Anaemia in Pregnancy: Prevalence and Possible Risk Factors in Kakamega County, Kenya
Science Journal of Public Health
Volume 2, Issue 3, May 2014, Pages: 216-222
Received: Apr. 8, 2014; Accepted: May 8, 2014; Published: May 20, 2014
Views 3428      Downloads 588
Authors
Mulambalah Chrispinus Siteti, Department of Medical Microbiology & Parasitology, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
Siamba Donald Namasaka, Department of Biological Sciences, Faculty of Science, Masinde Muliro University of Science & Technology, Kakamega, Kenya
Ogutu Philip Ariya, Department of Biological Sciences, Faculty of Science, Masinde Muliro University of Science & Technology, Kakamega, Kenya
Siteti Darwin Injete, College of Health Sciences, Jomo Kenyatta University of Agriculture & Technology, Nairobi, Kenya
Wekesa Antony Wanyonyi, Department of Biological Sciences, Faculty of Science, Egerton University, Njoro, Kenya
Article Tools
Follow on us
Abstract
Anaemia in expectant women is a serious world-wide public health problem with adverse pregnancy outcomes. Haematological parameters indicative of pregnancy anaemia need to be investigated to provide basis for prompt management of anaemia in pregnancy. The aim of the study was to determine the prevalence of anaemia in pregnant mothers of various age groups and at different gestation periods visiting antenatal clinic at a county level 5 hospital. The ages of recruited participants ranged from 16 to 40 years with a mean age of 26.8 ± 4.3 years. A total of 320 blood samples were collected during the first and subsequent visits to antenatal clinic from January to December 2013. The age, marital, socio-economic status, highest level of education, stages of each pregnancy of each participant were recorded. Haemoglobin estimation was done using a HemoCue® B-Hemoglobin system and positive anaemia cases were classified as mild, moderate, severe and very severe based on the world health organization criteria. The haemoglobin concentrations ranged from 6.5 g/dl – 15.5 g/dl with a mean of 10.2 ± 1.3g/dl. Data was analysed using the Chi-square test and Odds ratio. Out of all blood samples analyzed, 128 (40%) were anaemic of which 62.5% (n=80) were mildly anaemic cases whereas 37.5% (n=48) were moderately anaemic and no severe anaemic cases were detected. Anaemia was more prevalent (33.3% -60%) in second and third trimesters of pregnancy. Study results confirm that socio-economic deprivation and lack of basic education are important factors that predispose pregnant women to anaemia. Anaemia levels reported are low but persistent and present a potentially serious public health problem to the mother, foetal growth and delivery outcome and therefore require serious attention. It is recommended that the county government initiates free iron supplementation and enlist services of extension nutritionists in an integrated programme for the prevention and management of pregnancy related anaemia.
Keywords
Anaemia, Pregnancy, Prevalence, Public Health
To cite this article
Mulambalah Chrispinus Siteti, Siamba Donald Namasaka, Ogutu Philip Ariya, Siteti Darwin Injete, Wekesa Antony Wanyonyi, Anaemia in Pregnancy: Prevalence and Possible Risk Factors in Kakamega County, Kenya, Science Journal of Public Health. Vol. 2, No. 3, 2014, pp. 216-222. doi: 10.11648/j.sjph.20140203.23
References
[1]
Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Christopher J L Mu et al., Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360:1347-60.
[2]
World Health Organization 2004. The pre-valence of anaemia in women; WHO/MCH/MSM/92.2
[3]
World Health Organization. The World Health Report 2002: Reducing risks, promoting healthy life. Geneva, World Health Organization, 2002.
[4]
WHO, 2001, Iron deficiency anaemia, assessment, prevention, and control: A guide for program managers, Geneva: WHO.
[5]
Sifakis S, Pharmakides G. Anemia in pregnancy. Ann N Y Acad Sci. 2000; 900125-36.
[6]
Seshadri S. Prevalence of micronutrient deficiency particularly iron, zinc and folate in preg-nancy women in South East Asia. Br. J. Nutr. 2001;85(supp 2),S 87-92.
