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The prevalence and determinants of anaemia in Jordan

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DOI: 10.26719/emhj.18.047

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Research article EMHJ – Vol. 25 No. 5 – 2019

The prevalence and determinants of anaemia in Jordan

Nour Abdo,1 Shahd Douglas,1 Anwar Batieha,1 Yousef Khader,1 Hashem Jaddou,1 Sohaib Al-Khatib,2 Mohammed El-Khatib,3 Hussain AbuZaid 4 and Kamel
Ajlouni 3

Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. 2Department of Pathology and Micro-
1

biology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. 3National Center for Diabetes, Endocrinology, and Genetics,
Amman, Jordan. 4Royal Health Services, Jordanian Royal Medical Services, Amman, Jordan. (Correspondence to: Nour Abdo: [email protected]).

Abstract
Background: Anaemia is a global public health problem particularly in low- and middle-income countries and may be
associated with serious health consequences. Limited studies, if any, have examined the prevalence and risk factors of
anaemia in Jordan at the national level.
Aims: This study aimed to assess the prevalence of anaemia in Jordan for both sexes at the national level and to identify
high-risk population subgroups.
Methods: A national population-based household sample was selected from the 12 governorates of Jordan in 2017. A to-
tal of 1125 males and 2797 females aged between 18 and 90 years were included. The prevalence of anaemia, overall and
among subgroups of the population was estimated using Hb level as per WHO definition.
Results: Results showed prevalence of anaemia to be 5.2% in males, 20.3% in non-pregnant females, and 27.4% in pregnant
females. Anaemia was predominantly mild (males: 81%, non-pregnant females: 57.0%, and pregnant females: 65.2%). Sex,
age, region, marital status, and education were significantly associated with anaemia. Iron deficiency anaemia (IDA) ac-
counted for 68% of anaemic females and 38% of anaemic males.
Conclusions: The prevalence of anaemia in Jordan is lower than previously reported by WHO and the majority of anae-
mia was mild. Iron deficiency anaemia was the the most common type of anaemia, particularly in females. Flour fortifi-
cation with iron and folic acid could have accounted for the decline of anaemia in Jordan.
Keywords: Anaemia, Jordan, iron deficiency, prevalence, national study
Citation: Abdo N; Douglas S; Batieha A; Khader Y; Jaddou H; Al-Khatib S; et al. The prevalence and determinants of anaemia in Jordan. East Mediterr
Health J. 2019;25(5):341-349 https://doi.org/10.26719/emhj.18.047
Received: 16/01/18; accepted: 14/06/18
Copyright © World Health Organization (WHO) 2019. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://
creativecommons.org/licenses/by-nc-sa/3.0/igo).

Introduction one-third of the older anaemic population have folate,

iron, and/or vitamin B12 deficiency. Another third have
The prevalence of anaemia has gradually declined in
chronic inflammation and/or renal insufficiency, and the
high-income countries, but it is still a major public health
remaining third have unexplained anaemia. It has been
problem in many low- and middle-income countries. The
shown that anaemia is associated with poor survival
World Health Organization (WHO) defines anaemia as a
rates in older adults (8).
condition where the number of red blood cells (RBCs) or
the oxygen-carrying capacity of RBCs is insufficient to There are a number of studies conducted on pregnant
meet the physiological needs. Anaemia affects 1.6 billion women and anaemia in urban and rural areas in
people worldwide, which corresponds to 24.8% of the to- Jordan (9,10), but there are relatively few national level
tal world population (1). Anaemia symptoms range from studies done to address this burning issue in the adult
fatigue and weakness to reduced cognitive performance population. Anaemia is a serious problem that requires
and even death. It can increase hospitalization and mor- comprehensive understanding of its magnitude, types,
tality rates among the elderly (2), and increase the mater- and distribution in Jordan. The present study is an
nal mortality rate (3,4). Iron deficiency anaemia (IDA) is attempt to address this through assessment of the
considered to be the most common nutritional deficiency prevalence of the condition, its severity, causes, and
worldwide. It can cause reduced work capacity in adults distribution in different population subgroups.
and affect motor and mental development in children
and adolescents (5). Methods
Women of reproductive age are a high-risk group for
developing anaemia, due to menstruation, which is the Sampling and data collection
principal risk factor for anaemia in women (6). Also, it is A national multipurpose population-based household
common during pregnancy to develop anaemia when the sample was selected from the 12 governorates of Jordan.
body might not be able to produce sufficient RBCs needed A multistage sampling technique was used to select the
to make additional blood for the fetus (7). Approximately households. The first stage was a sampling of health

