PREVALENCE OF ANEMIA AND FACTORS ASSOCIATED WITH IT AMONG THE FEMALE POPULATION GOING TO COLLEGES AND UNIVERSITIES IN KHYBER PAKHTUNKHWA (KPK), PAKISTAN.

Main Article Content

Muhammad Sajid
Noor Ul Ain Nawaz
Sumaira Irum Khan
Junaid Ahmad
Shubana Hayat
Naseem Ullah
Zakia Subhan
Muhammad Usman Amin

Keywords

Anemia, Body mass index, Hemoglobin, normocytic anemia, microcytic anemia, Macrocytic anemia

Abstract

The study was conducted to investigate the prevalence of Anemia and its associated factors among females studying at colleges and Universities in KPK, Pakistan.  This is the institutional based cross sectional study carried out in different academic institutes of KPK, Pakistan where 3000 female students aged between 18 to 25 years were included. The prevalence of anemia was assessed by taking the blood samples for blood test including hemoglobin (Hb), smear test, serum ferritin, vitamin B12 and folic acid.  An interview oriented questionnaire was designed to obtain all the relevant data. Height, weight, mid arm circumference, body mass index (BMI) of each female was determined. Dietary habbits of the population was also included. The financial status such as monthly income of the participants was also assessed. The prevalence of anemia was 58% in the population under study. The BMI and anemia were found associated with each other. The imbalanced and inadequate diet along with monthly income was the key factors for anemia among females under study. About 46.8% population had mild anemia, 10% had moderate anemia and 1.2% had severe anemia on the basis of hemoglobin. The population with anemia was divided on mean corpuscular volume (MCV) basis into three groups, Normocytic normochromic anemia (73.2%), hypochromic anemia (24.4%) and macrocytic anemia (2.4%).  The study revealed that anemia is very common among females, especially at the adult stage. It is the need of the hour to reform health care system so that the prevalence of anemia can be reduced.

