Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences

Abstract

BackgroundThe global burden of anemia is large especially in sub-Saharan Africa, where HIV is common and lifestyles are changing rapidly with urbanization. The effects of these changes are unknown. Studies of anemia usually focus on pregnant women or children, among whom the burden is greatest. We describe prevalence and risk factors for anemia among rural and urban men and women of all ages in Malawi.MethodsWe analyzed data from a population-wide cross-sectional survey of adults conducted in two sites, Karonga (rural) and Lilongwe (urban), commencing in May 2013. We used multinomial logistic regression models, stratified by sex to identify risk factors for mild and moderate-to-severe anemia.ResultsAnemia prevalence was assessed among 8,926 men (age range 18–100 years) and 14,978 women (age range: 18–103 years). Weighted prevalence levels for all, mild, and moderate-to-severe anemia were 8.2, 6.7 and 1.2% in rural men; 19.4, 12.0 and 7.4% in rural women; 5.9, 5.1 and 0.8% in urban men; and 23.4, 13.6 and 10.1% in urban women. Among women, the odds of anemia were higher among urban residents and those with higher socioeconomic status. Increasing age was associated with higher anemia prevalence in men. Among both men and women, HIV infection was a consistent risk factor for severity of anemia, though its relative effect was stronger on moderate-to-severe anemia.ConclusionsThe drivers of anemia in this population are complex, include both socioeconomic and biological factors and are affecting men and women differently. The associations with urban lifestyle and HIV indicate opportunities for targeted intervention.

Spatial Distribution and Determinant Factors of Anaemia Among Adults Aged 15-59 in Ethiopia; Using Mixed-effects Ordinal Logistic Regression Model

“…In line with other study (20), the present study reported that likelihoods of rich adult developing severe anaemia (compared to moderate, mild or non-anemic) were lower than poor adults. Such result indicates that poor adults have less access to nutritious food and fall sick more frequently as compared to the rich adults.…”

“…The present study documented that the odds of rural adults experiencing severe anaemia (against moderate, mild or non-anaemic) were higher than urban adults and this is of course congruent with other reports (19,20). The possible reasons might be rural adults more likely to have low socioeconomic status, low chance of accessing iron-rich foods and lack of adequate nutrition information as compared to urban adults (19).…”

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

“…The difference in the socioeconomic status, educational and occupational status of pregnant women, difference in the health service access between rural and urban areas could be the justification for the difference. Additionally, inadequate counselling by health professionals in resolving the wrong beliefs and myths regarding the iron supplementation could contribute to higher prevalence of anemia among pregnant women in rural areas [54, 55]. A study conducted in India also showed that pregnant women from the rural areas are more likely to develop anemia than women from the urban area [54].…”

Tendencia en la prevalencia de anemia entre mujeres mexicanas en edad reproductiva 2006-2016. Ensanut MC 2016

“…23 Contrario a lo esperado, los datos del presente trabajo no mostraron diferencias significativas en la prevalencia de anemia según el índice de condición de bienestar. 14,24 Sin embargo, la hipótesis es que, dada la transición alimentaria en la población, actualmente existe un bajo consumo de alimentos ricos en hierro hem y un alto consumo de alimentos ricos en energía y pobres en nutrimentos; 25 no obstante, se requiere de análisis más profundos sobre la dieta para corroborar esta hipótesis.…”