Khat Chewing and Restrictive Dietary Behaviors Are Associated with Anemia among Pregnant Women in High Prevalence Rural Communities in Eastern Ethiopia

Abstract

BackgroundAnemia affects a high proportion of pregnant women in the developing countries. Factors associated with it vary in context. This study aimed to determine the prevalence and predictors of anemia among pregnant women in the rural eastern Ethiopia.MethodsA community-based cross-sectional study was done on 1678 pregnant women who were selected by a cluster random sampling technique. A pregnant woman was identified as anemic if her hemoglobin concentration was <11 g/dl. Data were collected in a community-based setting. Multilevel mixed effect logistic regression was used to determine the adjusted odds ratios (AOR) with 95% confidence intervals (CI) for the predictors of anemia.ResultsAnemia was observed among 737(43.9%) of the 1678 pregnant women studied (95% CI 41.5%–46.3%). After controlling for the confounders, the risk of anemia was 29% higher in the women who chewed khat daily than those who sometimes or never did so (AOR, 1.29; 95% CI, 1.02–1.62). The study subjects with restrictive dietary behavior (reduced either meal size or frequency) had a 39% higher risk of anemia compared to those without restrictive dietary behavior (AOR, 1.39; 95% CI, 1.02–1.88). The risk of anemia was increased by 68% (AOR, 1.68; 95% CI, 1.15–2.47), and 60% (AOR, 1.60; 95% CI, 1.08–2.37) in parity levels of 2 births and 3 births, respectively. Compared to the first trimester, the risk of anemia was higher by two-fold (AOR, 2.09; 95% CI, 1.46–3.00) in the second trimester and by four-fold (AOR, 4.23; 95% CI, 2.97–6.02) in the third trimester.ConclusionIn this study, two out of five women were anemic. Chewing khat and restrictive dietary habits that are associated with anemia in the setting should be addressed through public education programs. Interventions should also focus on the women at higher parity levels and those who are in advanced stages of pregnancy.

Predictors of anemia in pregnant women residing in rural areas of the Oromiya region of Ethiopia

“…These findings are supported by previous analyses in Ethiopia [6,7,10,15]. Pregnancy increases the requirements for iron in the body and often multiple pregnancies deplete the iron stores in the women's body, especially if they are closely spaced.…”

“…schistosomiasis, hookworm infection), prior use of contraceptives, use of iron supplementation, birth spacing/intervals, parity and gravidity, educational attainment, age, body weight, trimester of pregnancy and wealth status. [6][7][8][9][10][11][12][13][14][15][16][17][18]. The relationship between anemia and dietary practices in Ethiopia has shown mixed results [12,18,19].…”

Seasonal variation in nutritional status and anemia among lactating mothers in two agro-ecological zones of rural Ethiopia: A longitudinal study

“…As the parity of the mother increased the Hb level decreased (P < 0.05) in all models, indicating that a persistent factor associated with maternal malnutrition is parity. Similar findings were also documented elsewhere in Ethiopia [25,27]. This suggests that initiatives to encourage greater child spacing should be considered as a positive contribution to reducing anemia prevalence in conjunction with other factors (greater dietary diversity, iron supplementation, parasite control) that can modulate anemia risk.…”

Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis

“…The minimum sample size was 150 participants in a study conducted in Nekemte [24]. While, the higher sample size was 1678, conducted in Haramaya district of Oromia region [25]. Overall, this meta-analysis included a total of 10, 281 pregnant women.…”