Prevalence and Factors Associated to Persistent Anemia among Pregnant Women in the Buea Health District, Cameroon

Introduction: Anemia in pregnancy represents a life-threatening but preventable reason for maternal and childhood morbidity and mortality. Although intervention measures are practiced in most affected countries like Cameroon, the impact of anemia on pregnant women is still apparent in most local communities. The relative contribution of sociodemographic related to anemia throughout gestation varies greatly and warrants investigation in urban and rural communities in developing countries, where the condition is most apparent.

Methods: A cross-sectional study design was carried out from February to July 2019 at six sites, Regional Hospital Buea, Bokwango Integrated Health Center (IHC), Buea - Road IHC, Buea town IHC, Molyko IHC, and Great Soppo IHC. A total of 408 pregnant women were enrolled in the study. The sociodemographic characteristics identified through questionnaires filled by the participants included age, marital status, educational status, occupation, gravida status, alcohol intake, iron folate intake, knowledge on anemia and crave for non-food substance. The clinical factors of participants gathered included previous records of diarrhea within the last 6 months, diagnosis for worm infection for the last 6 months, diagnosis for Malaria for the last 6 months. A blood sample was collected and analyzed with a haemoglobinometer ( HemoCue 201+ system, Sweden). SPSS version 22 statistical package software was used to perform the data analysis. Factors related to anemia among participants unadjusted and adjusted odds ratios with their 95%CI were calculated using logistic regression models.

Results: The prevalence of anemia was 50 %. Among the anemic study participants 0.74 %, 11.76 %, and 37.50 % recorded severe, moderate, and mild levels of anemia respectively. The majority of the anemic participants 195 (95.6%) and 126 (61.8) had recently been diagnosed for Malaria and worm infections respectively. Craving for non-food substances (Calabar clay) and poor adherence to iron folate intake had a prevalence of 120 (58.8%) and 117 (57.4%) respectively. Multinomial logistic regression analysis showed that, irregular adherence to iron folate intake and reduce intake of iron folate frequency 2-3 times/week was statistically significantly associated with anemia (p=0.0001 and p= 0.0001 respectively). We equally observed a statistically significant association of alcohol drink consumption and craving for non-food substances (Calabar clay) with anemia (p=0.004 and p=0.0001 respectively). Cases of worm infection for the last 6 months were statistically significantly related to anemia (p = 0.004).

Conclusion: Anemia is high among pregnant women in the Buea health district. Factors associated with persistent anemia despite intervention measures in the community hospitals include malaria; no intake or reduced intake of iron folate; alcohol drinks consumption; craving for non-food substances (Calabar clay) and previously diagnosed worm infection within the last 6 months.