Anemia among Adolescent and Young Women in Low-and-Middle-Income Countries

Suzumi Yasutake; Huan He; Michele R. Decker; Freya L. Sonenstein; Nan M. Astone

doi:10.6000/1929-4247.2013.02.02.4

Authors

Suzumi Yasutake Department of Sociology, Johns Hopkins University, Baltimore, Maryland, USA
Huan He Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Michele R. Decker Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Freya L. Sonenstein Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Nan M. Astone Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

DOI:

https://doi.org/10.6000/1929-4247.2013.02.02.4

Keywords:

Iron deficiency, anemia, DHS, Sub-Saharan countries, preconception health, public health

Abstract

Objective: Anemia is a global public health problem that affects maternal and infant mortality as well as human capital development. Yet there is not much research on anemia among young women in low-and-middle-income countries with nationally representative samples. The aim of the current research is to assess the extent of anemia in a critical age group: adolescents and young adults ages 15 to 24.

Methods: The data are from 34 Demographic and Health Surveys and are used to describe the prevalence of anemia among pregnant and non-pregnant women by age, rural/urban residence, and household wealth. Anemia was assessed using the HemoCue® blood hemoglobin testing system.

Findings: The prevalence of anemia among young women ranges from 15% to over 50%. This is substantially higher than 5%, which is the cutoff to identify a population where anemia is a public health problem. African countries show the highest prevalence of anemia; Benin, Ghana and Mali have over 60% anemia prevalence. Moreover, the prevalence of moderate to severe anemia is particularly high in African countries, over 20% in Ghana and Guinea. Our results show that anemia is a public health concern for adolescents and young adult females in all 34 countries we analyzed.

Conclusion: The high prevalence of anemia among youth is alarming. Considering the importance of the adolescent and young adult years, when human capital development is consolidated and family formation begins, these findings call for interventions to redress the problem of anemia.

References

World Health Organization. Anaemia [Internet]. 2013; [cited 2013 Feb 24]: Available from: http: //www.who.int/topics/ anaemia/en/

McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 2009; 12(04): 444. http://dx.doi.org/10.1017/S1368980008002401

Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian S. Anaemia in low-income and middle-income countries. Lancet 2012; 378(9809): 2123-35. http://dx.doi.org/10.1016/S0140-6736(10)62304-5

Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet 2007 8/11–17; 370(9586): 511-20.

Orish VN, Onyeabor OS, Boampong JN, Acquah S, Sanyaolu AO, Iriemenam NC. The effects of malaria and HIV co-infection on hemoglobin levels among pregnant women in Sekondi-Takoradi, Ghana. Int J Gynaecol Obstet Available online 4 December 2012.

Mehta S, Manji KP, Young AM, Brown ER, Chasela C, Taha TE, et al. Nutritional indicators of adverse pregnancy outcomes and mother-to-child transmission of HIV among HIV-infected women. Am J Clin Nutr 2008; 87(6): 1639-49.

Naniche D, Lahuerta M, Bardaji A, Sigauque B, Romagosa C, Berenguera A, et al. Mother-to-child transmission of

HIV-1: association with malaria prevention, anaemia and placental malaria. HIV Med 2008; 9(9): 757-64.

Madan N, Rusia U, Sikka M, Sharma S. Developmental and neurophysiologic deficits in iron deficiency in children. Indian J Pediatr 2011; 78(1): 58-64. http://dx.doi.org/10.1007/s12098-010-0192-0

Perez EM, Hendricks MK, Beard JL, Murray-Kolb LE, Berg A, Tomlinson M, et al. Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr 2005; 135(4): 850-55.

Haas JD, Brownlie T. Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J Nutr 2001; 131(2): 676S-690S.

Gardner GW, Edgerton VR, Senewiratne B, Barnard RJ, Ohira Y. Physical work capacity and metabolic stress in subjects with iron deficiency anemia. Am J Clin Nut 1977; 30(6): 910-17.

Horton S, Ross J. The economics of iron deficiency. Food Policy 2003; 28(1): 51-75. http://dx.doi.org/10.1016/S0306-9192(02)00070-2

World Health Organization. Iron deficiency anemia: assessment, prevention, and control. A guide for program managers. Geneva, Switzerland: World Health Organization; 2001.

Schulze KJ, Dreyfuss ML. Anemia / Iron-deficiency anemia. In: Caballero B, Allen L, Prentice A, Eds. Encyclopedia of human nutrition. 2nd ed. Oxford: Elsevier Ltd. 2005; pp. 101-109. http://dx.doi.org/10.1016/B0-12-226694-3/00015-6

Crawley J. Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. Am J Trop Med Hyg 2004; 71(2 suppl): 25-34.

Stoltzfus RJ, Chwaya HM, Tielsch JM, Schulze KJ, Albonico M, Savioli L. Epidemiology of iron deficiency anemia in Zanzibari schoolchildren: the importance of hookworms. Am J Clin Nut 1997; 65(1): 153-59.

Mukuri A, Aboulafia C, Themme A. The context of women’s health: results from the demographic and health surveys, 1994-2001. Comparative Reports No. 11. Calverton, Maryland: ORC Macro 2005.

Lutter CK. Iron deficiency in young children in low-income countries and new approaches for its prevention. J Nutr 2008; 138(12): 2523-28. http://dx.doi.org/10.3945/jn.108.095406

ICF International. DHS Overview. [cited 2012 Sept 21]: Available from: http: //www.measuredhs.com/What-We-Do/Survey-Types/DHS.cfm

ICF International. Demographic and Health Surveys (various) [Datasets]. Calverton, Maryland: ICF International [Distributor], 2012. 2012.

ICF International. DHS Overview. [cited 2012 Sept 21]: Available from: http: //www.measuredhs.com/topics/Anemia. cfm

ICF International. Wealth Index [Internet]. [cited 2012 Sept 21]: Available fom: http: //www.measuredhs.com/topics/ Wealth-Index.cfm

Wolde-Gebriel Z, West CE, Gebru H, et al. Interrelationship between vitamin A, iodine and iron status in schoolchildren in Shoa Region, Central Ethiopia. Br J Nutr 1993. http://dx.doi.org/10.1079/BJN19930151

Sudo N, Sekiyama M, Maharjan M, Ohtsuka R. Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies. Eur J Clin Nutr 2006; 60: 469-77. http://dx.doi.org/10.1038/sj.ejcn.1602339

Shannon K, Mahmud Z, Asfia A, Ali M. The social and environmental factors underlying maternal malnutrition in rural Bangladesh: implications for reproductive health and nutrition programs. 2008: 29(8): 826-40.

Tee E, Kandiah M, Awin N, Chong S, Satgunasingam N, Kamarudin L, et al. School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls. Am J Clin Nut 1999; 69(6): 1249-56.

Kothari M, Abderrahim N. Nutrition Update 2010. Calverton, Maryland, USA: ICF Macro 2010.

Baltussen R, Knai C, Sharan M. Iron fortification and iron supplementation are cost-effective interventions to reduce iron deficiency in four subregions of the world. J Nutr 2004; 134(10): 2678-84.

Stoltzfus RJ. Iron interventions for women and children in low-income countries. J Nutr 2011; 141(4): 756S-762S. http://dx.doi.org/10.3945/jn.110.128793