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Research article EMHJ – Vol. 25 No. 5 – 2019

centres since the population has access to an extensive classified as follows: microcytic anaemia (<80 fL/red cell),
network of health centres and the study is required to normocytic anaemia (80–95 fL/red cell) and macrocytic
take place in a medical setting. A total of 17 health centres (>95 fL/red cell). Normal range for MCH was 27–33 pg/
were included from the different governorates of Jordan. cell and were considered to be normochromic. Normal
The second stage was a systematic sample of households ferriten levels were between 30 to 400 µg/L in males
from the catchment areas of the selected health centres. and betweem 13 to 150 µg/L in females. Iron Defcicney
Two-member teams (one male and one female) moved (ID) was based on low ferriten levels. Education was
door-to-door to select a systematic sample of households categorized according to study years: Illiterate (0 study
from the catchment area of the selected health centre. years), primary education (1–10 study years), secondary
The teams invited household members ≥18 years of age education (10–12 study years), and higher education
to participate in the study and to report next morning (above 12 study years). BMI was calculated by dividing
to the health centre after an overnight fast. In the health weight in kilogrammes over height in metres squared
centre, each subject was interviewed by a trained inter- and classified as: underweight (<18), normal weight
viewer using a structured questionnaire prepared spe- (18.5–24.9), overweight (25–29.9), and obese (≥30).
cifically for the purposes of the study. Physical measure- Data analyses were performed using SAS (Statistical
ments included height, weight, blood pressure, and waist Analysis System, version 9.2; SAS Institute, Cary, NC, USA).
and hip circumferences were measured. Blood samples The data were initially checked for errors by performing
were drawn from each participant by trained laboratory range and logical checks. Detected errors were dealt with
technicians and finally analyzed. A total of 4056 subjects as appropriate. Prevalence of anaemia was analysed
were finally included in the study from both sexes, 1193 for each sex separately by age groups, region, marital
males and 2863 females, aged between 18 and 90 years. status, education, occupation, and BMI. Differences
The study was multipurpose and collected extensive were assessed for statistical significance by Chi-square
data on cardiovascular disease risk factors, vitamin B12, test. To facilitate comparability, we used the WHO world
vitamin D, and healthcare services. It was approved population to obtain age standardized prevalence rates
by the Ethical Committee for Research on Humans of separately for males and females. Multivariable logistic
the National Center for Diabetes, Endocrinology, and regression analysis was performed to identify the most
Genetics, Amman, Jordan. The study team obtained relevent determinants and risk factors of anaemia after
informed consent from all participants. controlling for potential confounders. Due to the small
Sample size was estimated using the following number of severe cases of anaemia, moderate and severe
formula: cases were combined to form a moderate–severe category
in certain graphs.
n = (za/2)2 pq/Δ2
Where z is the standard normal deviate (1.96 for a
95% confidence level), p is the expected prevalence for Results
a disease, q is 1-p, and Δ is the margin of error. For the
Prevalence of anaemia and its determinants
purpose of the present study, the corresponding margin
of error is 1%. A total of 3922 individuals over 18 years of age were in-
cluded in the study: 1125 (28.7%) males, and 2797 (71.3%)
Study variables and analyses females. Several characteristics of the study population
All laboratory measurements were carried out at the Lab- were summarized by sex, age groups, nationality, region,
oratories of the National Center for Diabetes, Endocrinol- occupation, marital status, education, BMI, and pregnan-
ogy, and Genetics, Amman, Jordan. All laboratory work cy (in females only) (Table 1). The overall crude preva-
was carried out by the same team of laboratory techni- lence of anaemia in females was 20.5% (95% CI, 19–22).
cians. As the study is multipurpose, a wide range of lab- The overall crude prevalence of anaemia in males was
oratory measurements were obtained including, fasting 5.2% (95%, CI 3.9–6.5) (Table 1). The proportion of anaemic
sugar, HbA1c, 25(OH)D, B12, etc. Haematological param- females was four times that of males (P < 0.001).
eters, including haemoglobin, packed cell volume (PCV), Anaemia was significantly associated with age in
mean corpuscular volume (MCV), mean corpuscular hae- both sexes (P < 0.001). Figure 1 shows the prevalence of
moglobin (MCH) and mean corpuscular haemoglobin anaemia and moderate–severe anaemia in different age
concentration (MCHC), were measured using SYSMEX categories for each sex. Anaemia and moderate–severe
(XT-400i) instrument (Sysmex Corporation,, Kobe, Ja- anaemia has an increasing trend with age in males, with
pan). Biochemical parameters, serum iron, and total iron those aged over 70 years having the highest prevalence
capacity were each measured using automated chemis- of anaemia (25%) and moderate–severe anaemia (4.3%)
try analyzer, COBAS 601, (Roche Diagnostics, Basel, Swit- (Figure 1; Table 1). However, middle-aged (40–49 years)
zerland), while ferritin was measured by immunoassay females had the highest prevalence of anaemia (28%)
using ADVIA CENTURA XP (Siemens Healthcare, Erlan- and moderate–severe anaemia (13.1%) (Figure 1; Table 1).
gen, Germany). The age-adjusted prevalence of anaemia was 19.3 (95% CI,
Haemoglobin (Hb) cutpoints used in this study 17.8–20.8) in females and 4.9 (95% CI, 3.4–5.8) in males,
are summarized in Supplementary Table 1. MCV was using the WHO standard population.

