Risk Of Anemia Research Articles

Anemia Prevalence and Risk Factors in Two of Ethiopia's Most Anemic Regions among Women: A Cross-Sectional Study.

In Sub-Saharan African (SSA) nations, including Ethiopia, anemia is a significant public health issue. Ethiopia has continued to bear the enormous burden of anemia infections. Over time, the prevalence of anemia has significantly increased in Ethiopia. In addition, there is a paucity of literature and regional variations in the pace of increment expansion. Therefore, the primary goal of this study was to evaluate the prevalence of anemia and risk factors among women in Ethiopia's two most anemic regions. 2,519 women participated in a community-based cross-sectional study from January 18 to June 27, 2016. In order to determine the causes of anemia in women in two of Ethiopia's most anemic regions, an ordinal logistic regression model was taken into consideration. The applicability of the proportional odds test was evaluated using the chi-square test of the parallelism assumption. A p value of 0.05 or below was used to define crucial and statistically significant predictor variables. The overall prevalence rate of anemia was 56.8% (95% CI (54.8%-58.7%)). The chi-square test of the parallelism assumption indicated that the odds ratios were constant across all cut-off points of women's anemia levels at a 5% significance level (p value = 0.122). Of the severity of anemia levels among women, 48.2, 46.1, and 5.7% had mild, moderate, and severe anemia levels, respectively. In multivariable ordinal logistic regression analyses, being born (lived) in the Somali region (AOR = 1.6, 95% CI: 1.37, 1.90), having a parity of 4-5 (AOR = 1.3, 95% CI: 1.05, 1.66), and having ≥6 children (AOR = 1.4, 95% CI: 1.1, 1.7), being a contraceptive user (AOR = 3, 95% CI: 2.5, 3.6), being currently pregnant (AOR = 2.8, 95% CI: 2.3, 3.4), having no ANC follow-up (AOR = 1.9, 95% CI: 1.6, 2.3), being married women (AOR = 1.4, 95% CI: 1.1, 1.9), and user of unimproved toilet facility (AOR = 1.3, 95% CI: 1.1, 1.6) were significantly positively associated with anemia. Finally, the anemia burden was dangerously greater than the national average. The region, usage of contraceptives, being pregnant at the time, ANC follow-up, toilet facilities, parity, and marital status all had a substantial impact on anemia. Therefore, to lessen the prevalence of anemia in certain parts of Ethiopia, public health initiatives that improve maternal health service utilization are required, such as ANC follow-up to minimize parity.

Factors influencing the prevalence of anaemia in female adolescents: A population-based study of rural setting in Karanganyar, Indonesia

BackgroundAnaemia among women of reproductive age (15–49 years) poses substantial public health concerns, particularly in LMICs, due to its adverse effects during pregnancy and childbirth. Understanding its determinants is pivotal for devising strategies to combat this condition. This study investigates the prevalence of anaemia and its associations with anthropometric indices, dietary habits, and menstruation status among female adolescents in Karanganyar, a rural subdistrict in Indonesia. MethodsIn this population-based cross-sectional study, a multi-stage sampling method was employed to represent all female high-school students in Karanganyar. Participants underwent capillary haemoglobin testing, anthropometric measurements, and completed dietary intake and menstruation status assessments. Anaemia was defined as Hb < 12.0 g/dL. Logistic regressions were performed to assess the associations between anthropometric indices, dietary intake, menstruation status, and the prevalence of anaemia. ResultsApproximately 49 % of female adolescents in Karanganyar had anemia. Both BMI and Mid-Upper-Arm-Circumference exhibited inverse associations with anaemia [AOR(95%CI): 0.87(0.79–0.95) and 0.89(0.81–0.99)]. Compared to individuals with BMI-for-age-Z-Score (BAZ) > -2 SD, those with BAZ < −2 SD had more than double the odds of anaemia [2.43 (0.94–6.29)]. Consumption of fruits [0.32(0.10–0.98)] and vegetables [0.30(0.11–0.78)] were negatively associated with anaemia. No association was observed between menstruation status (length, duration, pads/day) and anaemia. DiscussionHigh prevalence of anaemia among female adolescents in Karanganyar, and potentially other rural areas in Indonesia, underscores the need for targeted interventions. Being underweight rapidly increases the risk of anaemia, emphasizing the importance of nutritional improvements. Consuming iron-rich fruits and vegetables may prevent anaemia. Menstruation status did not appear to be a determinant of anaemia.

