mixed deficiency and 9·7 % acute inflammation. Anaemia of other causes was found in 16·8 % of the anaemic participants. Girls with Fe and isolated folate deficiency had 2·5 times and four times higher odds of developing anaemia, respectively, as compared with non-anaemic girls. Fe deficiency with no anaemia was found amongst 11 % non-anaemic girls. Non-anaemic girls had a high prevalence of combined deficiency of folate or vitamin B12 (29·5 %) and acute inflammation (14·4 %). The current strategy of Fe and folic acid supplementation alone will not suffice for achieving the desired reduction in the prevalence of anaemia as unknown causes and anaemia of inflammation contribute to a substantial proportion of anaemia. Integrating other nutrition-specific components like improving water, sanitation and hygiene practices with the ongoing micronutrient supplementation program will comprehensively tackle anaemia. Unknown causes of anaemia warrant further research.

Increased prevalence of anemia (Faqr-al-dam) among teenagers and related control programs in India

Abstract In anemia, red blood cells or the hemoglobin concentration are below the defined cutoff value in their number and size. In the Unani System of Medicine, anemia is termed Faqr al-Dam which means “shortage of blood.” Anemia is still common in India, and its prevalence has increased across all age groups. Among infants, pregnant and nonpregnant women as well as men, anemia has increased by 2%–9% according to data from NFHS-5 released on November 24, 2021. The main purpose of this article is to describe the prevalence, severity, and burden of anemia among teenagers at the national and subnational levels. All the data were collected from various articles, the Ministry of Health and Family Welfare website, and other manuscripts. Between NFHS-4 and NFHS-5, the prevalence of anemia has increased among children by 8.5% and adolescents (girls by 5% and boys by 1.9%). State-wise situation, Assam had the worst performance rise of 32.7%, followed by Mizoram with an increase of 27.1% among children aged 6–59 months. The Indian government has launched different control programs to combat anemia for several years, but current data shows that there should be more improvement and strict implementation of those control programs in every state.

Anemia in pregnancy: Prevalence among clients attending antenatal clinics in Chikun LGA, Kaduna, Nigeria

Background: Despite concerted global efforts to reduce the burden of maternal anemia, it remains a major public health issue. Over 40% of pregnant women worldwide are anemic; low- and middle-income countries (especially those in sub-Saharan Africa) make a disproportionately higher contribution to the global burden. The condition can lead to undesirable outcomes for the mother and child. This study was conducted to determine the prevalence of anemia in pregnancy among women attending antenatal clinics in Chikun LGA, Kaduna. Methods: This study was conducted among 145 women attending antenatal clinics in Chikun LGA. Data were collected using a pretested, semi-structured interviewer-administered questionnaire. Hemoglobin (Hb) level was determined and anemia was defined using the World Health Organization-recommended cutoff of <11 g/dl. The results were presented in frequency tables. Data were analyzed using IBM SPSS Statistics version 26. Statistical significance was set at P < 0.05. Results: Fifty-five (37.9%) of the respondents were between the ages of 25 and 29 years. The mean age of the respondents was 28.61 ± 5.5 years. The majority, 107 (73.8%), had a household size of 2–4. Only 16 (11.0%) respondents were aware of anemia. Pregnant women were identified by half (50.0%) of the respondents as being more at risk of anemia. Only a quarter (25.0%) of respondents had good knowledge of anemia. Over two-fifth (42.8%) of the respondents were anemic. There was a statistically significant relationship between household size and anemia in respondents. Conclusion: A large proportion of the respondents were anemic; this underscores the need to strengthen the nutritional counseling and routine hematinics given during the antenatal period. Social drivers should also be addressed in terms of favorable public policies.

Effect of Picture-based health education and counselling on knowledge and adherence to preconception Iron-folic acid supplementation among women planning to be pregnant in Eastern Ethiopia: a randomized controlled trial.