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Research article EMHJ – Vol. 25 No. 5 – 2019

Table 1. Prevalence of anaemia and its determinants

Characteristics N Males P-value N Females P-value
of the population Prevalence of Prevalence of
anaemia (%) anaemia (%)
Total 1125 5.2 2797 20.5
Age group
18–29 148 2.7 <0.001 563 17.8 <0.001
30–39 166 0.6 614 19.9
40–49 296 1.7 748 28.2
50–59 276 4.0 535 15.9
60–69 146 9.6 246 16.3
>=70 92 25.0 84 17.9
Nationality
Jordanian 1056 5.1 0.28 2607 20.7 0.96
Others 169 10.8 64 58.0
Region
North 385 6.8 0.16 910 25.1 <0.001
Central 470 3.8 1281 17.6
South 270 5.2 606 20.0
Occupation
Field work 337 1.5 <0.001 159 22.6 0.12
Office work 328 2.1 507 19.5
Retired 314 10.8 135 13.3
Unemployed 136 8.1 1917 21.4
Marital status
Married 977 5.3 0.05 2020 21.6 0.01
Single 136 3.0 448 14.7
Others* 10 25.0 320 73.6
Education
Illiterate 10 20 <0.001 189 19.6 0.004
Primary 325 9.0 735 18.5
Secondary 352 4.0 847 24.8
Higher 416 3.1 963 18.7
BMI
Underweight 20 15.0 0.17 72 25.0 0.53
(<18)
Normal weight 226 4.9 547 19.0
(18.5-24.9)
Overweight (25- 456 5.7 802 21.6
29.9)
Obese (≥30) 422 4.3 1363 20.3
Pregnancy status
Yes ---- ---- 84 27.4 0.30
No 2713 20.3
Age-adjusted 4.9 19.3
*Others included divorced, separated, and widowed were combined due to low numbers.

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Research article EMHJ – Vol. 25 No. 5 – 2019

Figure 1. Prevalence of anaemia and moderate–severe anaemia Table 2. Adjusted odds ratios for significant variables using
by age groups. stepwise multivariate logistic regression
Anaemia and Moderate-Severe Significant risk factors for
Odds Ratio (95% CI)
50 Anaemia Prevalence in Famales each sex
Males
40 Age
Prevalence (%)

18–29 0.08 (0.03-0.25)

30 30–39 0.02 (0.00-0.12)
40–49 0.05 (0.02-0.13)
20
50–59 0.11 (0.05-0.25)
60–69 0.28 (0.13-0.60)
10
> =70 1
Region*
0
18-29 30-39 40-49 50-59 60-69 >=70 Northern 1.43 (0.71-2.90)

Age groups Central 0.56 (0.26-1.21)

Southern 1
Moderate-Severe Anaemia Anaemia
Females
Age

Anaemia and Moderate-Severe 18–29 1.40 (0.70-2.79)