Characteristics of erythropoiesis in sows during different periods of the production cycle

The tactics of periodic monitoring of the hematology of sows allows timely measures to prevent anemia, which inevitably occurs, since the targeted screening and selection of industrial breeds are aimed at multiple births, which increases the risks of anemia during pregnancy and suckling period. With periodic and constant monitoring, it is possible to deduce individual reference intervals of hematological indicators for a particular animal and control the response to compensatory measures that directly affects the yield of viable piglets and their survival rate. The purpose of this study was to study the number of red blood cells, hemoglobin level, hematocrit, average volume of red blood cells and erythrocyte indices depending on the production cycle of the sow. The groups were formed from sows on the 80th day of pregnancy (group 1, n=5), after farrowing (group 2, n=5) and before weaning piglets (group 3, n=5). The Vet ABCTM analyzer (Horiba Medical Poland) was used. Counting of reticulocytes by “supravital staining” with a solution of “brilliant cresyl blue”. Statistical processing in the Microsoft Excel program (Data Analysis package), evaluation of the reliability of differences based on the Mann—Whitney U criterion. As a result, it was found that the average volume of red blood cells increases with a decrease in their number and hemoglobin concentration, which is quite natural and indicates a regenerative response with the appearance of reticulocytes in the blood. The correlation coefficient between erythrocytes and the average volume of erythrocytes was r=-0.53 (r2=0.28, p=0.01), between the average volume of erythrocytes and reticulocytes r=-0.50 (r2=0.25, p=0.05). There were no significant differences among the groups in reticulocytes and the average volume of erythrocytes. The dynamics and intensity of regeneration are moderate in all three groups.

The Relationship Between Anemia in Maternity and Prematurity at the Balaraja Community Health Center

The aim of this study was to determine the relationship between anemia in mothers giving birth and prematurity. The research method used a cross sectional approach using secondary data based on medical records of mothers giving birth at the Balaraja health center, which met the inclusion criteria of 735 people. The data is presented in a frequency distribution table and cross table, then the chi squre test is used. The results of this study show that based on maternal characteristics, 78.5% were aged 20-34 years, 68.8% were primiparas, 59.3% had ≥ 4 ANC visits, 8.6% had a high prevalence of moderate anemia, and 8.6% had a severe anemia. as much as 0.5%. The prevalence of prematurity is 7.76%. The relationship between anemia in mothers giving birth and prematurity is statistically significant (p&lt;0.05). Relative risk (RR) of mild anemia with prematurity 1.47; RR of moderate anemia with prematurity 3.45; and RR of severe anemia with prematurity 18. The conclusion of this study is that the relationship between anemia in mothers giving birth and prematurity is statistically significant (p &lt; 0.05).

Development of a Practical Nomogram for Personalized Anemia Management in Patients Treated with Ataxia Telangiectasia and Rad3-related Inhibitor Camonsertib.

Camonsertib is a highly selective and potent inhibitor of ataxia telangiectasia and Rad3-related (ATR) kinase. Dose-dependent anemia is a class-related on-target adverse event often requiring dose modifications. Individual patient risk factors for the development of significant anemia complicate the selection of a "one-size-fits-all" ATR inhibitor (ATRi) dose and schedule, possibly leading to suboptimal therapeutic doses in patients at low risk of anemia. We evaluated whether early predictors of anemia could be identified to ultimately inform a personalized dose-modification approach. On the basis of preclinical observations and a mechanistic understanding of ATRi-related anemia, we identified several potential factors to explore in a multivariable linear regression modeling tool for predicting hemoglobin level ahead of day 22 (cycle 2) of treatment. In patients treated with camonsertib monotherapy (NCT04497116), we observed that hemoglobin decline is consistently preceded by reticulocytopenia, and dose- and exposure-dependent decreases in monocytes. We developed a nomogram incorporating baseline and day 8 hemoglobin and reticulocyte values that predicted the day 22 hemoglobin values of patients with clinically valuable concordance (within 7.5% of observations) 80% of the time in a cross-validation performance test of data from 60 patients. The prediction of future hemoglobin decrease, after a week of treatment, may enable a personalized, early dose modification to prevent development of clinically significant anemia and resulting unscheduled dose holds or transfusions.

Frequency of Gastrointestinal Parasites, Anemia, and Nutritional Status among Children from Different Geographical Regions of Bolivia.

