Anemia in women of reproductive age in Ecuador: Data from a national survey

PLoS One. 2020 Sep 24;15(9):e0239585. doi: 10.1371/journal.pone.0239585. eCollection 2020.

Abstract

Background: Anemia is a condition characterized by a decline in the number of functional red blood cells or hemoglobin. Women of reproductive age from low- and middle-income countries are at higher risk of anemia, which could lead to prenatal, obstetric and perinatal complications. The aim of our study was to explore associations between anemia status and a set of demographic, socio-economic and reproductive factors, among Ecuadorian women of reproductive age (WRA).

Methods: We used data from non-pregnant, WRA (≥12 and ≤49 years) women enrolled in the nationally representative cross-sectional Ecuadorian National Health and Nutrition Survey 2012 (ENSANUT-ECU 2012). Anemia and moderate-severe anemia were assessed using hemoglobin concentrations cutoffs of <12 g/dL and <11 g/dL, respectively. Logistic regression was used to obtain unadjusted and adjusted prevalence odds ratios (aOR). All analyzes were adjusted for multi-stage sampling, stratification and clustering.

Results: The study population included a subset of 7415 non-pregnant WRA. Mean hemoglobin concentration was 12.84 g/dL (95% CI = 12.8-12.9). The overall prevalence of anemia and moderate-severe anemia was 16.8% and 5.0%, respectively. Some factors were associated with an increase in anemia prevalence odds: living in Guayaquil (aOR 1.82, 95% CI 1.16-2.84) and Quito (aOR 1.84, 95% CI 1.17-2.90) compared to living in the rural Amazon, having given birth to more than four alive children compared with being nulliparous (aOR 1.85, 95% CI 1.00-3.43), currently taking contraceptives compared with former use (aOR 1.46, 95% CI 1.09-1.97). In addition, moderate-severe anemia was associated with age and region of residence.

Conclusion: In 2012, the prevalence of anemia among Ecuadorian WRA was considered a mild public health concern. However, we identified groups with higher anemia prevalence. Thus, emphasizing the importance of analyzing the prevalence in sub-populations of WRA and identifying populations where more frequent surveillance may be helpful.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia / epidemiology*
  • Cross-Sectional Studies
  • Ecuador / epidemiology
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Odds Ratio
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Prevalence
  • Reproduction
  • Risk Factors
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

The institutions, Universidad San Francisco de Quito through the Grupo de Quimica Computacional y Téorica, (QCT), the Instituto de Simulación Computacional (ISC) and the USFQ Research Publication Fund supported this research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.