50
Anaemia Prevalence in Males 30–39 1.30 (0.67-2.54)
40 40–49 2.05 (1.07-3.93)
Prevalence (%)

50–59 0.94 (0.49-1.80)

30
60–69 0.87 (0.44-1.73)

20 > =70 1
Region*
10 Northern 1.36 (1.05-1.77)
Central 0.87 (0.67-1.13)
0
18-29 30-39 40-49 50-59 60-69 >=70 Southern 1
Marital status
Age groups
Married 1.60 (1.15-2.22)
Moderate-Severe Anaemia Anaemia
Other* 2.05 (1.32-3.18)
Single 1

The prevalence of anaemia in females was Education

significantly higher in northern Jordan, among subjects Illiterate 0.86 (0.55-1.35)
with secondary education, and in divorced, separated, or Primary 0.70 (0.54-0.90)
widowed females (Table 1). The prevalence of anaemia in Higher 0.67 (0.54-0.85)
males was significantly higher among working, lower Secondary 1
educated, and divorced, separated, or widowed men *Others included divorced, separated, and widowed were combined due to low numbers.
(Table 1). Nationality, BMI, and pregnancy were not
significantly associated with anaemia (Table 1).

Stepwise multivariable logistic regression The odds of having anaemia were significantly higher in
analysis males aged over 70 years. The odds of having anaemia in
females were significantly higher among those that have
Using logistic regression, the overall adjusted odds ra-
low levels of education, not single, aged 40–49 years, and
tio of anaemia in females versus males was 5.3 (95% CI,
living in northern Jordan.
3.9–7.1) after adjusting for education, marital status, re-
gion, and age (data not shown in tables). Multivariable
logistic regression analysis was also performed for each Severity and type of anaemia in the Jor-
sex separately. Table 2 shows the adjusted odds ratios for danian population
each variable and their 95% confidence intervals. Age and The prevalence of anaemia classified by its severity in
region were the only risk factors for anaemia in males. both sexes according to the WHO classification is sum-
In females, region, marital status, age, and education marized in Table 3. The proportion of moderate–severe
were found to be significantly associated with anaemia. anaemia in non-pregnant females (43%) was almost twice

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Research article EMHJ – Vol. 25 No. 5 – 2019

Figure 2. Prevalence of anaemia and moderate–severe Table 3. Severity of anaemia

anaemia by age groups.
Severity of Males Non- Pregnant
anaemia n(%) pregnant females
A females n(%)
n(%)
Blood Ferritin Concentration (g/dl)

150
P<0.0001 Mild anaemia* 15(65.2) 314(57.0) 47(81.0)
Moderate
8(34.8) 223(40.5) 11(19.0)
anaemia*
100 Severe anaemia* 0(0) 14(2.5) 0(0)
*According to WHO classifications, for males, non-anaemia: ≥13 g/dl, mild anaemia: 11-12.9
g/dl, moderate anaemia: 8-10.9 g/dl and severe anaemia <8 g/dl. For non-pregnant females,
non-anaemia: ≥12 g/dl, mild anaemia: 11-11.9 g/dl, moderate anaemia: 8-10.9 g/dl, severe
50 anaemia <8 g/dl. For pregnant females, non-anaemia: ≥11 g/dl, mild anaemia: 10-10.9 g/dl,
moderate anaemia: 7-9.9 g/dl, severe anaemia <7 g/dl.

0
Males Non-Pregnant Pregnant
Supplemental Figure 1. Haemoglobin vs ferritin in low
Females Females ferritin individuals by sex

Anaemia in low-Ferretin Females

B

Blood Ferritin Concentration (ng/ml)

Blood Hg Concentration (g/dl)

20 12
P<0.0001
10
15 8
6
10
4

5 2

6 8 10 12 14
0 Hemoglobin Concentration (g/dl)
Males Non-Pregnant Pregnant
Females Females No Anaemia Anaemia

Anaemia in low-Ferretin Males

c
Blood Ferritin Concentration (ng/ml)

30

0-3 25
Density Distribution

20
0-2
15
0-1 10

5
0
10 15 20 10 12 14 16 18
Blood Hemoglobin Concenrration (g/dl) Hemoglobin Concentration (g/dl)