The study aimed to measure the frequency of occurrence of infections with helminths, protozoa, and risk factors of undernutrition and anemia among schoolchildren from the Bolivian highland (altiplano) and lowland (subtropical) rural regions, with a high frequency of gastrointestinal parasite infections. Cross-sectional data were collected from 790 children, 5-13 years old. Microscopic examination of stool using the Ritchie technique, hemoglobin testing using the HemoCue analyzer, and anthropometric measurements were performed. Over 60% and 20% of children were infected with protozoa and helminth parasites, respectively. Infections caused by pathogenic Hymenolepis nana (15.7-5.2%), Ascaris lumbricoides (41.9-28.5%), Giardia lamblia (30.1-11.2%), Entamoeba histolytica (5.7-0.7%), and nonpathogenic Entamoeba coli (48.9-16%), Blastocystis hominis (40.2-28.5%), Iodamoeba butschli (16.1-2.5%), Chilomastix mesnili (19.2-7.3%), and Entamoeba histolytica/dispar (7.4-5.5%) parasites, were more prevalent in the highlands than the lowlands. Single parasitic infections were more prevalent in the lowlands; polyparasitism of light or heavy intensity predominated in the highlands. A strongly increased risk of anemia and a low prevalence of wasting were determined in children in the highlands. A higher risk for stunting was associated with children of older age, and a low burden of intestinal helminths would prevent wasting in children of highlands. Infections with A. lumbricoides and G. lamblia pathogens in older children were not significant covariates for stunting. Environmental, nutritional, and parasitic factors may predispose to anemia in the highlands. A nutritional intervention and parasite control effort will substantially improve children´s health in the highlands.

Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania

BackgroundThe use of primaquine for mass drug administration (MDA) is being considered as a key strategy for malaria elimination. In addition to being the only drug active against the dormant and relapsing forms of Plasmodium vivax, primaquine is the sole potent drug against mature/infectious Plasmodium falciparum gametocytes. It may prevent onward transmission and help contain the spread of artemisinin resistance. However, higher dose of primaquine is associated with the risk of acute haemolytic anaemia in individuals with a deficiency in glucose-6-phosphate dehydrogenase. In many P. falciparum endemic areas there is paucity of information about the distribution of individuals at risk of primaquine-induced haemolysis at higher dose 45 mg of primaquine.MethodsA retrospective cross-sectional study was carried out using archived samples to establish the prevalence of G6PD deficiency in a malaria hotspot area in Misungwi district, located in Mwanza region, Tanzania. Blood samples collected from individuals recruited between August and November 2010 were genotyped for G6PD deficiency and submicroscopic parasites carriage using polymerase chain reaction.ResultsA total of 263 individuals aged between 0 and 87 were recruited. The overall prevalence of the X-linked G6PD A− mutation was 83.7% (220/263) wild type, 8% (21/263) heterozygous and 8.4% (22/263) homozygous or hemizygous. Although, assessment of the enzymatic activity to assign the phenotypes according to severity and clinical manifestation as per WHO was not carried out, the overall genotype and allele frequency for the G6PD deficiency was 16.4% and 13. 2%, respectively. There was no statistically significant difference in among the different G6PD genotypes (p > 0.05). Out of 248 samples analysed for submicroscopic parasites carriage, 58.1% (144/248) were P. falciparum positive by PCR. G6PD heterozygous deficiency were associated with carriage of submicroscopic P. falciparum (p = 0.029).ConclusionsThis study showed that 16.4% of the population in this part of North-western Tanzania carry the G6PD A− mutation, within the range of 15–32% seen in other parts of Africa. G6PD gene mutation is widespread and heterogeneous across the study area where primaquine would be valuable for malaria control and elimination. The maps and population estimates presented here reflect potential risk of higher dose of primaquine being associated with the risk of acute haemolytic anaemia (AHA) in individuals with a deficiency in glucose-6-phosphate dehydrogenase and call further research on mapping of G6PD deficiency in Tanzania. Therefore, screening and education programmes for G6PD deficiency is warranted in a programme of malaria elimination using a higher primaquine dose.

Anemia among pregnant women in Cambodia: A descriptive analysis of temporal and geospatial trends and logistic regression-based examination of factors associated with anemia in pregnant women.

