Social and ecological disparities in anaemia among adolescent girls 15–19 years old in Nepal

Abstract

Objective Adolescent girls are at risk of anaemia due to the increased nutrient demands because of growth, menstrual blood loss and possible pregnancies. Sociocultural and household conditions influence their risk. We aimed to identify the sociocultural and economic factors of anaemia in adolescent girls in Nepal. Design The Nepal Demographic and Health Surveys (NDHS) conducted in 2006, 2011, and 2016 were pooled for secondary analysis. We used data on haemoglobin measurements for anaemia and conducted bivariate and multivariable logistic regression analyses to identify factors associated with anaemia. Setting Nationally representative NDHS households with adolescent girls 15-19 years of age. Participants Non-pregnant adolescent girls 15 to 19 years, with a haemoglobin measurement (N=3731). Results The overall prevalence of anaemia among adolescent girls was 39.6%. Adolescents from socially disadvantaged caste/ethnicity groups were 1.42 times (95% CI: 1.13, 1.78) more likely to have anaemia compared to those from Brahmin/Chhetri households. We found a counter-intuitive association between socio-economic status and anaemia where adolescents from the middle (aOR 1.37, 95% CI: 1.01, 1.85) and highest (aOR 1.74, 95% CI: 1.18, 2.56) quintiles were at increased odds of anaemia. Relative geographical inequality was observed where adolescents from the Terai region had 3.5 times (95% CI: 2.32, 5.33) higher odds of anaemia. Conclusions The disparities in the distribution of anaemia among adolescents by caste/ethnicity groups, wealth quintiles and geographical regions are evident. Reducing the anaemia burden will require addressing the social determinants of anaemia by allocating resources and expanding anaemia prevention programmes to target adolescents at higher risk.

Prevalence of anemia in patients with rheumatoid arthritis and its association with dietary inflammatory index: A population-based study from NHANES 1999 to 2018

“…Several studies have found inverse associations of serum Hb levels with antirheumatic medication, PIR, and CRP. [ 34 – 36 ] To eliminate the possibility of antirheumatic medication, PIR, and CRP affecting our results, we adjusted for them in the sensitivity analysis. We found that there was still an association between the DII and the risk of anemia.…”

“…In the sensitivity analysis, we adjusted for antirheumatic medication, family poverty income ratio (PIR), and C-reactive protein (CRP) as covariates in weighted multivariate logistic regressions to minimize their potential impact on the association between the DII and anemia in RA patients. [ 34 – 36 ] We carried out stepwise regression and the nomogram model to further identify the association between anemia and DII. The receiver operating characteristic curve was performed to determine the discriminatory ability of the nomogram model in identifying anemic risk.…”