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Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data.
BMJ Open. 2017 12 22; 7(12):e018007.BO

Abstract

OBJECTIVE

To determine the prevalence and possible factors associated with anaemia, and vitamin B12 and folate deficiencies in women of reproductive age (WRA) in Pakistan.

METHODS

A secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels <12 g/dL, vitamin B12 deficiency as serum vitamin B12 levels of <203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels <4 ng/mL (10 nmol/L).

RESULTS

A total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12 deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) P<0.00, food insecure with moderate hunger (RR 1.03; 95% CI 1.00 to 1.06) P=0.02, four or more pregnancies (RR 1.03; 95% CI 1.01 to 1.05) P<0.00, being underweight (RR 1.03; 95% CI 1.00 to 1.05) P=0.02, being overweight or obese (RR 0.95; 95% CI 0.93 to 0.97) P<0.00 and weekly intake of leafy green vegetables (RR 0.98; 95% CI 0.95 to 1.00) P=0.04. For vitamin B12 deficiency, a positive association was observed with rural population (RR 0.81; 95% CI 0.66 to 1.00) P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95% CI 1.11 to 1.43) P<0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95% CI 1.08 to 2.08) P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95% CI 0.81 to 0.98) P=0.02 and (RR 0.88; 95% CI 0.78 to 0.99) P=0.03.

CONCLUSIONS

In Pakistan, anaemia, and vitamin B12 and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12 and folate deficiencies among Pakistani women.

Authors+Show Affiliations

Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan. Global Child Health at the Hospital for Sick Children, Toronto, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29275342

Citation

Soofi, Sajid, et al. "Prevalence and Possible Factors Associated With Anaemia, and Vitamin B 12 and Folate Deficiencies in Women of Reproductive Age in Pakistan: Analysis of National-level Secondary Survey Data." BMJ Open, vol. 7, no. 12, 2017, pp. e018007.
Soofi S, Khan GN, Sadiq K, et al. Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data. BMJ Open. 2017;7(12):e018007.
Soofi, S., Khan, G. N., Sadiq, K., Ariff, S., Habib, A., Kureishy, S., Hussain, I., Umer, M., Suhag, Z., Rizvi, A., & Bhutta, Z. (2017). Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data. BMJ Open, 7(12), e018007. https://doi.org/10.1136/bmjopen-2017-018007
Soofi S, et al. Prevalence and Possible Factors Associated With Anaemia, and Vitamin B 12 and Folate Deficiencies in Women of Reproductive Age in Pakistan: Analysis of National-level Secondary Survey Data. BMJ Open. 2017 12 22;7(12):e018007. PubMed PMID: 29275342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data. AU - Soofi,Sajid, AU - Khan,Gul Nawaz, AU - Sadiq,Kamran, AU - Ariff,Shabina, AU - Habib,Atif, AU - Kureishy,Sumra, AU - Hussain,Imtiaz, AU - Umer,Muhammad, AU - Suhag,Zamir, AU - Rizvi,Arjumand, AU - Bhutta,Zulfiqar, Y1 - 2017/12/22/ PY - 2017/12/25/entrez PY - 2017/12/25/pubmed PY - 2018/8/16/medline KW - anaemia KW - folic acid, KW - nutrition KW - pakistan KW - vitamin b12 SP - e018007 EP - e018007 JF - BMJ open JO - BMJ Open VL - 7 IS - 12 N2 - OBJECTIVE: To determine the prevalence and possible factors associated with anaemia, and vitamin B12 and folate deficiencies in women of reproductive age (WRA) in Pakistan. METHODS: A secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels <12 g/dL, vitamin B12 deficiency as serum vitamin B12 levels of <203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels <4 ng/mL (10 nmol/L). RESULTS: A total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12 deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) P<0.00, food insecure with moderate hunger (RR 1.03; 95% CI 1.00 to 1.06) P=0.02, four or more pregnancies (RR 1.03; 95% CI 1.01 to 1.05) P<0.00, being underweight (RR 1.03; 95% CI 1.00 to 1.05) P=0.02, being overweight or obese (RR 0.95; 95% CI 0.93 to 0.97) P<0.00 and weekly intake of leafy green vegetables (RR 0.98; 95% CI 0.95 to 1.00) P=0.04. For vitamin B12 deficiency, a positive association was observed with rural population (RR 0.81; 95% CI 0.66 to 1.00) P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95% CI 1.11 to 1.43) P<0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95% CI 1.08 to 2.08) P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95% CI 0.81 to 0.98) P=0.02 and (RR 0.88; 95% CI 0.78 to 0.99) P=0.03. CONCLUSIONS: In Pakistan, anaemia, and vitamin B12 and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12 and folate deficiencies among Pakistani women. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/29275342/Prevalence_and_possible_factors_associated_with_anaemia_and_vitamin_B_12_and_folate_deficiencies_in_women_of_reproductive_age_in_Pakistan:_analysis_of_national_level_secondary_survey_data_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&amp;pmid=29275342 DB - PRIME DP - Unbound Medicine ER -