Females Males No Anaemia Anaemia

that in males (19%). Anaemia was predominantly mild at females (data not shown in tables). Slightly less than one
81%, 57%, and 65% in males, non-pregnant females, and third of the female population (28.7%) had iron deficiency
pregnant females, respectively (Table 3). compared to 11.1% of males (data not shown in table). IDA
The most common type of anaemia observed in accounted for 68.2% of anaemic females and 38.6% in
males and females was microcytic hypochromic anaemia anaemic males (data not shown in table). Average ferritin
accounting respectively for 29.3% and 33.1%, followed by levels and standard errors are shown in Figure 2 panel C
normocytic normochromic anaemia at 24.1% in males for males, females, and pregnant females.
and normocytic hypochromic anaemia at 30.8% in Mean Hb levels in females (12.9 g/dL, 95% CI, 12.9–13.0)

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Research article EMHJ – Vol. 25 No. 5 – 2019

Supplemental Table 1: Haemoglobin levels (g/dL) to diagnose females was four times that of males. Being a female
anaemia and its severity used in the study at the childbearing age is considered a risk factor for
Population Non- Anaemia developing anaemia. Results of this study are consistent
Anaemia Mild Moderate Severe
with most studies in the literature. Le et al. (2016)
suggested that women of reproductive age had a high
Non- >12 11 - 11.9 8 - 10.9 <8
prevalence of anaemia (13), while a study conducted in
Pregnant Saudi Arabia indicated that the prevalence of anaemia
Females in adolescent girls was higher than that in adolescent
Pregnant >11 10 - 10.9 7 - 10.9 <7 males (14). Ismail et al. (2016) stated that the prevalence of
Females anaemia in females was almost double that in males in a
Males >13 11 - 12.9 8 - 10.9 <8 study conducted in Kerala, India (15).
*According to WHO classifications (1). Anaemia and moderate–severe anaemia prevalence
has an increasing trend with age in males. Males aged
over 70 years had the highest prevalence of anaemia and
were lower than that in males (15.3 g/dL, 95% CI, 15.2–15.4) moderate–severe anaemia, which agrees with the results
(Figure 2A). As expected, the distribution of haemoglobin of most studies in the literature (8,16). The prevalence of
for females was lower than that in males (Figure 2A). anaemia increases with age particularly after 50 years
Haemoglobin levels were significantly different between of age (8). Similarly, Guralnik et al. (2004) found that
males, non-pregnant females, and pregnant females. anaemia prevalence rose rapidly after 50 years of age, and
Means and standard errors for haemoglobin are shown to a rate greater than 20% at age 85 years and older (16).
for males, non-pregnant females, and pregnant females In a study conducted in India, males above 30 years had
in Figure 2B. significantly more chance of anaemia than males below
30 years (17). In Rural Uganda, a study stated that the
prevalence of anaemia was higher for males than females
Discussion and increased rapidly with age in males, to almost double
The present study is the first national study of anaemia between 50 and 65 years (18). On the other hand, middle-
incorporating both sexes in Jordan. We aimed to study aged (40 to 49 years) females had the highest prevalence
a large representative sample of the population from all of anaemia (28%) and moderate–severe anemia (13.1%),
governorates. However, as expected, females were gross- which concurs with the results in most studies. Women
ly overrepresented in our sample. The main reason be- of reproductive age were found to be at high risk of
hind that is the much higher rate of female unemploy- developing anaemia, due to menstruation (19). In men,
ment exceeding 70% as compared to 12% in males, which rates of anaemia increased monotonically with age, but
makes women more available for participation. for women increased bimodally with peaks in age group
A main finding of our study is the low rate of 40–49 years and 80–85 years (20).
anaemia in males (4.9%) and females (19.7%). Compared Several studies revealed that there is a direct
to previous WHO findings in their 2006 report (11), association between education and the prevalence of
Jordan has witnessed a substantial decline in anaemia anaemia. Factors such as socio-economic status and level
in females, while the WHO report provides no data of education were found to be significantly associated
about males, which was based on data collected in 2002. with the prevalence of anaemia among women (21).
Anaemia decreased in non-pregnant females from 29% in Moreover, among school-aged children, children with
2002 to 20%, in 2017, and in pregnant females from 39% less educated mothers were more likely to develop
to 27%. This can be attributed to the flour fortification anaemia and iron deficiency than were those with more
programme with iron and folic, acid indicating that educated mothers, since they consume more iron and
the programme is proving successful. The majority of protein from animal sources than do children of less
remaining anaemic cases have mild anaemia. educated mothers (22). Zaytoun et al. (2016) found that
In non-pregnant females, only 3 out of 21 countries there was a significant association between anaemia and
in the Eastern Mediterranean Region (EMR), namely social status and educational level (20). In India, higher
Pakistan, Saudi Arabia, and Somalia, have a prevalence of prevalence of anaemia was found in people with below
more than 40% (12). The remaining 18 countries, including senior secondary education than those with above senior
Jordan, showed anaemia to be of moderate public health secondary education (17).
significance (20 to 40% prevalence) (12). The 2011 WHO The northern region of Jordan had the highest
estimates ranked Jordan as the 13th highest country in prevalence and odds ratio of anaemia. This is due to a
the prevalence of anaemia among non-pregnant females noticeable high prevalence of anaemia, in both sexes,
in EMR (12). Kuwait had the lowest prevalence of 22% and from a particular health centre in Shouneh Al-Shamalyia
Pakistan had the highest prevalence of 51% (12). Our 2017 (Shouneh). The increased prevalence in this particular
study shows that the age-adjusted prevalence of anaemia region could be related to the low socio-economic status
among females is even less than that previously reported and low altitude that is below sea level. Generally,
from Kuwait. haemoglobin levels are usually affected by high altitude.
Our study showed that the proportion of anaemic Interestingly, a 2012 study in Jordan showed that Hb levels

