Table 4. Determinants of anemia, iron and folate deficiency in non-pregnant women 15–49 years of age, Sierra Leone 2013.
| Anemia (n = 871) | Iron deficiency (n = 774) | Folate deficiency (n = 766) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Characteristic | % a, b | (95% CI)c | P value d | % a, e | (95% CI)c | P value d | % f | (95% CI)c | P value d |
| Age group (in years) | |||||||||
| 15–19 | 46.0 | (36.6, 55.7) | 0.263 | 10.3 | (5.6, 18.2) | 0.595 | 84.2 | (74.8, 90.5) | 0.190 |
| 20–24 | 41.0 | (32.2, 50.4) | 10.2 | (5.6, 17.7) | 82.0 | (73.5, 88.1) | |||
| 25–29 | 38.0 | (30.0, 46.7) | 5.5 | (2.7, 10.9) | 87.2 | (79.3, 92.4) | |||
| 30–34 | 47.3 | (37.0, 57.7) | 9.8 | (4.9, 18.7) | 80.7 | (69.6, 88.5) | |||
| 35–39 | 49.6 | (37.3, 62.0) | 8.7 | (3.4, 20.6) | 71.2 | (59.2, 80.9) | |||
| 40–44 | 45.9 | (32.7, 59.7) | 5.8 | (2.4, 13.2) | 73.0 | (59.4, 83.4) | |||
| 45–49 | 60.4 | (44.4, 74.4) | 3.2 | (0.8, 12.6) | 61.9 | (39.5, 80.1) | |||
| Residence | |||||||||
| Urban | 42.9 | (36.4, 49.6) | 0.474 | 7.8 | (5.0, 12.0) | 0.719 | 82.3 | (77.4, 86.3) | 0.185 |
| Rural | 46.2 | (39.7, 52.9) | 8.7 | (5.8, 12.9) | 76.6 | (68.2, 83.4) | |||
| Region | |||||||||
| East | 46.0 | (34.3, 58.2) | 0.481 | 9.9 | (5.6, 17.1) | 0.706 | 79.8 | (61.2, 90.8) | 0.180 |
| North | 48.5 | (39.4, 57.7) | 7.0 | (3.7, 12.9) | 75.7 | (67.2, 82.6) | |||
| South | 43.5 | (34.8, 52.5) | 7.5 | (4.5, 12.3) | 88.2 | (81.4, 92.8) | |||
| West | 39.2 | (34.1, 44.7) | 9.9 | (5.8, 16.3) | 74.9 | (67.3, 81.2) | |||
| Education | |||||||||
| Never attended school | 46.2 | (40.1, 52.5) | 0.630 | 7.9 | (5.4, 11.5) | 0.384 | 78.1 | (71.3, 83.7) | 0.692 |
| Primary school or less | 45.6 | (32.6, 59.2) | 4.9 | (2.2, 10.8) | 78.0 | (65.3, 87.0) | |||
| Some secondary and above | 41.9 | (35.6, 48.5) | 10.1 | (5.9, 16.8) | 81.3 | (74.6, 86.5) | |||
| Wealth Quintile | |||||||||
| Lowest | 50.9 | (41.6, 60.1) | 0.485 | 4.6 | (2.2, 9.2) | 0.309 | 77.0 | (62.0, 87.3) | 0.948 |
| Second | 44.9 | (35.5, 54.6) | 8.6 | (4.7, 15.3) | 80.8 | (72.5, 87.1) | |||
| Middle | 44.0 | (33.5, 55.0) | 9.0 | (5.1, 15.6) | 78.1 | (65.0, 87.2) | |||
| Fourth | 44.5 | (34.4, 55.1) | 12.2 | (6.7, 21.3) | 80.5 | (72.8, 86.5) | |||
| Highest | 38.5 | (32.3, 45.1) | 7.8 | (4.5, 13.3) | 78.1 | (69.6, 84.7) | |||
| Consumed iron tablets or syrup in past 6 months | |||||||||
| Yes | 40.9 | (33.3, 48.9) | 0.23 | 11.3 | (6.9, 18.0) | 0.21 | 75.0 | (66.5, 82.0) | 0.136 |
| No | 46.5 | (40.9, 52.2) | 7.5 | (5.0, 11.1) | 80.6 | (75.4, 84.9) | |||
| Consumed foods rich in iron in past 24 hours | |||||||||
| Yes | 45.5 | (39.9, 51.1) | 0.654 | 13.0 | (9.6, 17.4) | 0.770 | 80.3 | (73.8, 85.5) | 0.399 |