Anemia is a major public health problem for thirty-two million pregnant women worldwide. Anemia during pregnancy is a leading cause of child low birth weight, preterm birth, and perinatal/neonatal mortality. Pregnant women are at higher risk of anemia due to micronutrient deficiencies, hemoglobinopathies, infections, socio-demographic and behavioral factors. This study aimed to: 1) assess temporal and geospatial trends of anemia in Cambodia and 2) identify factors associated with anemia among pregnant women aged 15-49 years old in Cambodia. We analyzed data from the Cambodia Demographic and Health Survey (CDHS) for 2005, 2010, and 2014. Data were pooled across the three survey years for all pregnant women aged 15-49 years. Survey weights were applied to account for the complex survey design of the CDHS. Descriptive statistics were estimated for key sociodemographic characteristics of the study population. We used logistic regressions to assess factors associated with anemia among pregnant women aged 15-49 years old. Anemia in pregnant women aged 15-49 in Cambodia decreased from 56% in 2005 to 53% in 2014. With the highest in Preah Vihear and Stung Treng provinces (74.3%), in Kratie province (73%), and in Prey Veng (65.4%) in 2005, 2010, and 2014 respectively. Compared to pregnant women from the wealthiest households, women from poorest households were more likely to have anemia (AOR = 2.8; 95% CI: 1.6-4.9). Pregnant women from coastal regions were almost twice as likely of having anemia (AOR = 1.9; 95% CI: 1.2-3.0). Pregnant women were more likely anemic if they were in their 2nd trimester (AOR = 2.6; 95% CI: 1.9-3.6) or 3rd trimester (AOR = 1.6 95% CI: 1.1-2.3). Anemia remains highly prevalent among pregnant women in Cambodia. Public health interventions and policies to alleviate anemia should be prioritized and shaped to address these factors.

Prevalence and Predictors of Anaemia Among Women of Reproductive Age in South and Southeast Asia.

Background Anaemia is a global public health issue that mostly affects children, women, and adults in low- and middle-income countries. Aim This study sought to evaluate the prevalence of anaemia and its contributing factors among South and Southeast Asian (SSEA) women of reproductive age. Methods Data analysis was undertaken utilising data from 10 SSEA countries' Demographic and Health Surveys. The link between anaemia and independent variables was established using a multivariate logistic regression model with a 95% confidence interval. To investigate the relationship between explanatory variables and anaemia, the Pearson's correlations test was carried out. Results In SSEA, the prevalence of anaemia among women (15-49 years old) was 50.17% (95% CI: 39.4, 61.0), ranging from 13.3% (95% CI: 2.5, 24.1) in the Philippines to 70.3% (95% CI: 59.5,81.1) in Nepal. Being younger, having rural residents, having lower educational attainment, and being in households with lower wealth quantiles were linked to a higher prevalence of anaemia in most countries. Conclusion The findings of this study imply that a variety of individual characteristics play a role in the higher risk of anaemia. To combat anaemia, evidence-based, multidisciplinary policies and initiatives targeting women's health and nutrition, as well as scaling up women's education, empowerment, and socioeconomic position, are needed.

Effect of Iron Polymaltose Complex Prophylaxis on Frequency of Iron Deficiency and Iron Deficiency Anemia.

To evaluate the effectiveness of national iron prophylaxis policy in 9-12 mo-old infants in Turkey. This study was planned as a cross-sectional study, and it included healthy infants aged 9 to 12 mo who presented to the pediatric outpatient clinic for routine check-ups. Parents were interviewed to identify risk factors for iron deficiency (ID) and gather information on Fe+3- iron polymaltose complex (IPC) prophylaxis usage. Blood samples were collected for hemogram and ferritin analysis. Multiple logistic regression analyses were conducted to determine risk factors for ID and iron deficiency anemia (IDA). The study included 317 infants. In the non-prophylaxis group, the frequency of IDA was 31.1%, compared to 13.4% in the regular prophylaxis group. Iron deficiency was detected in 25% of individuals receiving regular prophylaxis and 13.1% of those without prophylaxis. The risk factors for IDA were insufficient iron diets (OR 2.45, 95% CI: 1.35-4.45) and not receiving Fe+3 - IPC prophylaxis (OR 2.57, 95% CI: 1.24-5.31). The relationship between Fe+3-IPC prophylaxis and ID did not reach statistical significance (p = 0.253). Fe+3- IPC prophylaxis is associated with a lower risk of iron deficiency anemia, but not iron deficiency.

Prevalence and risk factors of preoperative anemia in patients undergoing elective orthopedic procedures in Northwest Ethiopia: a multicenter prospective observational cohort study