[7]
Chenoufi B, Essafi B, Star E, Chelli H, Ben HA, Ben AS, Ben TN, Ben AK, Kastilli R. Screening for carential anaemia in pregnant women: Prospective study. Report of 200 cases. Tunis Med. 2001:79:423-8
[8]
Olukoya AA & Abidoye RO. A study of intestinal parasites in antenatal clinic patients in Lagos- Nigeria. Health and Hygiene 1996;55:66-70.
[9]
World Bank, World Health Organization, UNFPA. Preventing the tragedy of maternal deaths. A report of the International Safe Motherhood Conference, Nairobi, Kenya. Geneva: WHO. 1987: 1-16.
[10]
Roy S and Chakravorty PS. Maternal and perinatal outcome in severe anaemia. J Obstet Gynecol Indian 1992;42:743-50.
[11]
Ezzati M, Lopez AD, Rodgers A, Murray CJL. Comparative quantification of health risks: Global and regional burden of disease attributable to selected major risk factors. Geneva, Switzerland: WHO, 2004.
[12]
Kilbridge J, Baker TG, Paragia LA, Khoury SA, Shugaidef SW, Jerwood D. Anaemia during pregnancy a risk factor for iron deficiency anaemia in infancy: a case-control study in Jordan. Int. J. Epid. 1999;28:461-8
[13]
Goldenberg RL, Tamura T, Dubard M, Neggers Y, Coppers RL. Plasma ferritin and Pregnancy outcome. Amer J Obstet Gynecol 1996; 175: 1357-9.
[14]
Rita M. Study of anaemia in pregnancy and its outcome in Nepal medical college. Nepal medical college Journal 2007 Dec;9(4):270-4.
[15]
WHO/CDC. 2008. Worldwide prevalence of anaemia 1993–2005 : WHO global database on anaemia. De Benoist B, McLean E, Egli I, Cogswell M eds. World Health Organization, Geneva. Available at http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf
[16]
Nkuruma B, Nguah SB, Srprong N, Dekker D, Idriss A, Juergen M, Sarkodie YA. Haemoglobin estimation by Hemocue portable haemoglobin photometer in a resource poor setting. BMC Clinical Pathology, 2011; 11: 5.
[17]
World Health Organization. Prevention and management of severe anaemia in pregnancy. WHO 1993. WHO/FHE/MSM/93-5.
[18]
Dairo MD, Lawoyin TO. Socio-demographic determinants of anaemia in pregnancy at primary care level: A study in urban and rural Oyo state, Nigeria. Afr. J. Med. Med. Sci. 2004; 33: 213-217.
[19]
Marti-Carvajal. Prevalence of anaemia during pregnancy: Results of Valencia- Venezuela. Arch. Latino Amer. De Nutricion Vol.52;1:2002
[20]
Cyril D & Hyacinth O. The prevalence of anaemia among pregnant women at booking in Enugu, Southern Nigeria. Medscape general Medicine. 2007; 9 (3):11
[21]
Meda N, Mandesbrot L, Cartoux M, Dao B, Ouangre A, Dabis F. Anaemia during pregnancy in Burkina Faso West Africa 1995-96: Prevalence and associated factors. Bull World Health Org. 1999;77:916-22
[22]
Msolla MJ & Kinabo JL. Prevalence of anaemia in pregnant women during the last trimester. Int. J. Food Sci Nutr.1997 :48(4):265-70.
[23]
Hoque M, Kader SB, Hoque E. Prevalence of anaemia in pregnancy in the Uthungulu health district of KwaZulu-Natal, South Africa. SA Farm Pract. 2007; 49(6): 16.
[24]
Critchley J, Bates I. Haemoglobin colour scale for anaemia in diagnosis where there is no laboratory: A systematic review. Int. J. Epidemiol. 2005: 34(6): 1425-1434.
[25]
Singh K, Fong YF, Arulkumaran S. Anaemia in pregnancy a cross sectional study in Singapore. Eur. J. clinical Nutri. 1998;52:65-70.
