Prevalence and factors associated with anemia among pregnant women in Nakfa district, Eritrea: A cross-sectional study

Background: Anemia in pregnancy is a fairly common public health problem with major implications for fetal and maternal health. Despite its importance, data on pregnancy-related anemia is hard to obtain for countries in Sub-Saharan Africa. In this study, we aimed to determine the prevalence of anemia and associated risk factors in women attending Antenatal clinic of Nakfa hospital, Nakfa sub-zone, Eritrea. Methods: Hospital based cross-sectional study was conducted from 1 ^st May – 31 ^st August of 2024. In total, 283 women, visiting Nakfa hospital Antenatal Care clinic, were enrolled. Relevant metadata was collected via researcher administered questionnaire and medical records. In addition, standard phlebotomy techniques were employed to collect specimen for diagnosis of anemia. To identify and categorize anemia, the WHO criteria was employed. Data were analyzed using SPSS software version 26. Result: The median age of the participants was 25 years [IQR: 22-28 years] with minimum and maximum age of 18 and 42 years, respectively. The overall, prevalence of anemia was 43% (95% CI: 38.9 – 48.7) with a mean hemoglobin concentration of 11.09 gm/dl (±1.64 SD). Among patients with anemia, 25% had moderate anemia and 17.6% had mild anemia. Factors associated with anemia in the bivariate analysis included level of education of mother and husband, mode of transport; and trimester. Protective factors included consumption of meat, poultry or diary; dark green vegetables; and fresh fruits. However, anemia was higher among the participants who took Iron-Folate than those who did not take (63% Vs 10%, p<0.01 ). In the multivariate analysis age was negatively associated with anemia (AOR=0.9, 95% CI: 0.8-0.9, p=0.03 ). Those who traveled by animal carrier or car (AOR=2.3, 95% CI:1.2-4.7, p=0.01 ), women in third trimester (AOR=2.7, CI:1.5-5.1, p=0.001 ), those who did not consume dark green vegetable (AOR=2.1, 95% CI:1.1-4, p=0.002 ) and participants with more than four children (AOR=3, CI:1.01-9.2, p= 0.048 ) had higher rate of anemia. Conclusion: This study demonstrated that the prevalence of anemia is high among pregnant women attending Nakfa hospital’s ANC clinic. The findings underscore the urgent need for improved ANC monitoring along with relevant public health strategies directed at addressing the problem. In addition, expanded research on anemia etiology is warranted.