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References

1. Agha F, Sadaruddin A, Khan R, Ghafoor A. Iron deficiency in adolescents. J Pak Med Assoc 1992; 42:3-5.
2. Al-Assaf AH. Anemia and iron intake of adult Saudis in Riyadh City-Saudi Arabia. Pak J Nutr2007; 6:355-358.
3. Alleyne M, Horne MK, Miller JL.Individualized treatment for iron-deficiency anemia in adults. The Am J Med 2008; 121:943-948.
4. Ausk KJ, Ioannou GN. Is obesity associated with anemia of chronic disease? A population‐based study. Obesity 2008; 16:2356-2361.
5. Balarajan Y, Ramakrishnan U, Özaltin E, et al.Anaemia in low-income and middle-income countries. The Lancet 2011; 378:2123-2135.
6. Balducci L.Epidemiology of anemia in the elderly: information on diagnostic evaluation. J Am Geriatr Soc 2003; 51:2-9.
7. Beghé C, Wilson A, Ershler WB. Prevalence and outcomes of anemia in geriatrics: a systematic review of the literature. The Am J Med 2004; 116:3-10.
8. Bekele A, Tilahun M, Mekuria A. Prevalence of anemia and Its associated factors among pregnant women attending antenatal care in health institutions of Arba Minch town, Gamo Gofa Zone, Ethiopia: A Cross-sectional study Anemia 2016;2016(3):1-9. DOI: 10.1155/2016/1073192.
9. Chalco JP, Huicho L, Alamo C, et al. Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis. BMC Pediatr 2005; 5:46.
10. Chulilla JAM, Colás MSR, Martín MG. 2009. Classification of anemia for gastroenterologists. World J Gastroenterol 2009;15:4627.
11. Clark SF 2008. Iron deficiency anemia. Nutr Clin Pract 2008; 23: 128-141.
12. Clark SF. 2009. Iron deficiency anemia: diagnosis and management. Curr Opin Gastroenterol 2009; 25: 122-128.
13. Cohen B, Gibor Y. Anemia and menstrual blood loss. Obstet Gynecol Surv 1980;35:597-618.
14. Cook JD. Diagnosis and management of iron-deficiency anaemia. Best Pract Res Clin Haematol 2005;18:319-332.
15. Cuervo L, Mahomed K. Treatments for iron deficiency anaemia in pregnancy. The Cochrane Database Syst Rev 2000;80(2): DOI: 10.1002/14651858.CD003094.
16. Dallman PR, Yip R, Johnson C.1984. Prevalence and causes of anemia in the United States, 1976 to 1980. The Am J Clin Nutr 1984; 39:437-445.
17. de Souza Queiroz S, Macrco A, de A T 2000. Iron deficiency anemia in children. Journal de pediatria 76.
18. Eftekhari M, Mozaffari-Khosravi H, Shidfar F.The relationship between BMI and iron status in iron-deficient adolescent Iranian girls. Public health Nutr 2009;12:2377-2381.
19. Gibson RS. Principles of nutritional assessment. Oxford university press 2005; USA.
20. Goddard AF, James MW, McIntyre AS, et al . Guidelines for the management of iron deficiency anaemia. Gut 2011; 60:1309.e1316. doi:10.1136/gut.2010.228874.
21. Goodnough LT, Schrier SL. Evaluation and management of anemia in the elderly. Am J Hematol 2014;89:88-96.
22. Guralnik JM, Eisenstaedt RS, Ferrucci L et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004; 104:2263-2268.
23. Haidar J . Prevalence of anaemia, deficiencies of iron and folic acid and their determinants in Ethiopian women. J Health, Popul Nutr 2010; 28:359.
24. Hurrell R, Egli I. Iron bioavailability and dietary reference values–. The Am J Clin Nutr 2010; 91:1461S-1467S.
25. Jain N, Jain VM. Prevalence of anemia in school children. Medical Pract Rev 2012;3:1-4.
26. Johnson-Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol 2011; 4:177-184.
27. Joosten E. Strategies for the laboratory diagnosis of some common causes of anaemia in elderly patients. Gerontol 2004; 50:49-56.
28. Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood 2014;123(5):615-24.
29. Keikhaei B, Askari R, Aminzadeh M 2012. Adolescent with unfeasible body mass index: a risk factor for iron deficiency anemia. J Health Med Informat 2012; 3(1):109.
30. Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician 2007; 75:671-678.
31. Kumera G, Haile K, Abebe N, Marie T, EsheteT.Anemia and its association with coffee consumption and hookworm infection among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia. PloS one 2018;13(11):e0206880. doi: 10.1371/journal.pone.0206880
32. Leenstra T, Kariuki SK, Kurtis JD, et al. Prevalence and severity of anemia and iron deficiency: cross-sectional studies in adolescent schoolgirls in western Kenya. European J Clin Nutr 2004;58:681.
33. Leung A, Chan KW. Iron deficiency anemia. Adv in Pediatr 2001; 48:385-408.
34. Moor CV. The importance of nutritional factors in the pathogenesis of iron-deficiency anemia. The Am J Clin Nutr 1955; 3:3-10.
35. Morck TA, Lynch S, Cook J. Inhibition of food iron absorption by coffee. The Am J Clin Nutr 1983; 37:416-420.
36. Pasricha SR, Flecknoe-Brown SC, Allen KJ, et al. 2010. Diagnosis and management of iron deficiency anaemia: a clinical update. Med J Aust 2010; 193:525-532.
37. Qureshi MIM, Khan SA, Farzana K, et al. Prevalence of iron deficiency in adult population: A case study from Khyber Pakhtunkhwa (KPK), Pakistan. International J Physical Sci 2012; 7:1874-1877.
38. Qureshi NA, Chauhan MAZ, Goswami A, et al. Study of anemia and its correlation with hematological parameters in patients of various age group. J Dental Med Sci 2015; 14;29-35.
39. Qurtom H, Al-Saleh Q, Lubani M. The value of red cell distribution width in the diagnosis of anaemia in children. European J Pediatr 1989; 148:745-748.
40. Saunders AV, Craig WJ, BainesSK, et al. Iron and vegetarian diets. The Medical Journal of Australia 2013; 199:11-16.
41. Sgnaolin V, Engroff P, Ely LS. Hematological parameters and prevalence of anemia among free-living elderly in south Brazil. Revista brasileira de hematologia e hemoterapia 2013; 35:115-118.
42. Stoltzfus RJ. Defining iron-deficiency anemia in public health terms: a time for reflection. The J Nutr 2001; 131, 565S-567S.
43. Tatala S, Svanberg U, Mduma B. Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania. The American journal of clinical nutrition 1998;68:171-178.
44. Tettamanti, M., Lucca, U., Gandini, F, et al. Prevalence, incidence and types of mild anemia in the elderly: the" Health and Anemia" population-based study. haematologica 2010;95(11):1849-56
45. Toteja G, SinghP, Dhillon B, et al. 2006. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull 2006; 27:311-315.
46. Valderrábano F. Quality of life benefits of early anaemia treatment. Nephrol Dialysis Transplant 2000;5: 23-28.
47. Walter T, De Andraca I, Chadud P, Perales, CG. 1989. Iron deficiency anemia: adverse effects on infant psychomotor development. Pediatrics 1989; 84:7-17.
48. World Health Organization. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. Geneva: WHO, 2001.
49. Zijp, I.M., Korver, O., Tijburg, L.B., 2000. Effect of tea and other dietary factors on iron absorption. Critical Rev in Food Sci Nutr 2000; 40:371-398.