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Morphological patterns of anaemia among pregnant women from Sudan.

ABSTRACT: Background:Morphological patterns of anaemia in pregnancy are considered essential for classification, diagnosis and management of patients, especially in regions with high maternal mortality like Sudan. Objectives:This study evaluated morphological patterns of anaemia among pregnant women in Sudan and morphological differences across characteristics of participants. Methods:This cross-sectional study was conducted from September 2016 to February 2017. A total of 200 women were selected according to specific criteria. Laboratory tests were performed for complete blood count, blood smears were performed for morphology and vitamin B12, folate and iron levels were measured. Participants were classified as: normochromic normocytic, microcytic hypochromic, macrocytic or dimorphic. Further classification based on haemoglobin levels was also performed. Results:A total of 116 participants (58%) had a dimorphic pattern, followed by 50 participants (25%) with a microcytic hypochromic pattern, 20 participants (10%) with a macrocytic pattern and 14 participants (7%) with a normochromic normocytic pattern. Participants with the dimorphic pattern also had low levels of iron and folate. The majority of dimorphic participants presented with mild anaemia, whereas the majority of participants with the microcytic hypochromic pattern presented with moderate or severe anaemia. A high percentage of participants in late pregnancy had the dimorphic pattern, and there were significant differences in the degree of anaemia by parity, gestational age and regular intake of haematinic supplements. Conclusion:The most frequent morphological pattern of anaemia in this study was dimorphic, followed by microcytic hypochromic, macrocytic and normochromic patterns. Morphological patterns appeared to predict types of vitamin and mineral deficiency and the degree of anaemia.

SUBMITTER: Abusharib AB

PROVIDER: S-EPMC6852600 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Morphological patterns of anaemia among pregnant women from Sudan.

Abusharib Abuobieda B AB

African journal of laboratory medicine 20191014 1

<h4>Background</h4>Morphological patterns of anaemia in pregnancy are considered essential for classification, diagnosis and management of patients, especially in regions with high maternal mortality like Sudan.<h4>Objectives</h4>This study evaluated morphological patterns of anaemia among pregnant women in Sudan and morphological differences across characteristics of participants.<h4>Methods</h4>This cross-sectional study was conducted from September 2016 to February 2017. A total of 200 women ...[more]

PMID: 31745454

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Project description:BackgroundReducing the burden of anaemia is a critical global health priority that could improve maternal outcomes amongst pregnant women and their neonates. As more counties in Kenya commit to universal health coverage, there is a growing need for optimal allocation of the limited resources to sustain the gains achieved with the devolution of healthcare services. This study aimed to describe the spatio-temporal patterns of maternal anaemia prevalence in Kenya from 2016 to 2019.MethodsQuarterly reported sub-county level maternal anaemia cases from January 2016 - December 2019 were obtained from the Kenyan District Health Information System. A Bayesian hierarchical negative binomial spatio-temporal conditional autoregressive (CAR) model was used to estimate maternal anaemia prevalence by sub-county and quarter. Spatial and temporal correlations were considered by assuming a conditional autoregressive and a first-order autoregressive process on sub-county and seasonal specific random effects, respectively.ResultsThe overall estimated number of pregnant women with anaemia increased by 90.1% (95% uncertainty interval [95% UI], 89.9-90.2) from 155,539 cases in 2016 to 295,642 cases 2019. Based on the WHO classification criteria, the proportion of sub-counties with normal prevalence decreased from 28.0% (95% UI, 25.4-30.7) in 2016 to 5.4% (95% UI, 4.1-6.7) in 2019, whereas moderate anaemia prevalence increased from 16.8% (95% UI, 14.7-19.1) in 2016 to 30.1% (95% UI, 27.5-32.8) in 2019 and severe anaemia prevalence increased from 7.0% (95% UI, 5.6-8.6) in 2016 to 16.6% (95% UI, 14.5-18.9) in 2019. Overall, 45.1% (95% UI: 45.0-45.2) of the estimated cases were in malaria-endemic sub-counties, with the coastal endemic zone having the highest proportion 72.8% (95% UI: 68.3-77.4) of sub-counties with severe prevalence.ConclusionAs the number of women of reproductive age continues to grow in Kenya, the use of routinely collected data for accurate mapping of poor maternal outcomes remains an integral component of a functional maternal health strategy. By unmasking the sub-county disparities often concealed by national and county estimates, our study findings reiterate the importance of maternal anaemia prevalence as a metric for estimating malaria burden and offers compelling policy implications for achieving national nutritional targets.

