P H Nguyen1, I Gonzalez-Casanova2, H Nguyen3, H Pham3, T V Truong3, S Nguyen3, R Martorell2, U Ramakrishnan2. 1. 1] Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam [2] Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Hanoi, Vietnam. 2. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 3. Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam.
Abstract
BACKGROUND/ OBJECTIVES: Anemia is a significant public health concern, especially among women and young children. An improved understanding of the complex etiology of anemia is crucial for developing appropriate prevention strategies. This paper examines the determinants of anemia in a large sample of Vietnamese women of reproductive age (WRA). METHODS: We included baseline data from 4986 WRA participating in a randomized controlled trial (PRECONCEPT). Hemoglobin (Hb) concentrations were measured with Hemocue. Plasma ferritin (Fe), retinol binding protein (RBP) and markers of inflammation were assessed using the ELISA technique. We used multivariate logistic regression to describe associations with anemia and structural equation modeling (SEM) to characterize direct and indirect pathways influencing Hb concentrations. RESULTS:Prevalence of anemia, iron deficiency (Fe <12 μg/l), insufficient iron stores (Fe<30 μg/l) and iron deficiency anemia was 19.7, 3.5, 14.4 and 1.9%, respectively. Ferritin concentration (0.29 per log-mg/dl), being an ethnic minority (-0.24 compared with Kinh), number of children (-0.17) and socioeconomic status (0.09) were directly associated with Hb concentration (P<0.05). Similarly, RBP was directly (0.27 per mg/dl) associated with Hb and also indirectly (0.09 mg/dl) with ferritin. Hookworm infection was indirectly associated with Hb (-0.11) through RBP and ferritin. CONCLUSION: These findings illustrate the complex etiology of anemia and provide a useful framework for designing, targeting and evaluating appropriate strategies for the prevention and control of anemia. Contrary to expectations, iron deficiency accounted for a very small proportion of anemia in Northern Vietnam.
RCT Entities:
BACKGROUND/ OBJECTIVES:Anemia is a significant public health concern, especially among women and young children. An improved understanding of the complex etiology of anemia is crucial for developing appropriate prevention strategies. This paper examines the determinants of anemia in a large sample of Vietnamese women of reproductive age (WRA). METHODS: We included baseline data from 4986 WRA participating in a randomized controlled trial (PRECONCEPT). Hemoglobin (Hb) concentrations were measured with Hemocue. Plasma ferritin (Fe), retinol binding protein (RBP) and markers of inflammation were assessed using the ELISA technique. We used multivariate logistic regression to describe associations with anemia and structural equation modeling (SEM) to characterize direct and indirect pathways influencing Hb concentrations. RESULTS: Prevalence of anemia, iron deficiency (Fe <12 μg/l), insufficientiron stores (Fe<30 μg/l) and iron deficiency anemia was 19.7, 3.5, 14.4 and 1.9%, respectively. Ferritin concentration (0.29 per log-mg/dl), being an ethnic minority (-0.24 compared with Kinh), number of children (-0.17) and socioeconomic status (0.09) were directly associated with Hb concentration (P<0.05). Similarly, RBP was directly (0.27 per mg/dl) associated with Hb and also indirectly (0.09 mg/dl) with ferritin. Hookworm infection was indirectly associated with Hb (-0.11) through RBP and ferritin. CONCLUSION: These findings illustrate the complex etiology of anemia and provide a useful framework for designing, targeting and evaluating appropriate strategies for the prevention and control of anemia. Contrary to expectations, iron deficiency accounted for a very small proportion of anemia in Northern Vietnam.
Authors: Phuong H Nguyen; Alyssa E Lowe; Reynaldo Martorell; Hieu Nguyen; Hoa Pham; Son Nguyen; Kimberly B Harding; Lynnette M Neufeld; Gregory A Reinhart; Usha Ramakrishnan Journal: BMC Public Health Date: 2012-10-24 Impact factor: 3.295
Authors: Anne M Williams; O Yaw Addo; Scott D Grosse; Nicholas J Kassebaum; Zane Rankin; Katherine E Ballesteros; Helen Elizabeth Olsen; Andrea J Sharma; Maria Elena Jefferds; Zuguo Mei Journal: Ann N Y Acad Sci Date: 2019-07-02 Impact factor: 6.499
Authors: Phuong H Nguyen; Melissa Young; Ines Gonzalez-Casanova; Hoa Q Pham; Hieu Nguyen; Truong V Truong; Son V Nguyen; Kimberly B Harding; Gregory A Reinhart; Reynaldo Martorell; Usha Ramakrishnan Journal: PLoS One Date: 2016-12-05 Impact factor: 3.240
Authors: Ellen S Michalski; Phuong H Nguyen; Ines Gonzalez-Casanova; Son V Nguyen; Reynaldo Martorell; Vin Tangpricha; Usha Ramakrishnan Journal: J Clin Transl Endocrinol Date: 2017-05-04
Authors: Daniel J Raiten; Lynnette M Neufeld; Luz-Maria De-Regil; Sant-Rayn Pasricha; Ian Darnton-Hill; Richard Hurrell; Laura E Murray-Kolb; K Madhavan Nair; Terry Wefwafwa; Roland Kupka; Modou Cheyassin Phall; Fayrouz A Sakr Ashour Journal: Adv Nutr Date: 2016-01-15 Impact factor: 8.701