Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 560

P12-040 - Diet, Geophagy and Malaria Are Associated with Anemia among Adolescent Ghanaian Schoolgirls

Monday, Jun 11
8:00 AM – 3:00 PM

Objectives: Anemia is a public health problem among adolescent girls in Ghana. Data on anemia and its potential modifiable factors are needed to monitor and evaluate this population's progress as part of a broad anemia reduction strategy.


Methods:
Probability proportional to size sampling was used to select 60 schools in the Volta and Northern regions of Ghana. Within each school, 29 girls 10-19 y were randomly selected and invited to participate (N=1,551 girls). Hemoglobin (Hb) was measured using HemoCue® 301 and malaria using the CareStartrapid diagnostic test. Diet was assessed using a modified food frequency questionnaire (24-hour recall period); knowledge and practices related to anemia and control were also assessed. Geophagy was self-reported as "sometimes" consumes soil or clay. Wealth tertiles were created following principal components analysis of household assets. Multivariate logistic regression modeling was used to predict anemia based on age-defined unadjusted Hb cut-offs (<11.5g/dL for


Results:
Overall 26.6% of girls engaged in geophagy, 25.8% had malaria, and 25.0% had anemia. Supplementation to reduce anemia prevalence had not been implemented, yet 4.3% reported consuming an iron supplement in the last 7 days. Girls who engaged in geophagy and those with malaria had lower mean Hb concentrations than those who did not (12.5 g/dL vs 12.8 g/dL, p<.0001 and 12.4 g/dL vs 12.9 g/dL p<.0001, respectively). Anemia was positively associated with white meat/poultry consumption (aOR: 1.9, 95% CI: 1.2 to 2.8), geophagy (aOR: 1.8, 95% CI: 1.2 to 2.5), and malaria (aOR: 1.5, 95% CI: 1.1 to 2.0), while egg consumption was inversely associated (aOR: 0.4, 95% CI: 0.3 to 0.7) and iron supplementation as currently practiced had no association with anemia (aOR: 1.1, 95% CI: 0.4 to 3.2), in a model adjusted for other elements of the diet, age, wealth, menarche, and knowledge of anemia. Additionally, we observed significant multiplicative interactions among some food groups such that reported joint consumptions were associated with anemia.


Conclusions:
Diet, geophagy, and malaria are associated with anemia. These may be important modifiable factors for the Ghanaian anemia reduction strategy.




Funding Source: Emory Global Health Institute Marcus Foundation Grant

CoAuthors: Katie Tripp, MSc – Centers for Disease Control and Prevention; Parmi Suchdev, MD – Emory University; Abraham Mahama – UNICEF Ghana; Kate Quarshie – Ghana Health Service; Esi Foriwa Amoaful – Ghana Health Service; Lilian Selenje – UNICEF Ghana; Yaw Addo, PhD – Emory University

Lucas Gosdin

PhD Student
Nutrition and Health Sciences, Laney Graduate School, Emory University
Atlanta, Georgia