Project description:Anaemia in pregnancy is a major health problem and an important cause of adverse foetomaternal outcomes in developing countries. Iron deficiency is the cause of the overwhelming majority of the cases of anaemia in pregnancy. Iron deficiency anaemia (IDA) has been linked with adverse foetal and maternal outcomes. This study investigated the prevalence of IDA and evaluated its effects on foetomaternal outcomes among parturients in Lagos, Nigeria. This was a cross-sectional study that enrolled 220 women aged 15-49 years with singleton gestation at term, between May 1, 2016, and March 31, 2017. Participants were selected by systematic sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure haemoglobin and serum ferritin concentrations, and the associations between IDA (defined as anaemia and iron deficiency) and pregnancy outcomes were examined. A P-value <0.05 was considered as statistically significant. The prevalence of IDA was 12.3%. Routine antenatal iron supplementation (adjusted odds ratio 0.18, 95% confidence interval 0.07-0.46; P = 0.001) and interpregnancy interval of at least 2 years (adjusted odds ratio 0.20, 95% confidence interval 0.05-0.97; P = 0.021) have significant association with IDA. Iron deficiency anaemia was not significantly associated with adverse perinatal outcomes but there were significant associations with increased risk of blood transfusion (P = 0.001) and maternal infectious morbidities such as puerperal pyrexia (P = 0.041) and wound infection (P = 0.020). IDA is still a fairly common condition among parturients in Lagos and it's mostly associated with maternal peripartum morbidities. Adequate pregnancy spacing through the use of effective contraception and routine antenatal iron supplementations in pregnancy is a recommended preventive measure against IDA and its adverse sequelae. Future studies should adopt the use of transferrin saturation (TSAT) in compliment with serum ferritin assay as a more sensitive marker of iron deficiency.

Project description:BackgroundAnemia during pregnancy is a public health problem especially in developing countries and it is associated with maternal and perinatal adverse outcomes. There is no meta-analysis on anemia during pregnancy in Sudan. The current systemic review and meta-analysis was conducted to assess the prevalence, types and determinant of anemia during pregnancy in Sudan.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases (PubMed, Cochrane Library, Google Scholar, CINAHL, and African Journals Online) were searched using; anemia, pregnancy related anemia and Sudan. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Modified Newcastle - Ottawa quality assessment scale were used for critical appraisal of studies. The pooled Meta logistic regression was computed using OpenMeta Analyst software.ResultsSixteen cross-sectional studies included a total of 15, 688 pregnant women were analyzed. The pooled prevalence of anemia among pregnant women in Sudan was 53.0% (95%, CI?=?45.9-60.1). The meta-analysis showed no statistical significant between the age (mean difference?=?0.143, 95 CI?=?-?0.033?-?0.319, P?=?0.112), parity (mean difference?=?0.021, 95% CI?=?-?0.035?-?0.077, P?=?0.465) between the anemic and no anemic women. Malaria was investigated in six studies. Pregnant women who had malaria infection during pregnancy were 1.94 times more likely to develop anemia than women who had no malaria infection (OR?=?1.94, 95% CI =1.33-2.82). Six (37.5%) studies investigated type of anemia. The pooled prevalence of iron deficiency anemia (IDA) among pregnant women in Sudan was 13.6% (95% CI?=?8.9-18.2).ConclusionThere is a high prevalence of anemia among pregnant in the different region of Sudan. While age and parity have no association with anemia, malaria infection was associated with anemia. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition, and malaria preventive measures are needed to reduce the high level of anemia among pregnant women in Sudan.

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Morphological patterns of anaemia among pregnant women from Sudan.

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Morphological patterns of anaemia among pregnant women from Sudan.

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