Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization.
Anemia is a significant risk factor for poor health outcomes for both the mother and neonate; however, the determinants of anemia in many epidemiological settings are poorly understood. Using a subset of a nationally representative cluster survey (2010 Demographic and Health Survey) in combination w...
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doaj-0b6f21fc04bf44d49604d6cd62177ace2020-11-25T01:34:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0193e9125210.1371/journal.pone.0091252Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization.Andrew A LoverMikael HartmanKee Seng ChiaDavid L HeymannAnemia is a significant risk factor for poor health outcomes for both the mother and neonate; however, the determinants of anemia in many epidemiological settings are poorly understood. Using a subset of a nationally representative cluster survey (2010 Demographic and Health Survey) in combination with other non-contemporaneous survey data, the epidemiology of anemia among women of reproductive age in Timor-Leste has been explored. Logistic regression was used to identify risk factors, population-level impacts were estimated as population attributable fractions and spatial analytics were used to identify regions of highest risk. The DHS survey found that ∼ 21% of adult women in Timor-Leste are anemic (49,053; 95% CI: 37,095 to 61,035), with hemoglobin <12.0 g/dL. In this population, the main risk factors (adjusted odds ratio; 95% CI) are: currently abstaining from sex for any reason (2.25; 1.50 to 3.38); illiteracy (2.04; 1.49 to 2.80); giving birth within the previous year (1.80; 1.29 to 2.51); consumption of fruits/vegetables low in vitamin A (1.57; 1.13 to 2.20); and the district-level confirmed malaria incidence (1.31; 1.15 to 1.49). A review of prior soil-transmitted helminth surveys in Timor-Leste indicates low-to-moderate prevalence with generally low egg counts, suggesting a limited impact on anemia in this setting, although comprehensive survey data are lacking. Examination of the population-level effects highlights the impacts of both recent births and malaria on anemia, with more limited impacts from diet; the evidence does not suggest a large contribution from geohelminths within Timor-Leste. These patterns are divergent from some other settings in the Asia-Pacific region and highlight the need for further focused research. Targeting high-burden districts and by increasing access to pre/postnatal care, raising literacy levels, increasing access to family planning, and improving malaria control should be prioritized to maximize inherently limited health budgets in reaching these populations.http://europepmc.org/articles/PMC3954687?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrew A Lover Mikael Hartman Kee Seng Chia David L Heymann |
spellingShingle |
Andrew A Lover Mikael Hartman Kee Seng Chia David L Heymann Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. PLoS ONE |
author_facet |
Andrew A Lover Mikael Hartman Kee Seng Chia David L Heymann |
author_sort |
Andrew A Lover |
title |
Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. |
title_short |
Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. |
title_full |
Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. |
title_fullStr |
Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. |
title_full_unstemmed |
Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization. |
title_sort |
demographic and spatial predictors of anemia in women of reproductive age in timor-leste: implications for health program prioritization. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2014-01-01 |
description |
Anemia is a significant risk factor for poor health outcomes for both the mother and neonate; however, the determinants of anemia in many epidemiological settings are poorly understood. Using a subset of a nationally representative cluster survey (2010 Demographic and Health Survey) in combination with other non-contemporaneous survey data, the epidemiology of anemia among women of reproductive age in Timor-Leste has been explored. Logistic regression was used to identify risk factors, population-level impacts were estimated as population attributable fractions and spatial analytics were used to identify regions of highest risk. The DHS survey found that ∼ 21% of adult women in Timor-Leste are anemic (49,053; 95% CI: 37,095 to 61,035), with hemoglobin <12.0 g/dL. In this population, the main risk factors (adjusted odds ratio; 95% CI) are: currently abstaining from sex for any reason (2.25; 1.50 to 3.38); illiteracy (2.04; 1.49 to 2.80); giving birth within the previous year (1.80; 1.29 to 2.51); consumption of fruits/vegetables low in vitamin A (1.57; 1.13 to 2.20); and the district-level confirmed malaria incidence (1.31; 1.15 to 1.49). A review of prior soil-transmitted helminth surveys in Timor-Leste indicates low-to-moderate prevalence with generally low egg counts, suggesting a limited impact on anemia in this setting, although comprehensive survey data are lacking. Examination of the population-level effects highlights the impacts of both recent births and malaria on anemia, with more limited impacts from diet; the evidence does not suggest a large contribution from geohelminths within Timor-Leste. These patterns are divergent from some other settings in the Asia-Pacific region and highlight the need for further focused research. Targeting high-burden districts and by increasing access to pre/postnatal care, raising literacy levels, increasing access to family planning, and improving malaria control should be prioritized to maximize inherently limited health budgets in reaching these populations. |
url |
http://europepmc.org/articles/PMC3954687?pdf=render |
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