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Reducing iron deficiency anaemia due to heavy menstrual blood loss in Nigerian rural adolescents

Published online by Cambridge University Press:  01 December 1998

Fiona Barr ,
Loretta Brabin ,
Shola Agbaje ,
Fiekumo Buseri ,
John Ikimalo  and
Nimi Briggs
Fiona Barr
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
Loretta Brabin*
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
Shola Agbaje
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
Fiekumo Buseri
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
John Ikimalo
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
Nimi Briggs
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
*
*Corresponding author: E-mail tah@liv.ac.uk
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Abstract

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Objective:

Menstrual disorders are common in young women, and heavy menstrual blood losses (MBL) are an important cause of anaemia. Menstrual morbidity normally goes untreated in developing countries where cultural barriers also serve to mask the problems. We investigated the prevalence of menstrual morbidity, and measured MBL and its relationship to iron deficiency in a rural adolescent population. The rationale was to assess whether or not reducing heavy MBL could be part of a strategy to reduce iron deficiency anaemia.

Setting:

Rural village in south-east Nigeria.

Design:

Cross-sectional survey.

Subjects:

The study included all non-pregnant, unmarried nulliparous girls (< 20 years) who had menstruated, and who lived in K'Dere village.

Methods:

A field worker allocated to each girl completed a questionnaire, and supervised recovery and collection of soiled pads and ensured blood sampling. MBL was measured using the standard alkaline haematin method. Haemoglobin (Hb), serum iron, transferrin saturation and protoporphyrin levels (ZPP) were also measured.

Results:

307 girls completed MBL measurements; 11.9% refused to participate. 12.1% had menorrhagia (> 80 ml); median MBL was 33.1 ml. Menorrhagia was more frequent in girls who had menstruated for > 2 years (P = 0.048), and had longer duration of menses (P < 0.001). Iron status as measured by haematocrit, serum iron, transferrin saturation and ZPP values was inversely related to MBL. Neither height nor body mass index for age was associated with current iron status.

Conclusions:

The level of menorrhagia detected (12%) may be an ‘expected’ level for a condition which often has no underlying pathology. Heavy MBL is one of the most important factors contributing to iron deficiency anaemia. Measures are needed to alleviate menstrual disorders, and improve iron status. Oral contraceptives can be part of a strategy to reduce anaemia, particularly for adolescents at high risk of unwanted pregnancies.

Keywords

MenotrhagioAdolescentsNueriaIron statusOral contraceptives
Type
Research Article
Information
Public Health Nutrition , Volume 1 , Issue 4 , December 1998 , pp. 249 - 257
Copyright
Copyright © The Nutrition Society 1998

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