title: Spatial and social factors drive anemia in Congolese women.
abstract: Anemia is common in women of child-bearing age in the Democratic Republic of the Congo (DRC). As part of the 2007 DRC Demographic and Health Survey (DHS), 4638 women of childbearing age (including 526 pregnant women) were tested for HIV and had the hemoglobin content of their blood recorded. We used the leftover dried blood spots to assess malaria prevalence using PCR assays. The DHS provided extensive information on individuals, as well as the geographic coordinates of household clusters which enabled us to derive several variables that characterize the spatial context of these clusters. Multilevel analyses were conducted to determine individual and contextual risk factors for anemia. Prevalence varied geographically; the odds of anemia were associated with both one's ethnic group and the amount and type of nearby agriculture. The odds were not affected by HIV or malaria status.
authors.affiliation: Department of Zoology, University of Oxford, Oxford, UK. Electronic address: jane.messina@gmail.com.
authors.forename: Jane P
authors.initials: JP
authors.lastname: Messina
authors.forename: Kashamuka
authors.initials: K
authors.lastname: Mwandagalirwa
authors.forename: Steve M
authors.initials: SM
authors.lastname: Taylor
authors.forename: Michael
authors.initials: M
authors.lastname: Emch
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D003223:Congo / Q000453:epidemiology; D003466:Cultural Characteristics; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D012111:Residence Characteristics; D012307:Risk Factors
keywords: Anemia; Congo; Disease ecology; Malaria; Multilevel models
references.citation: Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):36-44
references.pmid: 11425176
references.citation: Soc Sci Med. 2000 Apr;50(7-8):937-52
references.pmid: 10714918
references.citation: J Am Diet Assoc. 2011 Apr;111(4):532-41
references.pmid: 21443985
references.citation: Disaster Med Public Health Prep. 2009 Jun;3(2):88-96
references.pmid: 19491603
references.citation: Am J Trop Med Hyg. 1975 Mar;24(2):161-7
references.pmid: 1091165
references.citation: Soc Sci Med. 1998 Jan;46(1):97-117
references.pmid: 9464672
references.citation: J Clin Microbiol. 2010 Feb;48(2):512-9
references.pmid: 19940051
references.citation: Food Nutr Bull. 2007 Mar;28(1):76-89
references.pmid: 17718015
references.citation: Acta Obstet Gynecol Scand. 2001 May;80(5):402-8
references.pmid: 11328215
references.citation: J Adolesc Health. 1994 Sep;15(6):444-56
references.pmid: 7811676
references.citation: Am J Trop Med Hyg. 2002 Jul;67(1):44-53
references.pmid: 12363063
references.citation: J Infect Dis. 2006 Jul 1;194(1):108-14
references.pmid: 16741889
references.citation: Malar J. 2011 Jun 09;10:161
references.pmid: 21658268
references.citation: Am J Clin Nutr. 1994 Feb;59(2 Suppl):492S-500S discussion 500S-501S
references.pmid: 8304287
references.citation: Am J Trop Med Hyg. 2000 Mar;62(3):335-40
references.pmid: 11037774
references.citation: Soc Sci Med. 1997 Mar;44(5):657-71
references.pmid: 9032833
references.citation: Soc Sci Med. 1999 Aug;49(4):519-30
references.pmid: 10414811
references.citation: MCN Am J Matern Child Nurs. 2002 May-Jun;27(3):171-7
references.pmid: 12015445
references.citation: Indian Pediatr. 1994 Oct;31(10):1221-5
references.pmid: 7875782
references.citation: Soc Sci Med. 2010 Oct;71(8):1428-35
references.pmid: 20739108
references.citation: Am J Clin Nutr. 1997 Apr;65(4):1057-61
references.pmid: 9094893
references.citation: BMC Public Health. 2009 Jul 09;9:222
references.pmid: 19589154
references.citation: Am J Trop Med Hyg. 2008 Mar;78(3):375-81
references.pmid: 18337329
references.citation: Lancet. 2006 Jan 7;367(9504):44-51
references.pmid: 16399152
references.citation: Food Nutr Bull. 2006 Mar;27(1):3-11
references.pmid: 16572713
references.citation: Annu Rev Public Health. 1986;7:313-35
references.pmid: 3521646
references.citation: Am J Trop Med Hyg. 2001 Nov;65(5):614-22
references.pmid: 11716124
references.citation: Am J Trop Med Hyg. 2004 Aug;71(2 Suppl):25-34
references.pmid: 15331816
references.citation: Am J Trop Med Hyg. 2004 Aug;71(2 Suppl):41-54
references.pmid: 15331818
references.citation: PLoS One. 2011 Jan 31;6(1):e16420
references.pmid: 21305011
references.citation: Public Health Nutr. 2009 Sep;12(9):1462-9
references.pmid: 19105867
references.citation: Proc Nutr Soc. 2008 Feb;67(1):105-8
references.pmid: 18234138
references.citation: Am J Obstet Gynecol. 2001 Aug;185(2):438-43
references.pmid: 11518906
references.citation: Annu Rev Public Health. 2000;21:171-92
references.pmid: 10884951
references.citation: J Nutr. 2000 Aug;130(8):1950-7
references.pmid: 10917907
references.citation: Am J Clin Nutr. 1994 Aug;60(2):183-8
references.pmid: 8030595
references.citation: Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):28-35
references.pmid: 11425175
references.citation: J Acquir Immune Defic Syndr. 2001 Jan 1;26(1):28-35
references.pmid: 11176266
references.citation: J Nutr. 2001 Feb;131(2S-2):565S-567S
references.pmid: 11160589
references.citation: JAMA. 2012 May 16;307(19):2079-86
references.pmid: 22665107