The present study examined the effect of picture-based nutrition education on knowledge and adherence to pre-conception iron-folic acid supplement (IFAS) in Ethiopia, a country where there is a high burden of neural tube defects (NTDs) and anaemia. In eastern Ethiopia, a parallel randomised controlled trial design was employed among women planning to get pregnant. The interventional arm (n 122) received a preconception picture-based nutrition education and counselling along with an IFAS and the control arm (n 122) received only a preconception IFAS. The effects of the intervention between-group differences were assessed using a χ 2 and independent sample t-test. Bivariate and multivariable linear regression model was fitted to detect independent variables affecting the outcome. The outcome measures regarding the knowledge and adherence to the IFAS intake during the three months of the intervention period were deteremined. It was observed that large proportion of women in the intervention group (42⋅6 %) had an adherence to IFAS compared to the control group (3⋅3 %); (P < 0⋅0001). Based on bivariate and multivariable linear regression analyses, among NTDs affecting pregnancy, the history of spontaneous abortion and knowledge were independently associated with adherence to the IFAS (P < 0⋅05). Preconception nutrition education with regular follow-ups could be effective in improving knowledge and adherence to the IFAS intake. This intervention is very short, simple, cost-effective and has the potential for adaptation development to a large-scale implementation in the existing healthcare system in Ethiopia to prevent NTDs and adverse birth outcomes among women who plan to get pregnant. This clinical trial was registered on 6 April 2021 under the ClinicalTrials.gov with an identifier number PACTR202104543567379.

Is ignorance of the weekly iron and folic acid scheme among adolescents the deciding factor for its suboptimal utilization and ineffectiveness? A cross-sectional study.

INTRODUCTION:Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acid Supplementation (WIFS) was launched by the Government of India. Few studies have been done to assess the effective functioning of the program since its inception. The present study was done to assess the knowledge WIFS among adolescents of Madhya Pradesh and the associated factors.MATERIALS AND METHODS:A cross-sectional study was done in a total of six districts (3 districts where the national adolescent program was implemented and 3 districts where it was not) of Madhya Pradesh. Multistage stratified random sampling technique was used for the enrollment of 3213 adolescent boys and girls, and a prestructured and validated tool was used to collect paperless data. Ethical approval and consent from the participants were obtained. Statistical analysis was performed using SPSS v21.RESULTS:It was observed that the knowledge of WIFS was more among adolescent girls (29.3%) as compared to adolescent boys (14.1%). More of the adolescent girls received Iron and folic acid tablets as compared to adolescent boys (60.8% girls vs. 24.1% boys). Mostly, the adolescents got Iron tablets from school followed by Anganwadi and PHC/CHC. Girls, rural location, literacy, below poverty line status, knowledge of anemia, adolescents who got iron and albendazole tablets, and adequate consumption of iron tablets (>4) were associated with higher knowledge of WIFS.CONCLUSION:The knowledge of WIFS was found to be less in adolescent boys. There is a hint of the fact that effective execution of the program among its beneficiaries leads to an automatic increased knowledge of the program, at least among the beneficiaries. Thus, an indirect but significant indirect finding is that the nationwide WIFS program needs to be put to greater focus among the adolescent boys, apart from its major focus on the female gender among most age groups.

Menstrual abnormality, maternal illiteracy, and household factors as main predictors of anemia among adolescent girls in Ethiopia: Systematic review and meta-analysis.

Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. The study aimed to describe the pooled prevalence of adolescent girls' anemia and the factors that contribute. We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls' anemia was calculated using a random-effects meta-analysis model. The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.

Evaluation of Ibrutinib Cardiotoxicity By Comparative Use of Speckle-Tracking Technique and Biomarkers.

Ibrutinib, a relatively new antineoplastic agent, has multiple cardiovascular effects that are still insufficiently known and evaluated, including subclinical myocardial damage. The present study aims to assess the role of the myocardial strain, alone and in combination with cardiac biomarkers, in the early detection of ibrutinib-induced cardiotoxicity. We included 31 outpatients with normal left ventricular ejection fraction (LVEF) on ibrutinib, in a tertiary University Hospital between 2019 and 2020, and evaluated them at inclusion and after 3 months. Data on myocardial strain, cardiac biomarkers [high-sensitive troponin T (hs TnT) and N-terminal probrain natriuretic peptide (NT-proBNP)], and ambulatory electrocardiographic monitoring were collected. Myocardial deformation decreased significantly (P < 0.001) at later evaluation and hs TnT and NT-proBNP increased significantly (P = 0.019 and P = 0.03, respectively). The increase in hs TnT correlated with the increase in the left ventricle global longitudinal strain (LVGLS); in other words, it correlated with the decrease in myocardial deformation. No association was found between LVGLS increase and the increase in NT-proBNP. LVGLS modification was not significantly influenced by age, anemia, or arrhythmia burden quantified by 24-hour Holter monitoring (P = 0.747, P = 0.072, respectively; P = 0.812). LVEF did not change significantly during follow-up. In patients on ibrutinib, evaluation of myocardial strain is useful in identifying early cardiac drug toxicity, surpassing the sensitivity and specificity limits of LVEF. In these patients, concomitant assessment of hs TnT increases the predictive power for subclinical myocardial involvement.