Risk factors for anaemia among Ghanaian women and children vary by population group and climate zone

Petry, Nicolai; Wirth, James P.; Adu‐Afarwuah, Seth; Wegmüller, Rita; Woodruff, Bradley A.; Tanumihardjo, Sherry A.; Bentil, Helena; Donkor, William E S; Williams, Thomas N.; Shahab‐Ferdows, Setareh; Selenje, Lilian; Mahama, Abraham B.; Steiner-Asiedu, Matilda; Rohner, Fabian

doi:10.1111/mcn.13076

Cited by 17 publications

(20 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost forty percent of children had elevated CRP or AGP concentrations, indicative of inflammatory responses to infection. These results alongside the finding that CRP and AGP were strongly correlated with Hb concentrations suggest that anemia in this sample is in part attributable to infectious factors, in agreement with recent studies of anemia in Ghanaian children [10,11]. As has been found in other studies investigating the burden of enteropathogens among children in LMICs, most children (87.0%) in this study had at least one bacterial enteropathogen detected in their stool, with EAEC and aEPEC being the most prevalent [20,47].…”

Section: Discussionsupporting

confidence: 92%

“…Analysis of the 2017 Ghana Micronutrient Survey found that only 35% of total anemia in 6-59-month-old children was associated with iron deficiency [10]. In the Southern Belt of Ghana, where our study took place, anemia was neither associated with children's iron status nor vitamin A deficiency [11]. Indeed, three-quarters of the anemia burden was attributable to factors associated with infectious diseases (i.e., malaria, inflammation, and fever) [11].…”

Section: Introductionmentioning

confidence: 58%

“…In the Southern Belt of Ghana, where our study took place, anemia was neither associated with children's iron status nor vitamin A deficiency [11]. Indeed, three-quarters of the anemia burden was attributable to factors associated with infectious diseases (i.e., malaria, inflammation, and fever) [11]. To reduce the anemia burden, understanding the causes of inflammation, especially from non-malarial infections, is thus critical [12,13].…”

Section: Introductionmentioning

confidence: 93%

See 2 more Smart Citations

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

et al. 2022

View full text Add to dashboard Cite

Anemia remains a pervasive public health problem among preschool-age children in Ghana. Recent analyses have found that anemia in Ghanaian children, particularly in Southern regions, is largely attributable to infectious causes, rather than nutritional factors. Infections with enteropathogens can reduce iron absorption and increase systemic inflammation, but few studies have examined direct links between enteropathogens and anemia. This study investigated associations between detection of individual bacterial enteropathogens and systemic inflammation, iron deficiency, and anemia among 6- to 59-month-old children in Greater Accra, Ghana. Serum samples were analyzed from a cross-sectional sample of 262 children for concentrations of hemoglobin (Hb), biomarkers of systemic inflammation [C-reactive protein (CRP) and α-1-acid glycoprotein (AGP)], and biomarkers of iron status [serum ferritin (SF) and serum transferrin receptor (sTfR)]. Stool samples were analyzed for ten bacterial enteropathogens using qPCR. We estimated associations between presence of each enteropathogen and elevated systemic inflammation (CRP > 5 mg/L and AGP > 1 g/L), iron deficiency (SF < 12 μg/L and sTfR > 8.3 mg/L) and anemia (Hb < 110 g/L). Enteropathogens were detected in 87% of children’s stool despite a low prevalence of diarrhea (6.5%). Almost half (46%) of children had anemia while one-quarter (24%) had iron deficiency (low SF). Despite finding no associations with illness symptoms, Campylobacter jejuni/coli detection was strongly associated with elevated CRP [Odds Ratio (95% CI): 3.49 (1.45, 8.41)] and elevated AGP [4.27 (1.85, 9.84)]. Of the pathogens examined, only enteroinvasive Escherichia coli/Shigella spp. (EIEC/Shigella) was associated with iron deficiency, and enteroaggregative Escherichia coli (EAEC) [1.69 (1.01, 2.84)] and EIEC/Shigella [2.34 (1.15, 4.76)] were associated with anemia. These results suggest that certain enteroinvasive pathogenic bacteria may contribute to child anemia. Reducing exposure to enteropathogens through improved water, sanitation, and hygiene practices may help reduce the burden of anemia in young Ghanaian children.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 93%