BackgroundPreoperative anemia is a common hematologic problem in major orthopedic surgery in developing countries. It is a condition in which the number and size of red blood cells are insufficient to meet the body’s physiologic needs, consequently impairing the capacity of the blood to transport oxygen to the body. Preoperative anemia is common in elective orthopedic surgical patients and is an independent risk factor for perioperative morbidity and mortality. This study aimed to assess preoperative anemia prevalence and risk factors in patients undergoing elective orthopedic procedures.MethodA multicenter prospective observational cohort study was conducted from June 01 to August 30, 2022. A systematic random sampling technique was used to select the study unit. Data were collected using a structured questionnaire. Descriptive statistics were expressed in percentages and presented with tables and figures. Binary logistic regression was used to see the association between independent and dependent variables. A P-value < 0.05 was considered statistically significant.ResultPreoperative anemia’s prevalence and risk factors in patients undergoing elective orthopedic procedures was 24.1[95%CI= (18.2–30.6)]. Multivariable logistic analyses showed that low monthly income level [AOR:5,95%CI:(1.36–7.98)], patient with cancer [AOR:3.4,95%CI:(3.7–8.84)], patient with malaria infectious [AOR: 3.2,95%CI:( 1.13–8.91)], patient with anti-retroviral therapy [AOR: 5.2,95%CI:( 1.8-11.04)], and previous history of surgery [AOR:1,95%CI(1.43–2.4)], were factors significantly associated with preoperative anemia.ConclusionThe prevalence of preoperative anemia among adult patients who underwent elective orthopedics procedures was high. Low Monthly income, patients with cancer, patient with malaria infection, and patients with anti-retroviral therapy, previous histories of surgery were found significantly associated with preoperative anemia. So, we recommend to health professional’s early identification, diagnosis and treatment of preoperative anemia should be done to reduce the risks of anemia and related adverse outcomes.

Pemantauan dan Deteksi Dini Risiko Anemia pada Ibu Hamil dan Stunting Balita melalui Pemeriksaan Antropometri di Puskesmas Kuranji Kota Padang

Stunting and anaemia in pregnant women are global conditions that are interrelated with the risk of declining health status in children and pregnant women. Anaemia in pregnant women poses a risk of stunting in children, impacting growth and development, brain function, immune system, and learning abilities. For this reason, the purpose of community service is to detect the early risk of stunting in children and anaemia in pregnant women. The method used is an anthropometric examination of toddlers and pregnant women using weight, height, upper arm circumference, and haemoglobin examination to detect the risk of stunting and anaemia. Inspection and measurement data were processed using KMS online and SPSS and presented descriptively in frequency distribution tables and central tendency values. This activity was carried out at the Durian Tiga Batang Posyandu, Kuranji Health Center, Padang City, on 10 August 2023. Data was collected on 50 infants/toddlers and nine pregnant women who visited the Posyandu. The examination revealed that 48% of infants and toddlers were at risk of stunting (short and very short stature), and 11.1% of pregnant women had anaemia. Thus, early detection of stunting through the online KMS application facilitates data interpretation so that it can provide information quickly and recommend further treatment to mothers to achieve ideal child height growth. In addition, early detection of anaemia can prevent stunting in children.

Micronutrient status of New Zealand adolescent women consuming vegetarian and non-vegetarian diets.

Globally, there appears to be an ever-increasing interest in adopting a vegetarian diet. However, there are concerns that avoiding meat may increase the risk of anaemia and micronutrient deficiencies, especially for vulnerable populations, such as adolescent women. The objective of this study was to compare the micronutrient status of vegetarian and non-vegetarian adolescent women in New Zealand. Adolescent women aged 15-18 y were recruited from eight locations across New Zealand. Blood samples were analysed for: haemoglobin, serum ferritin, soluble transferrin receptor, zinc, selenium, retinol binding protein, folate, vitamin B-12, vitamin D and parathyroid hormone. Of the 182 participants who provided a blood sample, 15% self-identified as vegetarian (n=27). On average, vegetarians had 3.1% (95% CI -5.8 to -0.4, p=0.025) lower haemoglobin, and 8.3% (95%CI -14.1 to -2.1, p=0.004) lower selenium. In contrast, serum folate was 80.5% (95% CI 45.7 to 123.7, p<0.001) higher. The prevalence of zinc and selenium deficiency was higher among vegetarians (50% and 12%, respectively) than non-vegetarians (21%, and 2%, respectively). Adolescent vegetarian women may be at increased risk of deficiency of micronutrients commonly found in animal products, including zinc and selenium, and may benefit from following dietary practices that enhance micronutrient intake and absorption.

Uncovering Determinant of Anaemia Among Adolescent Girls

Anaemia is a significant global public health issue that primarily affects adolescent girls. Smoking, malaria, and low family income are associated with teenage Anaemia in girls. The purpose of the study was to uncover determinant Anaemia among adolescent girls. This type of research is cross-sectional. The research location was at the high schools in Central Sulawesi from March to September 2023. The study sample was teenage girls, with as many as 384 respondents. Simple random sampling was the method used for the sample. The study's independent variables included the respondents' anthropometrics, sociodemographics, and infectious illnesses. The dependent variable was haemoglobin levels. The research instrument used a Kobotoolbox application questionnaire. They measure weight with digital scales, height with Length board measuring, and arm circumference with mid-upper arm circumstances. Laboratory analysts carried out measurements of haemoglobin levels. Chi-square test analysis of research data with a 95% confidence level. Test of logistic regression in multivariate analysis. The findings indicated that 20.3% of teenage girls suffered from Anaemia. Adolescent girls who smoke (OR=3.2, 95% CI (1.10, 8.70)), have malaria (OR=1.9, 95% CI (0.80, 5.00)), and come from an income family with less than Rp. 2.599.546 (OR=1.7, 95% CI (1.00, 2.90)) are at risk for Anaemia. Adolescent girls' anaemia prevalence was a moderate public health concern. Teenage girls who smoke, have malaria and have a family low income below are determinants for Anaemia.

