Anemia during pregnancy
is a major public health problem, with a global prevalence of 41.8%. It is associated
with high morbidity and mortality. Information on the prevalence of anemia and associated
factors among pregnant women in the study area is limited. This study aimed at determining
the prevalence and predictors of anemia among pregnant women attending antenatal
clinics (ANC) in Kyenjojo and Kole Districts, Uganda. Cross-sectional study was
conducted among randomly selected pregnant women. Quantitative data was collected
using a structured questionnaire that captured demographic and obstetric characteristics.
Haemoglobin concentration (Hb) was determined using HemoCue 201+. The
study outcome was the prevalence of anaemia (Hb <11 g/dl). Chi-square, odds ratio,
and logistic regression were used to test for associations. Of the total 760 pregnant
women who participated in this study, 20.1% were anaemic. The prevalence varied
from 13.4% in Kyenjojo to 26.9% in Kole District. Of 153 anaemic women, 121 (97%)
were mildly anaemic, 27 (18%) moderately anemic, and 5(3%) severely anemic. Malaria
infection [AOR: 0.46, 95% CI (0.26 – 0.83)], primigravida [AOR: 0.52, 95% CI: 0.29-0.93],
and residing in Kole [AOR: 0.50, 95% CI: 0.32-0.76] were significant predictors
of low haemoglobin concentration. This study highlighted the high prevalence of
anaemia in our settings and the significant association between anaemia and malaria
among pregnant women. Therefore, routine screening of pregnant women for anemia,
malaria, and other risk factors during their first ANC visit is recommended to identify
those at risk and prompt management provided to curb their negative consequences.
 McLean E et al., 2009. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005, Public Health Nutrition, vol. 12, no. 4, pp. 444–454.
 WHO 2008. Worldwide Prevalence of Anaemia 1993-2005: WHO Global Database on Anaemia, World Health Organization, Geneva Available from: http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf.
 Susan T and Blackburn D.O,
2007. Maternal, Fetal, & Neonatal Physiology, Clinical Perspective. Qualitative
Health Research, vol. 11, no. 6, pp. 780–794. Available from:
 UNICEF WHO,
Maternal Mortality in 2005: Estimates Developed by WHO, UNICEF, UNFPA and World
Bank, WHO, Geneva, Switzerland. Available from:
 Liyew A.M, et al., 2021. Prevalence
and determinants of anemia among pregnant women in East Africa; A multi-level analysis
of recent Demographic and Health Surveys. PLoS One. 16(4): e0250560. doi:
 Nyamu G.W et al., 2020. Prevalence
and risk factors associated with asymptomatic Plasmodium falciparum infection and
anemia among pregnant women at the first antenatal care visit: A hospital-based
cross-sectional study in Kwale County, Kenya. PLoS One. 15(10): e0239578.
 Mlugu E.M, et al., 2020. Prevalence
and Correlates of Asymptomatic Malaria and Anemia on First Antenatal Care Visit
among Pregnant Women in Southeast, Tanzania. International Journal Environmental
Research and Public Health. 17(9):3123.30. doi: 10.3390/ijerph17093123.
 Okube, O.T, et al., 2016. Prevalence
and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic
in the Second and Third Trimesters at Pumwani Maternity Hospital, Kenya. Open
Journal of Obstetrics and Gynecology, 6, 16-27. http://dx.doi.org/10.4236/ojog.2016.61003.
 UDHS. Uganda Bureau of Statistics
(UBOS) and ICF. 2016. Uganda Demographic and Health Survey 2016. Kampala, Uganda,
and Rockville, Maryland, USA: UBOS and ICF; 2016. Available from: https://dhsprogram.com/pubs/pdf/FR333/FR333.pdf.
 Baker SJ and DeMaeyer EM, 1979. Nutritional anemia: it’s understanding and control with special reference to the work of the world health organization. The American Journal of Clinical Nutrition; 32(2):368–417. https://doi.org/10.1093/ajcn/32.2.368.
 Asrie F, et al., 2017. Prevalence
of anemia and its associated factors among pregnant women receiving antenatal care
at Aymiba Health Center, northwest Ethiopia. Journal of blood medicine, 8,
 Bongomin F, et al., 2021. Anemia
in Ugandan pregnant women: a cross-sectional, systematic review and meta-analysis
study. Tropical Medical Health. 49: 19. Available from: https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-021-00309-z.
 Obai G, et al., 2016. Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross-sectional study. BMC Pregnancy Childbirth.;16(1):1–7. https://bmcpregnancychildbirth.biomedcentral.com/track/pdf/10.1186/s12884-016-0865-4.pdf.
 Ononge S, et al., 2014. Campbell
O, Mirembe F. Haemoglobin status and predictors of anaemia among pregnant women
in Mpigi, Uganda. BMC research notes, 7, 712. Available from: https://pubmed.ncbi.nlm.nih.gov/25304187/.
 WHO catalogue of indicators
for health monitoring. SCHI Unit. Division of Epidemiological Surveillance and Health
Situation and Trend Analysis. World Health Organization; Geneva: 1996. April 1993.
Available from: https://apps.who.int/iris/handle/10665/63030.
 Goonewardene M, et al., 2012.
Anaemia in pregnancy. Best practice & research. Clinical obstetrics &
gynaecology, 26(1), 3–24. Available from: https://pubmed.ncbi.nlm.nih.gov/22138002/.
