title: Determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania: analysis of data from the 2010 Tanzania Demographic and Health Survey.
abstract: OBJECTIVE
  To identify determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania.
  
  
  METHODS
  We included participants from the 2010 Tanzania Demographic and Health Survey, which collected data on socio-demographic and maternal health and determined haemoglobin levels from blood samples. We performed logistic regression to calculate adjusted odds ratios for associations between socio-demographic, contextual, reproductive and lifestyle factors, and moderate-to-severe anaemia and investigated interactions between certain risk factors.
  
  
  RESULTS
  Of 9477 women, 20.1% were anaemic. Pregnancy was significantly associated with anaemia (adjusted OR 1.75, 95% CI 1.43-2.15), but the effect varied significantly by urban/rural residence, wealth and education. The effect of pregnancy was stronger in women without education and those who were in lower wealth groups, with significant interactions observed for each of these factors. Education was associated with a lower anaemia risk, particularly in the poorest group (OR 0.58, 95% CI 0.43-0.80), and in pregnant women. The risk of anaemia fell with rising iron supplementation coverage. Lack of toilet facilities increased anaemia risk (OR 1.26, 95% CI 1.00-1.60), whereas using hormonal contraception reduced it. There was no association with age, urban/rural residence, wealth or type of cooking fuel in adjusted analysis.
  
  
  CONCLUSIONS
  Pregnant women in Tanzania are particularly at risk of moderate-to-severe anaemia, with the effect modified by urban/rural residence, education and wealth. Prevention interventions should target women with lower education or without proper sanitation facilities, and women who are pregnant, particularly if they are uneducated or in lower wealth groups.
authors.affiliation: Projects Department, Doctors with Africa CUAMM, Padua, Italy.
authors.forename: Calistus
authors.initials: C
authors.lastname: Wilunda
authors.forename: Siriel
authors.initials: S
authors.lastname: Massawe
authors.forename: Caroline
authors.initials: C
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012499:Sanitation; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: anaemia; education; health inequalities; pregnancy; women's health