Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 6;15(8):e0237147.
doi: 10.1371/journal.pone.0237147. eCollection 2020.

Spatiotemporal patterns of anemia among lactating mothers in Ethiopia using data from Ethiopian Demographic and Health Surveys (2005, 2011 and 2016)

Alemneh Mekuriaw Liyew  1 , Sewnet Adem Kebede  1 , Chilot Desta Agegnehu  2 , Achamyeleh Birhanu Teshale  1 , Adugnaw Zeleke Alem  1 , Yigizie Yeshaw  1   3 , Getayeneh Antehunegn Tesema  1
Affiliations

Spatiotemporal patterns of anemia among lactating mothers in Ethiopia using data from Ethiopian Demographic and Health Surveys (2005, 2011 and 2016)

Alemneh Mekuriaw Liyew et al. PLoS One. .

Abstract

Introduction: Maternal anemia is a worldwide public health problem especially in developing countries including Ethiopia. The burden of anemia among lactating mothers in Ethiopia was higher than those who were neither pregnant nor breastfeeding. To date, there is limited evidence on spatiotemporal patterns of anemia among lactating mothers in the country. Exploring the spatial patterns of maternal anemia is vital to design and monitor effective intervention programs. Therefore this study aimed to explore spatiotemporal patterns of anemia among lactating mothers in Ethiopia over the past one and half-decades.

Methods: A total of 11,989 lactating mothers were included from the three consecutive Ethiopian Demographic and Health Surveys(2005, 2011, and 2016). The trend of anemia over the three surveys was showed. Furthermore, spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographically risk areas of anemia among lactating mothers in Ethiopia. Finally, the most anemia risk areas were detected consistently by different spatial analytic methods in each survey.

Results: Anemia during lactation had an increasing trend from 2011 to 2016 in all regions of Ethiopia. It was also spatially clustered over three survey periods (Moran's I: 0.102-0.256, P<0.01).The hotspot areas were detected in Afar, Somali, Gambela, Dire Dawa, and Oromia regions during the last fifteen years. In 2005 and 2011, a total of 100 most likely clusters (Loglikelihood Ratio(LLR) = 8.8, P<0.05, and LLR = 45.94, P<0.001, respectively) were identified in the Afar region. However, in the 2016 survey period, primary clusters were shifted to the Somali region where 57 clusters (LLR = 72.73, P<0.001) were detected in the entire region. Besides, the risk prediction map showed that the eastern part of the country was at a higher risk of anemia during lactation.

Conclusion: Anemia during lactation was spatially clustered in Ethiopia. High-risk areas were detected in the eastern part of Ethiopia prominently in the Afar and Somali regions. Therefore, public health intervention activities designed in a targeted approach to impact high-risk populations in those hot spot areas wound be helpful to reduce anemia in Ethiopia.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of Ethiopia where the three surveys were undertaken with nine regions and two administrative cities (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 2
Fig 2. Trends of anemia among lactating mothers in Ethiopia overtime across regions 2005, 2011, and 2016.
Fig 3
Fig 3
a-c: Spatial distribution of anemia among lactating mothers in Ethiopia 2005 (a), 2011 (b), 2016 (c) EDHS (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 4
Fig 4
a-c: Spatial autocorrelation of anemia among lactating mothers in Ethiopia, 2005 (a), 2011 (b), 2016 (c) (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 5
Fig 5
a-c: Cluster outlier identification ofanemia among lactating mothers in Ethiopia, 2005 (a), 2011 (b), 2016 (c) EDHS (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 6
Fig 6
a-c: Hot spot identification of anemia among lactating mothers in Ethiopia 2005 (a), 2011 (b), 2016 (c) EDHS (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 7
Fig 7
a-c: Spatiotemporal interpolation of anemia among lactating mothers in Ethiopia 2005 (a), 2011 (b), 2016 (c) (Source: Shapefile from Central Statistical Agency, Ethiopia, 2013).
Fig 8
Fig 8
a-c. spatiotemporal patterns of primary clusters of anemia among lactating mothers in Ethiopia 2005 (a), 2011 (b), and 2016 (c) (Source: Shape file from Central Statistical Agency, Ethiopia, 2013).
See this image and copyright information in PMC

References

    1. Geneva S. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System. Document Reference WHO. NMH/NHD/MNM/11.1. http://www.who.int/entity/vmnis/indicators/haemoglobin …, 2011.
    1. Organization WH. Assessing the iron status of populations: report of a joint World Health Organization/Centers for Disease Control and Prevention technical consultation on the assessment of iron status at the population level.: Geneva, Switzerland. world health organization, 2007
    1. De Benoist B, Cogswell M, Egli I, McLean E. Worldwide prevalence of anaemia 1993–2005; WHO Global Database of anaemia. 2008. - PubMed
    1. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. The Lancet Global Health. 2013;1(1):e16–e25. 10.1016/S2214-109X(13)70001-9 - DOI - PMC - PubMed
    1. Central Statistical Agency (CSA) [Ethiopia] and ICF:2005. Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF, 2005.