See 1 more Smart Citation

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Given the multiple causes of anemia (inflammations due to infections, low dietary intake of iron and other micronutrients, inherited blood disorders) in Ghana, context-specific determinants of anemia are required to guide appropriate interventions. For instance, Petry et al showed that while iron deficiency was associated with children being anemic in the Northern and Middle belts of Ghana, there was no such relationship among children in the Southern Belt [ 52 ]. Lopes et al suggested in their systematic review of nutrition-specific interventions for preventing and controlling anemia that besides the continuous efforts to improve dietary diversity and quality, daily iron supplementation may increase the hemoglobin levels and decrease the risk of anemia in both non-pregnant and pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Co-Occurrence of Overweight/Obesity, Anemia and Micronutrient Deficiencies among Non-Pregnant Women of Reproductive Age in Ghana: Results from a Nationally Representative Survey

et al. 2022

Self Cite

View full text Add to dashboard Cite

Overweight/obesity (OWOB) often co-occurs with anemia or micronutrient deficiencies (MNDs) among women of reproductive age (WRA) in Ghana; identifying the risk factors of these conditions is essential for prevention. We aimed to examine the prevalence of OWOB, anemia, and MNDs and their co-occurrence and risk factors among non-pregnant women 15–49 years of age in Ghana. Data were from a 2017 two-stage national survey of 1063 women. We estimated the weighted prevalence of single and co-occurring malnutrition, and used logistic regression to explore risk factors. The prevalence of OWOB, anemia, and ≥1 MND was 39%, 22%, and 62%, respectively; that of OWOB co-occurring with anemia was 6.7%, and OWOB co-occurring with ≥1 MND was 23.6%. There was no significant difference between observed and expected prevalence of co-occurrence OWOB with anemia or MND. Risk factors were: living in southern (vs. northern) belt, high- (vs. low-) wealth household, being ≥ 25 years old, and being married (vs. single) for OWOB, and living in northern (vs. southern) belt and medium- (vs. low-) wealth household for anemia and ≥1 MND, respectively. Different interventions are required for addressing OWOB in WRA than those for anemia and MNDs.

show abstract

“…Our analysis showed that the peak of anaemia in 2008 was highest in the forest zone (not shown), which was contrary to other studies in Ghana (15,54) . The forest zone of Ghana has a tropical climate in which malaria exposure is higher (55) ; although we could not verify this with the available data, a recent study found that while anaemia in children and reproductive women was associated with iron deficiency in northern Ghana (Guinea savannah zone), it was rather associated with inflammation in the middle and southern belts (forest zone) of the country (56) .…”

Section: Discussionmentioning

confidence: 71%

Trends and factors associated with the nutritional status of adolescent girls in Ghana: a secondary analysis of the 2003–2014 Ghana demographic and health survey (GDHS) data

Azupogo

Abizari

Aurino

et al. 2021

Public Health Nutr.

View full text Add to dashboard Cite

Objective: We examined the trends-over-time and the factors associated with malnutrition among adolescent girls in Ghana. Design: Cross-sectional analysis from 3 nationwide Ghana Demographic and Health Surveys conducted in 2003 (n=983), 2008 (n=955) and 2014 (n=857). We used Cox proportional hazard models with sample weighting to model the prevalence ratio (PR) of malnutrition. Setting: Countrywide, covering rural and urban areas in Ghana. Subjects: Non-pregnant adolescents girls aged 15-19 years. Results: Compared with 2003, thinness declined marginally [PR 0.88 95% C.I (0.45, 1.73)] in 2008 and in 2014 [PR 0.71 95% C.I (0.38, 1.56)]. Stunting declined marginally by 19% in 2008 [PR 0.81 95% C.I (0.59, 1.12)], flattening out in 2014 [PR 0.81 95% C.I (0.57, 1.17)]. We found an increasing trend of overweight/obesity with the PR peaking in 2014 [PR 1.39 95% C. I (1.02, 1.88)] compared to 2003. The anaemia prevalence remained severe without a clear trend. A low level of education of the adolescent girl was positively associated with stunting. Increasing age was positively associated with stunting but inversely associated with thinness and anaemia. Girls who ever bore a child were more likely to be anaemic compared to those who never did. A lower level of household wealth and a unit increase in household size were negatively associated with overweight/obesity. Urban dwelling girls were less likely to be stunted. Conclusion: The stagnant burden of undernutrition and rising overnutrition emphasise the need for double-duty actions to tackle malnutrition in all its forms in Ghanaian adolescent girls.

show abstract

Risk factors for anaemia among Ghanaian women and children vary by population group and climate zone

Cited by 17 publications

References 42 publications

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

Co-Occurrence of Overweight/Obesity, Anemia and Micronutrient Deficiencies among Non-Pregnant Women of Reproductive Age in Ghana: Results from a Nationally Representative Survey

Trends and factors associated with the nutritional status of adolescent girls in Ghana: a secondary analysis of the 2003–2014 Ghana demographic and health survey (GDHS) data

Contact Info

Product

Resources

About