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Research article EMHJ – Vol. 25 No. 5 – 2019

were significantly lower for people living below sea level Relying on same Hb cutoff points to define anaemia and
(in Shouneh Al-Shamalyia) when compared with people its severity levels for all might not be completely accurate
living above sea level in healthy adults (23). Furthermore, (1,24). For example, smokers need different cutoff points
the lower socioeconomic and rural nature of Shouneh or adjustments for anaemia evaluation than nonsmokers
might also contribute to the poor nutritional status. (24), which was not carried out in the present study.
Studies have showed that individuals living in rural areas
were at a more than two fold increased risk of developing Conclusion
anaemia than those in urban areas (15,20). Further studies
should be conducted to confirm the suggested reasons In conclusion, anaemia in Jordan is currently a mild pub-
for this high prevalence in the northern region. lic health problem. The prevalence of anaemia has de-
clined from previous reported levels. Most anaemic cases
The most common type of anaemia observed in our
were mild in severity and caused by IDA as expected. It
study was microcytic hypochromic anaemia which seems that the national flour fortification programme is
predominantly represents IDA. Anaemia in females beneficial.
was predominantly caused by iron deficiency where
two thirds of anaemic females had IDA, while around Funding: This research was supported by the National
40% of anaemic males have IDA. Iron supplementation Center for Diabetes, Endocrinology, and Genetics, and
might increase Hb blood levels and greatly reduce the the Scientific Research Fund of the Ministry of Higher
prevalence of anaemia in Jordan. Anaemia is a complex Education. Both provided financial support for the study.
medical condition that might stem from multiple factors. Competing interests: None declared.

Prévalence et déterminants de l’anémie en Jordanie

Contexte : L’anémie est un problème de santé publique mondial, en particulier dans les pays à revenu faible et
intermédiaire, qui peut être associé à de graves conséquences pour la santé. Des études limitées ont examiné la prévalence
et les facteurs de risque de l’anémie en Jordanie au niveau national.
Objectifs : La présente visait à évaluer la prévalence de l’anémie au niveau national en Jordanie pour les deux sexes et à
identifier les sous-groupes de population à haut risque.
Méthodes : Un échantillon national de ménages représentatif de la population a été sélectionné dans les 12 gouvernorats
de Jordanie en 2017. Au total, 1125 hommes et 2797 femmes âgés de 18 à 90 ans ont été inclus. La prévalence de l’anémie,
dans l’ensemble et parmi les sous-groupes de population, a été estimée en utilisant le taux d’hémoglobine selon la
définition de l’OMS.
Résultats : Les résultats ont montré que la prévalence de l’anémie était de 5,2 % chez les hommes, de 20,3 % chez les
femmes non enceintes et de 27,4 % chez les femmes enceintes. L’anémie était principalement bénigne (hommes : 81 %,
femmes non enceintes : 57,0 %, et femmes enceintes : 65,2 %). Le sexe, l’âge, la région, la situation de famille et le niveau de
scolarité étaient significativement associés à l’anémie. L’anémie ferriprive touchait 68 % des femmes anémiques et 38 %
des hommes anémiques.
Conclusions : La prévalence de l’anémie en Jordanie est inférieure à celle précédemment signalée par l’OMS et la majorité
des cas d’anémie était de forme légère. L’anémie ferriprive était le type d’anémie le plus fréquent, en particulier chez les
femmes. L’enrichissement de la farine en fer et en acide folique pourrait expliquer la diminution de l’anémie en Jordanie.

