[AP3-E2-3-02] Effects of Renal Dysfunction on the Improvement of Anemia in Bangladesh: An Epidemiological Analysis of Health Checkup Data with ICT Intervention
Hemoglobin, Urine Protein, Health Checkup, Bangladesh, Multilevel Model
The association between improvements in anemia in regions with high urine protein (UP) was examined epidemiologically using the results of regional health checkups. The study hypothesis was that mild renal dysfunction emerging along with abnormal UP hindered improvements in hemoglobin (Hb) despite health checkups.
Of 14,906 first-time subjects who received a remote health checkup between 2012 and 2014, data from 3,104 subjects who had their Hb tested were collected from 13 regional sites for analysis. The average Hb was 11.5 (SD1.4) g/dl, indicating 1,821 (59%) had anemia, and 916 (30%) had abnormal UP. A statistically significant association between UP and anemia (p = 0.002) was shown. Considering this first checkup as an intervention, 350 women received checkups again after 2–4 months. The women were divided into two groups based on having abnormal UP or not and were compared.
No statistically significant difference was found between the two groups at baseline in terms of Hb, anemia, iron prescription rate, or age. At the second checkup, Hb significantly increased in each group. The positive increase in Hb in this period in the two groups were 0.5 (SD1.5) g/dl and 0.7 (SD1.5) g/dl, respectively, and the difference was statistically significant (p = 0.0291). In the multilevel analysis considering the time and the various survey sites, prescribed iron was shown to contribute to Hb improvements (Coefficient 0.65, p<0.001). The presence of UP also tended to impair Hb improvements, but the difference was not significant (Coefficient -0.24, p = 0.085).
In this study, the health checkup interventions improved Hb levels and decreased the prevalence of anemia, mainly due to iron supplements. Regarding the negative effect of UP on the improvement of Hb, there was some evidence that Hb improvements were impaired among subjects suspected of having mild renal dysfunction.
Of 14,906 first-time subjects who received a remote health checkup between 2012 and 2014, data from 3,104 subjects who had their Hb tested were collected from 13 regional sites for analysis. The average Hb was 11.5 (SD1.4) g/dl, indicating 1,821 (59%) had anemia, and 916 (30%) had abnormal UP. A statistically significant association between UP and anemia (p = 0.002) was shown. Considering this first checkup as an intervention, 350 women received checkups again after 2–4 months. The women were divided into two groups based on having abnormal UP or not and were compared.
No statistically significant difference was found between the two groups at baseline in terms of Hb, anemia, iron prescription rate, or age. At the second checkup, Hb significantly increased in each group. The positive increase in Hb in this period in the two groups were 0.5 (SD1.5) g/dl and 0.7 (SD1.5) g/dl, respectively, and the difference was statistically significant (p = 0.0291). In the multilevel analysis considering the time and the various survey sites, prescribed iron was shown to contribute to Hb improvements (Coefficient 0.65, p<0.001). The presence of UP also tended to impair Hb improvements, but the difference was not significant (Coefficient -0.24, p = 0.085).
In this study, the health checkup interventions improved Hb levels and decreased the prevalence of anemia, mainly due to iron supplements. Regarding the negative effect of UP on the improvement of Hb, there was some evidence that Hb improvements were impaired among subjects suspected of having mild renal dysfunction.