Peningkatan Pengetahuan Masyarakat Tentang Manfaat Fe Pada Kegiatan Kalteng Expo Tahun 2023

People, especially women of childbearing age, are prone to anaemia because they lose a lot of blood during menstruation. Women of childbearing age who suffer from anaemia have a high risk of anaemia during pregnancy. This will have an impact on the inhibition of fetal growth and development and potentially lead to complications of pregnancy and childbirth. Therefore, women of childbearing age (WUS) need to take Blood Addition Tablets (TTD) once a week. To overcome these problems, it is necessary to increase knowledge about the benefits of fe tablet consumption. The results of this activity were attended by 39 women of childbearing age who visited Kalteng Expo 2023. During the activity, the residents were very enthusiastic. This can be seen in the liveliness of the residents following the counselling activities and the increase in knowledge from before and after being given education.

THE EFFECT OF THE PROVISION OF MANDIRI POCKET BOOK (KUSADARI) CONSUMPTION KNOWLEDGE AND COMPLIANCE TABLET FOR ADDING BLOOD FOR PREGNANT MOTHERS

Background: Pregnant women were one of the prone groups to nutritional problems, where during pregnancy the need for iron increased so that they were at high risk of anemia, especially iron deficiency. This happened because the nutritional needs of the mother and fetus increase so that they were at high risk of it. One of the government's efforts in the context of preventing and overcoming iron deficiency anemia and folic acid in pregnant women was to give Blood-Added Tablets (TTD) which were given every day as much as one tablet or a minimum of 90 (ninety) tablets during pregnancy.&#x0D; Methods: This research type was a Quasy Experimental Design with a pretest-posttest design used. The subjects of this study were pregnant women in the first and second trimesters and the number of samples was 35 respondents. Data were taken using a questionnaire and analyzed using univariate analysis and bivariate analysis.&#x0D; Results: There was a difference in the knowledge score at the end of the study before and after education with pocket book media (p = 0.000), while the compliance score at the end of the study showed a difference in compliance before and after education with pocket book media (p = 0.000)&#x0D; Conclusion: There was an effect of providing an independent monitoring pocket book on the knowledge and compliance of the consumption of Blood-Added Tablets (TTD) in pregnant women. Keywords: Pregnant women, pocket book, blood-added tablets, knowledge, compliance to taking Blood-Added Tablets (TTD).

Prevalence and Risk Factors of Anemia in Adolescent Girls in Donggala District, Central Sulawesi

This study aims to assess the prevalence and risk factors of anemia in adolescent girls in Donggala District. It employed an observational analytical study design with a cross-sectional approach. The research was conducted in Senior High Schools (SMA) and Islamic Senior High Schools (Madrasah Aliyah) in Donggala District in May 2023. The sample included 428 respondents. Hemoglobin levels were measured by the laboratory staff of the Central Sulawesi Health Department. Respondents provided data through Kobocollect: https://ee.kobotoolbox.org/x/uZVqfjnh. Respondent characteristics included age, the occupation of both parents, family income, upper arm circumference, hemoglobin levels, body mass index, menstrual status, consumption of iron supplements, anemia education and knowledge, medical conditions, smoking status, physical activity status, and the frequency of iron-rich food intake (fish, eggs, meat, and milk). Data analysis was performed using percentages and RR (95% CI) with SPSS 22.0. Ethical approval was obtained from the Ethics Committee of the Poltekkes Kemenkes Palu with approval number 0016/KEPK-KPK/I/2023, and research permission was granted by the Central Sulawesi Provincial Government, Regional Unity of Community and Political Affairs, with approval number 070/0409/Bid.III-BKBPD/2023. The research results indicated a prevalence of anemia risk among adolescents in Donggala District at 9.8%. Risk factors included upper arm circumference &lt;23.5 cm, a history of kidney disease, limited knowledge of anemia, and infrequent meat consumption. The researchers recommend that adolescents increase their food intake to improve upper arm circumference, manage dietary patterns for those with kidney disease, enhance knowledge about anemia, and increase meat consumption frequency.