‫معدل انتشار فقر الدم والعوامل املحددة له يف األردن‬

‫ كامل عجلوين‬،‫ حسني أبو زيد‬،‫ حممد اخلطيب‬،‫ صهيب اخلطيب‬،‫ هاشم جدوع‬،‫ يوسف خرض‬،‫ أنور بطيحة‬،‫ شهد دوجالس‬،‫نور عبده‬
‫اخلالصة‬
‫ ولقد‬.‫ وقد يرتبط بعواقب صحية خطرية‬،‫سيام يف البلدان منخفضة ومتوسطة الدخل‬ ّ ‫ ال‬،‫ ُيم ِّثل فقر الدم مشكلة عاملية بالنسبة للصحة العامة‬:‫اخللفية‬
.‫ ببحث معدل انتشار فقر الدم وعوامل اخلطر املرتبطة به يف األردن عىل املستوى الوطني‬،‫ إن وجدت‬،‫قامت دراسات حمدودة‬
‫ وحتديد الفئات السكانية الفرعية‬،‫ هدفت هذه الدراسة إىل تقييم معدل انتشار فقر الدم يف األردن بني اجلنسني عىل املستوى الوطني‬:‫األهداف‬
.‫املعرضة للمخاطر املرتفعة‬
‫ من‬2797‫ من الذكور و‬1125 ‫ وشملت‬.2017 ‫ حمافظة باألردن يف عام‬12 ‫ تم اختيار عينة وطنية من األرس قائمة عىل السكان من‬:‫طرق البحث‬
‫ باستخدام مستوى‬،‫ وتم تقدير معدل انتشار فقر الدم بشكل عام وبني الفئات الفرعية من السكان‬.‫ عا ًما‬90‫ و‬18 ‫ وتراوحت أعامرهم بني‬،‫اإلناث‬
.‫اهليموجلوبني حسب تعريف منظمة الصحة العاملية‬
.‫ بني اإلناث احلوامل‬%27.4‫ و‬،‫ بني اإلناث غري احلوامل‬%20.3‫ و‬،‫ بني الذكور‬%5.2 ‫ أوضحت النتائج أن معدل انتشار فقر الدم بلغ‬:‫النتائج‬
‫ وارتبط نوع اجلنس والعمر واملنطقة‬.)%65.2 :‫ اإلناث احلوامل‬،%57.0 :‫ اإلناث غري احلوامل‬،%81 :‫ويعد فقر الدم يف الغالب خفي ًفا (الذكور‬

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Research article EMHJ – Vol. 25 No. 5 – 2019

‫ عند اإلناث املصابات بفقر الدم‬%68 ‫ وبلغ معدل فقر الدم الناجم عن نقص احلديد‬.‫واحلالة االجتامعية واملستوى التعليمي بفقر الدم بشكل كبري‬
.‫ عند الذكور املصابني بفقر الدم‬%38‫و‬
.‫ وكانت أغلب اإلصابات بفقر الدم خفيفة‬،‫ يعد معدل انتشار فقر الدم يف األردن أقل مما أبلغت عنه ساب ًقا منظمة الصحة العاملية‬:‫االستنتاجات‬
‫ ومن املحتمل أن يكون إغناء الدقيق باحلديد‬.‫سيام بني اإلناث‬
ّ ‫ ال‬،‫انتشارا من فقر الدم‬
ً ‫وكان معدل فقر الدم الناجم عن نقص احلديد النوع األكثر‬
.‫ومحض الفوليك قد أدى إىل انخفاض فقر الدم يف األردن‬

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