PREVALENCE OF ANEMIA AND ITS ASSOCIETED RISK FACTORS AMONG PREGNANT WOMEN ATTENDING ANC AT THE BUEA REGIONAL HOSPITAL, SOUTH WEST REGION OF CAMEROON

ABSTRACT

Anemia during pregnancy is a major health problem. There is conflict literature regarding the association between anemia and its severity and perinatal outcomes. This study aims to investigate the prevalence of anemia and its risk factor in pregnancy. This study used the cross-sectional analytical study designed to achieve the aim of the study, data was collected using a structural questionnaire and hemoglobin testing was done using the Haemoglobinometer and blood pressure/ weight was taken. Categorical variables were compared using Chi square test a P value less than 0.5 was considered significant. This study involves pregnant women attending ANC at Buea Regional Hospital. A total of 280 participants were enrolled in this study from February to March 2023. The prevalence of anemia was 35.7%. Among the study participants, 0.4% 8.2% and 27.1% were recorded for severe, moderate and mild levels of anemia respectively. Majority of the anemic participants where at age group of   26-30 age group (P value = 0.001) and Nulliparity was revealed to be an obstetrics risk factor of anemia (P value = 0.004) as presented in table two.

CHAPTER ONE

INTRODUCTION

1.1 Background of study

Anemia is a public health issue affecting the population of all age groups in both developed countries and under developed countries. With the highest prevalence among children age less down <5 years and pregnant women. Globally, anemia affects 1.62 billion people (25%), out of which 56 million are pregnant women (Balarajan et al., 2011). About 800 women a day are still dying from complications in pregnancy and childbirth globally (WHO, 2011). It was estimated that, about 38% of pregnant women across the globe are anemic, with 18% in higher income countries, and 35-75% in middle-and low income countries and the rate of deficiency seems to increase as pregnancy progress (WHO, 2021). In Cameroon, it was reported that the prevalence of anemia among its pregnant women is 44.4% in 2019 (WORLD BANK, 2019).

Anemia during gestation represents a dangerous cause of maternal and childhood morbidity and mortality (Menendez et al., 2000). The health effects for the mother include fatigue, poor work capacity, impaired immune function, increased risk of cardiac disease, and mortality (Victoria et al., 2018), which are still the leading causes of neonatal deaths in developing countries like Cameroon contributing to 60% of deaths (WHO-MCEE, 2016). As prematurity accounts for 29%, birth asphyxia and birth trauma accounts for about 31% of the death. In Cameroon, it was reported that the prevalence of anemia among it pregnant women is 44.4% in 2019 (WORLD BANK, 2019).

     During pregnancy, the entire blood volume increases by about 1.5 liters (Chandra et al., 2012). The plasma volume increases more compered to red call mass which resulting in hemodilution and reduced hemoglobin concentration, this is often termed physiological anemia in pregnancy (Pavord et al., 2018). According to World Health Organization (WHO), anemia in pregnancy is when the Hb level is <11 g/dl, severe when hemoglobin concentration (Hb) is less than 7.0 g/dl, moderate when it’s 7.0 to 9.9g/dl and mild when it is 10.0 to 10.9g/dl (WHO 2011).

Anemia during pregnancy can be attributed to variety on contributing factors such as; nutritional infectious diseases and iron deficiency, which accounts for about 75% of anemia cases (Tojeta et al., 2006). Other key determination of anemia includes maternal age, purity levels, trimester of pregnancy, rural residents (Wojtyla et al., 2011). The relative contribution of each of these factors to anemia during pregnancy varies greatly by geographical location, season, and dietary practice (Fikir et al., 2017).

In Cameroon, anemia is said to be a severe public health problem in pregnancy (Anchang et al., 2017). The Cameroon health sector has put in place various interventions to reduce the burden of anemia during pregnancy. The interventions implemented in Cameroon to reduce the burden of anemia during pregnancy include anemia screening during pregnancy and treatment, giving a mixture of the B complex (fefo) and iron supplements for about 3 months, deworming intermittent prophylaxis treatment for malaria (iptp) with sulfadoxine-pyrimethamine (sp) from 14 2weeks, there is a necessity to know current data on anemia among pregnant women (Simon et al., 2021). Therefore, this study aimed at determining prevalence of anemia, and assessing knowledge and associated factors among pregnant women attending antenatal care at Buea Health District. The findings of this study would help to guide the antenatal care service providers and other concerned stakeholders to work more towards alleviating the problem. Also it might be used as a base line data for other researchers who are interested on this area.

A recent research shows that, women with a severe anemia have about 3.6 time’s higher risk of preeclampsia than women with no anemia (Alo et al., 2011). It was recently observed that, 17 (17.7%) of 67 women with severe anemia had gestational hypertension or preeclampsia and 2 (2.1%) had eclampsia (Rohilla et al., 2010). However, it might be difficult to reach a firm conclusion from this report since the authors did not mention the incidence of these events in women with moderate anemia/mild anemia or with no anemia; therefore, this study aims to determine the prevalence of anemia and its associated risk factors among pregnant women attending ANC in Buea region.

1.2 Problem Statement

Anemia in pregnancy presents a life-threatening but preventable reason behind maternal and childhood morbidity and mortality (Menendez et al., 2000). The health effects for the mother include, fatigue, poor work capacity, impaired immune function, and increased of cardiac disease and mortality (Black et al., 2013). Anemia in pregnancy is related to increased risk of preterm birth and low birth weight babies (Stephen et al., 2018), which are the leading causes of neonatal deaths in developing countries such as Cameroon contributing to 60% of deaths (WHO-MCEE, 2016). As prematurity account for 29%, birth asphyxia and birth trauma accounts for 31% of death.

This study was carried out to assess the prevalence and risk factors associated with anemia among pregnant women attending ANC at the Buea regional hospital.

1.3 Research Questions

• What is the prevalence of anemia amongst pregnant women attending ANC in the Buea Regional Hospital?
• What is the level of knowledge of anemia amongst pregnant women attending ANC in the Buea Regional Hospital?
• What are the factors associated with anemia among pregnant women attending ANC at the Buea Regional Hospital?