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Journal of Public Health

, Volume 26, Issue 1, pp 39–49 | Cite as

Prevalence of anemia and associated factors in women of childbearing age in rural Lebanon

  • Michèle Kosremelli Asmar
  • Claire Ghafari Zablit
  • Rémy Daou
  • Joumana Stephan Yéretzian
  • Hélène Daoud
  • Alissar Rady
  • Randa Hamadeh
  • Walid Ammar
Original Article
  • 86 Downloads

Abstract

Aim

This community-based, cross-sectional survey was conducted to determine the prevalence of anemia and iron deficiency anemia (IDA) and their association with nutritional behavior and other determinants.

Subjects and methods

Arabic-speaking women, aged 15–49 years old, residing in Lebanon’s rural areas were included. Demographic and behavioral characteristics, obstetrical and gynecological history, personal and family medical history, and dietary intake data were collected. Predictors of anemia and IDA were determined using logistic regression.

Results

A total of 578 women were included (Lebanese: 55.2%; Syrian: 43.3%) in which 35.5% had anemia and 23.2% had IDA. The mean number of pregnancies was 3.1 ± 3.0 (number of children: 2.5 ± 2.5). In total, 30% had a personal history of anemia or IDA, 29% a family history of anemia, and 20% a family history of IDA. Iron-rich products were consumed by > 90% of the women, whereby > 66.7% mentioned eating liver, tuna, dates and nuts. Syrian nationality (OR = 2.21; CI 95%: 1.38–3.54), age (OR = 1.03, CI 95%: 1.00–1.06), personal history of anemia (OR = 1.97; CI 95%: 1.31–2.95), consumption of dates (OR = 2.07, CI 95%: 1.29–3.31), molasses (OR = 1.61; CI 95%: 1.03–2.51), and soft drinks > 5 times/week (OR = 1.66; CI 95%: 1.09–2.53) were predictors of anemia. Syrian nationality (OR = 1.73, CI 95%: 1.14–2.62), number of pregnancies (OR = 1.08; CI 95%: 1.01–1.15), period > 8 days (OR = 2.01, CI 95%: 1.07–3.80), consumption of eggs (OR = 0.48; CI 95%: 0.25–0.90), dates (OR = 2.58, CI 95%: 1.49–4.46), and coffee or tea (OR = 1.59, CI 95%: 1.03–2.45) were predictors of IDA.

Conclusion

Anemia and IDA are prevalent in women of childbearing age in rural Lebanon. Intervention programs for raising the population’s awareness about IDA’s risk factors and proper nutrition must be implemented.

Keywords

Anemia Diet Iron deficiency Lebanon Refugees 

Notes

Funding

This study was funded by the World Health Organization, Beirut, Lebanon—WHO reference: L/WR/LEB/07/004; WHO registration: 2015/519330–1; Reg file unit reference: EM-LEB-2015-APW-081.

Compliance with ethical standards

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Ethical Committee of Saint-Joseph University, Beirut, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interests

None.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Al Quaiz JM, Abdulghani HM, Khawaja RA, Shaffi-Ahamed S (2012) Accuracy of various iron parameters in the prediction of iron deficiency anemia among healthy women of child bearing age, Saudi Arabia. Iran Red Crescent Med J 14:397–394Google Scholar
  2. Geissler C, Singh M (2011) Iron, meat and health. Nutrients 3(3):283–316.  https://doi.org/10.3390/nu3030283 CrossRefPubMedPubMedCentralGoogle Scholar
  3. Hurrell R, Egli I (2010) Iron bioavailability and dietary reference values. Am J Clin Nutr 91(5):1461S–1467SCrossRefPubMedGoogle Scholar
  4. Hwalla N, Adra N, Jackson R (2004) Iron deficiency is an important contributor to anemia among reproductive age women in Lebanon. Ecol Food Nutr 43(1–2):77–92Google Scholar
  5. Institute of Medicine (2002) Dietary reference intake for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, manganese, molybdenum, nickel, silicon, vanadium and zinc. National Academy Press, Eastern Mediterranean Regional Office, Washington, DCGoogle Scholar
  6. Milman N (2011) Anemia: still a major health problem in many parts of the world. Ann Hematol 90:369–377CrossRefPubMedGoogle Scholar
  7. Pasricha SR, Drakesmith H, Black J, Hipgrave D, Biggs BA (2013) Control of iron deficiency anemia in low and middle income countries. Blood 121(14):2067–2017CrossRefGoogle Scholar
  8. Short M, Domagalski J (2013) Iron deficiency anemia: evaluation and management. Am Fam Physician 87:98–104PubMedGoogle Scholar
  9. UNHCR (2015) UNHCR country operations profile: Lebanon. http://data.unhcr.org/syrianrefugees/regional.php. Accessed September 2017
  10. WHO (1996) Guidelines for the control of iron deficiency in countries of the Eastern Mediterranean, Middle East and North Africa. (WHO/NUT/177,E/G/11.96/1000). http://whqlibdoc.who.int/cgi-bin/repository.pl?url=/emro/1994-99/WHO-EM_NUT_177.pdf. Accessed September 2017
  11. WHO (2001) Iron deficiency anemia assessment, prevention and control: a guide for programme managers. http://apps.who.int/iris/bitstream/10665/66914/1/WHO_NHD_01.3.pdf?ua=1. Accessed September 2017
  12. WHO (2011a) Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. http://www.who.int/vmnis/indicators/serum_ferritin.pdf. Accessed September 2017
  13. WHO (2011b) Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. http://apps.who.int/iris/bitstream/10665/85839/3/WHO_NMH_NHD_MNM_11.1_eng.pdf?ua=1. Accessed September 2017
  14. WHO (2015) The global prevalence of anemia in 2011. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017
corrected publication January/2018

Authors and Affiliations

  • Michèle Kosremelli Asmar
    • 1
  • Claire Ghafari Zablit
    • 2
  • Rémy Daou
    • 2
  • Joumana Stephan Yéretzian
    • 1
  • Hélène Daoud
    • 2
  • Alissar Rady
    • 3
  • Randa Hamadeh
    • 4
  • Walid Ammar
    • 4
  1. 1.Higher Institute of Public Health (ISSP), Campus of Medical SciencesSaint-Joseph University of BeirutBeirutLebanon
  2. 2.Centre Universitaire de Santé Familiale et Communautaire (CUSFC), Saint-Joseph University of BeirutBeirutLebanon
  3. 3.Beirut OfficeWorld Health OrganizationBeirutLebanon
  4. 4.Ministry of Public HealthBeirutLebanon

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