Effectiveness of nutrition counseling for pregnant women in low- and middle-income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review.

Nutritional counseling, which includes two-way interactive education, has been hypothesized to improve the health and nutritional status of pregnant women, but little is known about the impact such practice of care might have on maternal and infant health and behavioral outcomes of pregnant women living in low income, low-middle income, and upper-middle-income countries (LMIC)s. We conducted a systematic review to appraise the effectiveness and impact on health equity of two-way nutritional counseling practices in LMICs on maternal and infant behavioral, nutritional, and health outcomes. We conducted electronic searches for relevant studies on Medline, Embase, CINAHL, PsychInfo, and the Cochrane CENTRAL for randomized and non-randomized trials on the effectiveness of two-way interactive nutritional counseling among pregnant women from the date of database inception up to June 22, 2021. In addition, we searched references of included studies in systematic reviews, gray literature resources, and unpublished studies or reports that satisfied our eligibility criteria using a focused Google search. We included randomized and non-randomized controlled studies (NRS), controlled before and after, and interrupted time series that assessed the effectiveness of two-way interactive nutrition counseling targeting pregnant women in LMICs. Data extraction and risk of bias were conducted in duplicate. The risk of bias (ROB) for randomized trials (RCT) was assessed according to the Cochrane Handbook of Systematic Reviews, and ROB for NRS was assessed using the Newcastle-Ottawa scale (NOS). RCT and NRS were meta-analyzed separately. Our search identified 6418 records and 52 studies met our inclusion criteria, but only 28 were used in the quantitative analysis. Twenty-eight studies were conducted in Asia, the most in Iran. Eight studies were conducted in Africa. Two-way interactive nutritional counseling during pregnancy may improve dietary caloric intake (mean difference [MD]: 81.65 calories, 95% confidence interval [CI], 15.37-147.93, three RCTs; I 2 = 42%; moderate certainty of evidence using GRADE assessment), may reduce hemorrhage (relative risk [RR]: 0.63; 95% CI, 0.25-1.54, two RCTs; I 2 = 40%; very low certainty of evidence using GRADE assessment), may improve protein (MD: 10.44 g, 95% CI, 1.83-19.05, two RCTs; I 2 = 95%; high certainty of evidence using GRADE assessment), fat intake (MD: 3.42 g, 95% CI, -0.20 to 7.04, two RCTs; I 2 = 0%; high certainty of evidence using GRADE assessment), and may improve gestational weight gain within recommendations (RR: 1.84; 95% CI, 1.10-3.09, three RCTs; I 2 = 69%). Nutrition counseling probably leads to the initiation of breastfeeding immediately after birth (RR: 1.72; 95% CI, 1.42-2.09, one RCT). There was little to no effect on reducing anemia (RR: 0.77; 95% CI, 0.50-1.20, three RCTs; I 2 = 67%; very low certainty of evidence using GRADE assessment) risk of stillbirths (RR: 0.81; 95% CI, 0.52-1.27, three RCTs; I 2 = 0%; moderate certainty of evidence using GRADE assessment) and risk of cesarean section delivery (RR: 0.96; 95% CI, 0.76-1.20, four RCTs; I 2 = 36%; moderate certainty of evidence using GRADE assessment). Our review highlights improvements in maternal behavioral and health outcomes through interactive nutrition counseling during pregnancy. However, we are uncertain about the effects of nutrition counseling due to the low certainty of evidence and a low number of studies for some key outcomes. Moreover, the effects on health equity remain unknown. More methodologically rigorous trials that focus on a precise selection of outcomes driven by the theory of change of nutrition counseling to improve maternal and infant behavioral and health outcomes and consider equity are required.

Clinicopathologic Features of Autoimmune Metaplastic Atrophic Gastritis (AMAG) in an Underserved Community