[26]
Bruno de Benoist, MaClean E, Egli I, Cogswell M, Editors World-wide prevalence of anaemia 1993-2005; WHO global database on Anaemia, 1-51.
[27]
Bondevik GT, Lie RT, Ulstein M, Kvåle G. Maternal haematological status and risk of low birth weight and preterm delivery in Nepal. Acta Obstet Gynaecol Scand 2001;80:402-8
[28]
Yuan X, Hong Y, Shaonong D, Bianba Z, Xiaoyan Z, Duolao W. Hb levels and anaemia evaluation during pregnancy in the highlands of Tibet, a hospital-based study. BMC Public Health. 2009; 9:336.
[29]
Anorlu RI, Oluwole AA, Audu OO. Socio-demographic factors in anaemia in pregnancy at booking in Lagos Nigeria. Journal of Obstetrics and Gynaecology. 2006; 268:773-776.
[30]
Brabin BJ, Hakimi M, Pelletier D. An analysis of Anaemia and Pregnancy-Related Maternal Mortality. J. Nutri. 2001; 131:6045-6155.
[31]
Komolafe JO, Kuti O, Oni O, Egbewale BE. Socio-demographic chararcteristics of anaemic gravidae booking: a preliminary study at Ilesha, Western Nigeria. Niger J. Med. 2005; 14(2):151-154.
[32]
Oboro VO, Tabowei TO, Jemikalajah J. Prevalence and risk factors for anaemia in pregnancy in Southern Nigeria. Journal of Obstetrics and Gynaecology. 2002; 2296):610-613.
[33]
Mora JO, Nestel PS. Improving prenatal nutrition in developing countries: strategies, prospects and challenges. Am.J. clin. Nutri. 2000; 71:1353-1363.
[34]
Rush D. Nutrition and Maternal Mortality in the Developing World. Am. J. Clin. Nutri. 2000; 72(1):212-240.
[35]
Harrison KA. Anaemia in pregnancy. In: Lawson JB, Harrison KA, Bergstrom S, editors. Maternity Care in Developing Countries. 1st ed. RCOG Press, London. 2001; 112-128.
[36]
Akanmu AS, Abudu OO, Akinsete I. Influence of Socio-Economic status on haemoglobin and haematocrit levels during pregnancy in Lagos Nigeria. The Nigerian Postgrad. Med. J. 1998; 5(3): 131-135.
[37]
Desalegn S. Prevalence of anaemia in pregnancy in Jima Town, Southern Ethiopia. Ethiop Med J. 1993:31(4):251-8
[38]
Kiwanuka GN, Isharaza WK, Mahmoud S. Iron status of pregnant women at first antenatal booking in Mbarara University Teaching Hospital. Trop Doct 1999;29:228–30.
[39]
Jahan K & Hossain M. Bangladesh National Nutrition survey, 1995-96 Dhaka: Institute of Nutrition and food science, University of Dhaka, 1998.
[40]
Dreyfuss ML, Stoltzfus RJ, Shrestha JB et al. Hookworms, Malaria and Vitamin A Deficiency contribute to anemia and iron deficiency among pregnant women in the plains of Nepal. J Nutr 2000; 130: 2527-36.
[41]
Atukorala TMS, de Silva LDR, Dechering WHJC, Dassenaeike TS de C, Perera RS. Evaluation of effectiveness of iron-folate supplementation and anthelminthic therapy against anaemia in pregnancy - A study in the plantation sector of Sri Lanka. American Journal of Clinical Nutrition 1994;60:286-92.
[42]
Omoniyi YA & Gregory S. Anaemia in pregnancy and race in the United States: Blacks at risk. Fam Med 2005;37(9):655-62.
[43]
Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. JAMA 1997;277:973-76.
[44]
Fujimori E, Oliveira IMV, Nuñez de Cassana LM, Szarfarc SC. Estado Nutricional del hierro de gestantes adolescentes, São Paulo, Brasil. Arch Latinoamer Nutr 1999;49:8-12
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186