| No | 43.3 | (35.5, 51.5) | 12.2 | (8.0, 18.1) | 76.8 | (69.8, 82.7) | |||
| Iron status | |||||||||
| Deficient (<12 μg/L) | 74.8 | (61.8, 84.5) | <0.001 | - | - | - | 85.9 | (73.1, 93.1) | 0.177 |
| Sufficient (≥12 μg/L) | 40.9 | (35.7, 46.2) | - | - | 78.2 | (73.1, 82.6) | |||
| Consumed folic acid tablets in past 6 months | |||||||||
| Yes | 40.5 | (33.7, 47.7) | 0.16 | 11.1 | (7.4, 16.2) | 0.09 | 77.7 | (69.8, 84.0) | 0.416 |
| No | 47.5 | (40.9, 54.1) | 7.0 | (4.7, 10.4) | 80.3 | (75.5, 84.3) | |||
| Consumed foods rich in folate in past 24 hours | |||||||||
| Yes | 44.7 | (39.8, 49.7) | 0.968 | 12.1 | (9.3, 15.6) | 0.393 | 80.1 | (75.0, 84.4) | 0.216 |
| No | 44.9 | (34.7, 55.6) | 15.6 | (8.6, 26.6) | 74.1 | (62.6, 83.0) | |||
| Folate status | |||||||||
| Deficient (<10ηmol/L) | 46.1 | (40.6, 51.7) | 0.218 | 9.1 | (6.6, 12.5) | 0.135 | - | - | - |
| Sufficient (≥10ηmol/L) | 39.1 | (29.8, 49.4) | 5.0 | (2.2, 11.1) | - | - | |||
| Consumed multi-vitamin tablets or syrup in past six months | |||||||||
| Yes | 42.4 | (34.9, 50.2) | 0.47 | 11.2 | (6.8, 17.9) | 0.17 | 73.8 | (65.1, 81.0) | 0.046 |
| No | 45.3 | (40.3, 50.5) | 7.7 | (5.5, 10.8) | 80.4 | (75.6, 84.5) | |||
| Malaria status g | |||||||||
| Positive | 54.4 | (46.5, 62.1) | <0.01 | 8.6 | (4.9, 14.7) | 0.97 | 81.4 | (72.8, 87.8) | 0.333 |
| Negative | 39.3 | (33.8, 45.1) | 8.5 | (6.0, 11.9) | 77.8 | (72.6, 82.3) | |||
| Inflammation | |||||||||
| Incubation | 41.3 | (27.0, 57.2) | <0.05 | 12.0 | (4.9, 26.5) | 0.55 | 77.9 | (63.6, 87.7) | 0.322 |
| Early convalescence | 58.5 | (47.3, 68.9) | 4.6 | (1.5, 13.9) | 84.5 | (72.8, 91.7) | |||
| Late convalescence | 27.6 | (15.6, 43.9) | 9.9 | (3.7, 24.1) | 69.5 | (52.1, 82.7) | |||
| None | 45.6 | (40.2, 51.2) | 8.3 | (5.9, 11.4) | 79.6 | (73.9, 84.3) | |||
| Vitamin A insufficiency | |||||||||
| Insufficient (<1.05 μmol/L) | 51.5 | (42.5, 60.4) | 0.117 | 18.8 | (11.4, 29.4) | 0.093 | 86.4 | (78.7, 91.6) | 0.066 |
| Sufficient (>1.05 μmol/L) | 43.7 | (38.4, 49.2) | 11.3 | (8.2, 15.3) | 77.6 | (71.5, 82.7) | |||
a Percentages weighted for unequal probability of selection.
b Anemia defined as hemoglobin <110 g/L adjusted for altitude.
c CI = confidence interval, calculated taking into account the complex sampling design.
d Chi-square p-value <0.05 indicates that the proportion in at least one subgroup is statistically significantly different from the values in the other subgroups
e Iron deficiency defined as plasma ferritin <12 μg/L, values are adjusted for inflammation according to Thurnham [16].
f Vitamin A deficiency defined as retinol binding protein <0.70 μmol/L.
g Malaria status identified using rapid test kits testing for Plasmodium falciparum