Abstract Introduction/Objective Autoimmune metaplastic gastritis (AMAG), typically associated with pernicious anemia and subsequent risk of gastric neoplasia, is an entity often underrecognized in routine gastric biopsies and can lead to delay in the diagnosis and management of patients. In this study, we analyze the demographics and clinical features of AMAG in an inner city, underserved population with histopathologic and serologic correlation. Methods/Case Report We retrospectively collected data on patients diagnosed with or with probable AMAG over a 29-month period from Jan 2020-May 2022 and correlated the histopathology with demographics and clinical presentation. We retrieved prior biopsies on available cases. Results (if a Case Study enter NA) Our Data Demonstrates: -Almost equal prevalence of AMAG in African American and Caucasian patients, with a higher rate of incidence in older population (68% over the age of 60 years), and in female patients. -43.5% had antibody testing and only 25% of patients had testing for Gastrin levels, but the diagnosis of AMAG was frequently associated with a positive laboratory finding (78.7% and 74.3%, respectively) when performed. -57.8% had clinically documented anemia, among those, 88.9% had microcytic or normocytic anemia. Only 11.1% had macrocytic anemia -A history of prior biopsies demonstrating chronic gastritis was seen in 33% of patients. Conclusion Our study demonstrates that patients with AMAG come from diverse backgrounds and frequently lack laboratory findings typically associated with pernicious anemia at the time of diagnosis. As such, pathologists and gastroenterologists may benefit from a lower threshold when considering which patients to evaluate for AMAG. Complete laboratory evaluations were infrequent, which is a limitation, but this may be secondary to a lack of clinical knowledge regarding appropriate testing and an underserved patient population which lacks good continuity of care.

Risk of Anemia and Vitamin B12 Deficiency in Patients with Type 2 Diabetes Mellitus on Metformin Therapy: A Systematic Review and Meta-Analysis

Introduction Metformin is a commonly used medication for the treatment of Type 2 Diabetes Mellitus (T2DM). It has also been hypothesized to reduce the absorption of vitamin B12 in the GI tract. Development of B12 deficiency due to metformin-associated reduced absorption would take years to develop, because vitamin B12 has sufficient stores for 3-10 years. As such, the present systematic review and meta-analysis aims to evaluate the effect of metformin on anemia and vitamin B12 deficiency, with outcomes stratified by duration and dosage of metformin exposure. Methods Electronic searches were conducted on MEDLINE, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials from inception to June 2023, supplemented with manual citation search. Two reviewers independently and in duplicate assessed titles, abstracts, and full-text articles, with discrepancies resolved by a third member. Studies considered for inclusion were randomized controlled trials (RCTs) and non-randomized studies (NRS) in any language, evaluating anemia risk in T2DM patients using metformin compared to standard-of-care non-metformin treatments for T2DM . The primary outcome was frequency of anemia. Secondary outcomes included frequency of vitamin B12 deficiency, changes in serum hemoglobin and vitamin B12 levels, folate deficiency, changes in serum folic acid, and homocysteine levels. Results were stratified based on the Metformin Use Index (MUI), which categorizes daily metformin dose in mg x duration in years/1000 into three subgroups: MUI ≤ 5, MUI &amp;gt; 5, and MUI Unspecified (when the primary study did not report or stratify based on metformin dosage and duration). Mantel-Haenszel random effects model was used to synthesize binary and continuous endpoints, providing odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). Results 7443 studies were retrieved from electronic databases and 26 studies comprising 6 RCTs, and 20 NRS were included. In total, 17343 patients were included in this systematic review. Overall, the risk of anemia did not significantly differ between the metformin and control group (OR 1.10 [95%CI 0.64, 1.91]). Subgroup analysis also revealed no significant differences between metformin and control in the MUI ≤ 5 group (OR 1.58 [95%CI 0.54, 4.58]) and the MUI &amp;gt; 5 group (OR 1.12 [95%CI 0.48, 2.65]). Metformin was associated with an increased risk of vitamin B12 deficiency compared to control (OR 2.32 [95%CI 1.51, 3.57]). Subgroup analysis demonstrated that the difference was only significant in the MUI &amp;gt; 5 (OR 3.57 [95%CI 2.98, 4.27]) and the MUI Unspecified groups (OR 2.24 [95%CI 1.48, 3.38]), but not in the MUI ≤ 5 group (OR 1.01 [95%CI 0.83, 1.23]). The subgroup differences were significant (p&amp;lt;0.01). Metformin was associated with a decrease in serum vitamin B12 level (MD -71.55 pmol/L [95%CI -89.27, -53.82]), and change in serum hemoglobin could not be pooled given only one primary study. Serum homocysteine was higher in the metformin group (MD 2.45 µmol/L [95%CI 1.48, 3.41]), and there were no significant differences between metformin and control in both incidence of folate deficiency and change in serum folic acid. Conclusion Metformin use does not appear to increase the risk of anemia compared to placebo or other standard-of-care treatments in T2DM. Vitamin B12 deficiency is associated with metformin use, however likely only in those with longer/greater-dose (metformin use index &amp;gt; 5). Monitoring and supplementation of vitamin B12 level are likely beneficial in this population. Our study is limited by heterogenous criteria for anemia and vitamin B12 deficiency across jurisdictions. Further studies on the safety profile of metformin are recommended to include anemia as an outcome and result-stratification based on metformin dose and duration.