 Kibret K.T, et al., 2019. Spatial
distribution and determinant factors of anaemia among women of reproductive reproductive
age in Ethiopia: a multilevel and spatial analysis. BMJ Open. e027276. doi:
10.1136/bmjopen-2018-027276. Available from: https://pubmed.ncbi.nlm.nih.gov/30948614/.
 Buseri, F. I, et al., 2008. Prevalence and risk factors of anaemia among pregnant women in Nigeria. Open Journal of Hematology, vol. 2, pp. 14–19. Available from: https://benthamopen.com/ABSTRACT/TOHJ-2-14.
 Alem M, et al., 2013. Prevalence
of Anemia and Associated Risk Factors among Pregnant Women Attending Antenatal Care
in Azezo Health Center Gondar Town, Northwest Ethiopia. Journal of Interdisciplinary
Histopathology. 1(3): 137-144 doi: 10.5455/jihp.20130122042052. Available from:
 Nankinga, O and Aguta, D. 2019.
Determinants of Anemia among women in Uganda: further analysis of the Uganda demographic
and health surveys. BMC Public Health 19, 1757. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-8114-1.
 Mahamoud N.K, et al., 2020.
Prevalence of anemia and its associated socio-demographic factors among pregnant
women attending an antenatal care clinic at kisugu health center IV, Makindye Division,
Kampala, Uganda. Journal of blood medicine. 11:13–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32021527/.
 Okia C.C, et al., 2019. Prevalence,
Morphological Classification, And Factors Associated with Anaemia Among Pregnant
Women Accessing Antenatal Clinic at Itojo Hospital, Southwestern Uganda. Journal
of blood medicine, 10, 351–357. Available from: https://pubmed.ncbi.nlm.nih.gov/31695541/.
 Kassa, G. M. et al., 2017. Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis. BMC hematology, 17. https://doi.org/10.1186/s12878-017-0090-z. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646153/.
 Mahfouz A., et al., 1994. Anemia among pregnant women in the Asir region, Saudi Arabia: an epidemiologic study. The Southeast Asian journal of tropical medicine and public health, 25(1), 84–87. Available from: https://pubmed.ncbi.nlm.nih.gov/7825031/.
 Balarajan Y et al., 2011. Anaemia
in low-income and middle-income countries. Lancet.;378 (9809):2123–2135.
doi:10.1016/S0140-6736(10)62304-5. Available from: https://pubmed.ncbi.nlm.nih.gov/21813172/.
 Economic Development Policy and Research Department. Poverty status report 2014: Structural Change and Poverty Reduction in Uganda. Kampala: Ministry of finance, planning and economic development; 2014. https://www.ug.undp.org/content/uganda/en/home/library/human_development/TheUgandaPovertyStatusReport2014.html.
 Apili F, et al., 2020. Hookworm
Infection among Pregnant Women at First Antenatal Visit in Lira, Uganda: A Cross-Sectional
Study. International Journal of Reproductive Medicine. doi: 10.1155/2020/8053939.
Available from: https://www.hindawi.com/journals/ijrmed/2020/8053939/.
 Desai M, et al., 2007. Epidemiology
and burden of malaria in pregnancy. The Lancet. Infectious diseases, 7(2), 93–104.
 Shulman C.E, et al., 2002. Malaria as a cause of severe anaemia in pregnancy. Lancet.; 360:494. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)09662-9/fulltext.
 Shulman C.E and Dorman E.K,
2003. Importance and prevention of malaria in pregnancy. Transactions of the
Royal Society of Tropical Medicine and Hygiene, 97(1):30-5. https://pubmed.ncbi.nlm.nih.gov/12886801/.
 Muhangi L et al., 2007. Associations
between mild-to-moderate anaemia in pregnancy and helminth, malaria, and HIV infection
in Entebbe, Uganda. Transactions of the Royal Society of Tropical Medicine and
Hygiene, 101(9), 899–907. https://doi.org/10.1016/j.trstmh.2007.03.017.
 Kare A.P and Gujo A.B, 2021. Anemia among Pregnant women attending Ante Natal Care Clinic in Adare General Hospital, Southern Ethiopia: Prevalence and Associated Factors. Health Services Insights. 14: doi: 10.1177/11786329211036303. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327009/.
 Fondjo L.A, et al., 2020. A multicenter study of the prevalence and risk factor of malaria and anaemia among pregnant women at first antenatal care visit in Ghana. PLoS One. 15(8): e0238077 doi: 10.1371/journal.pone.0238077. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444479/.
 Adam I, Ibrahim Y and Elhardello
O, 2018. Prevalence, types, and determinants of Anaemia among pregnant women in
Sudan: a systematic review and meta-analysis. BMC Hematology. doi: 10.1186/s12878-018-0124-1.
Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225563/.
 White N. J. 2018. Anaemia and
malaria. Malaria Journal, 17(1), 371. https://doi.org/10.1186/s12936-018-2509-9.
Available from: https://malariajournal.biomedcentral.com/track/pdf/10.1186/s12936-018-2509-9.pdf.
 Sadeghian, M., Fatourechi,
A., Lesanpezeshki, M., & Ahmadnezhad, E. 2013. Prevalence of anemia and correlated
factors in the reproductive-age women in rural areas of tabas. Journal of family
& reproductive health, 7(3), 139–144. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064781/.