Abstract:
Background: Anemia is a global public health problem that mainly affects pregnant women and children.
Anemia during pregnancy results in increased feto-maternal morbidity and mortality, especially in malaria
endemic areas. Inadequate access to micronutrients, malaria infection and intestinal parasitic infestation in
refugee environments can play a substantial role in exposing pregnant women to anemia.
Objective: To assess the prevalence, severity, type and associated factors of anemia among pregnant women in
South Sudanese refugees attending antenatal care Clinic at Pugnido Administration of Refugee and Returnee
Affairs Health Center, Gambela, Western Ethiopia.
Methods: A facility-based cross-sectional study involving 360 pregnant women was conducted in Pugnido
Administration of Refugee and Returnee Affairs Health Center from April 15 to June 30/2015. Data collection
was done after obtaining informed consent. Socio-demographic, obstetric and nutritional data were collected
using interviewer administered questionnaire. Mid-upper arm circumference measurement was taken. Complete
blood cell counting was done using CELL-DYN 1800 (Abbott Laboratories Diagnostics Division, USA).
Peripheral blood smear was examined for red blood cell morphological analysis and hemoparasite
identification. Stool specimen was examined for intestinal parasites detection. Anemia during pregnancy was
defined as hemoglobin concentration <11 g/dl. Statistical analyzes were done using Statistical Package for
Social Sciences (SPSS) version 20.0 for windows. Association between dependent and independent variables
was analyzed by logistic regression, and variables with P-value <0.05 were considered statistically significant.
Result: The overall prevalence of anemia was 36.1%. Majority of the anemic pregnant women had mild form
(89.2%), and the normocytic-normochromic (56.2%) type of anemia. The mean hemoglobin concentration was
11.3 ± 1.5 g/dl. Being in third trimester of pregnancy (AOR= 3.12, 95%CI:1.16-9.83), eating meat at most once
a week (AOR= 2.00, 95%CI:1.11-3.58), drinking tea immediately after meal at least once a day (AOR= 3.01,
95%CI:1.74-5.22), having mid-upper arm circumference below 21 cm (AOR= 3.90, 95%CI:1.94-7.84) and
intestinal parasitic infestation (AOR= 2.17, 95%CI:1.20-3.91) were significantly associated with anemia.
Conclusion: Anemia prevalence was a moderate public health problem, majority of which was mild and
normocytic-normochromic type. Third trimester, intestinal parasitic infestation, low mid-upper arm
circumference, less frequent eating of meat and repeated tea intake had increased the risk of anemia among
pregnant women. These identified factors should be considered for prevention and control of anemia with
particular attention on ensuring optimal micronutrient status among the pregnant women in the study area.
