Anemia, Iron Deficiency, Meat Consumption, and Hookworm Infection in Women of Reproductive Age in Northwest Vietnam

Sant-Rayn Pasricha Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Sonia R. Caruana Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Tran Q. Phuc Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Gerard J. Casey Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Damien Jolley Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Sally Kingsland Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Nong T. Tien Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Lachlan MacGregor Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Antonio Montresor Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Beverley-Ann Biggs Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre of Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, Victoria, Australia; National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam; Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia; Clinical Epidemiology and Health Service Evaluation Unit, The Royal Melbourne Hospital, Parkville, Victoria, Australia; and World Health Organization, Hanoi, Vietnam

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Iron deficiency anemia poses an important public health problem for women of reproductive age living in developing countries. We assessed the prevalence of iron deficiency and anemia and associated risk factors in a community-based sample of women living in a rural province of northwest Vietnam. A cross-sectional survey, comprised of written questionnaires and laboratory analysis of hemoglobin (Hb), ferritin, transferrin receptor, and stool hookworm egg count, was undertaken, and the soluble transferrin receptor/log ferritin index was calculated. Of 349 non-pregnant women, 37.53% were anemic (Hb < 12 g/dL), and 23.10% were iron deficient (ferritin < 15 ng/L). Hookworm infection was present in 78.15% of women, although heavy infection was uncommon (6.29%). Iron deficiency was more prevalent in anemic than non-anemic women (38.21% versus 14.08%, P < 0.001). Consumption of meat at least three times a week was more common in non-anemic women (51.15% versus 66.67%, P = 0.042). Mean ferritin was lower in anemic women (18.99 versus 35.66 ng/mL, P < 0.001). There was no evidence of a difference in prevalence (15.20% versus 17.23%, P = 0.629) or intensity (171.07 versus 129.93 eggs/g, P = 0.412) of hookworm infection between anemic and non-anemic women. Although intensity of hookworm infection and meat consumption were associated with indices of iron deficiency in a multiple regression model, their relationship with hemoglobin was not significant. Anemia, iron deficiency, and hookworm infection were prevalent in this population. Intake of meat was more clearly associated with hemoglobin and iron indices than hookworm. An approach to addressing iron deficiency in this population should emphasize both iron supplementation and deworming.

Author Notes

Reprint requests: Beverley-Ann Biggs, Department of Medicine (RMH/WH), The University of Melbourne, 4th Floor, Clinical Sciences Building, The Royal Melbourne Hospital, Parkville, Victoria 3050, Australia.
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