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The surge of teenage pregnancy in Delta State is worrying.

Africa: 50% of Pregnant Women Suffer Anaemia – Pate

The Coordinating Minister of Health and Social Welfare, Professor Ali Pate, has revealed that 50 per cent of pregnant women in Africa are suffering from anaemia.

Pate, who was represented by the Chief Medical Director of the Lagos University Teaching Hospital, Professor Lanre Adeyemo, disclosed this recently at the close-out ceremony of the IVON Clinical Trial.

The IVON Clinical Trial is a study funded by Bill and Melinda Gates Foundation and conducted in 11 health facilities in Lagos and Kano States to determine the efficacy of either intravenous or oral iron for iron deficiency anaemia in pregnant Nigerian women.

Anaemia, according to the World Health Organisation, WHO, is haemoglobin concentration below a specified cut-off point caused by iron deficiency, acute and chronic infections that result in inflammation and blood loss, deficiencies of other vitamins and minerals, especially folate, vitamin B12 and vitamin A; and genetically inherited traits, such as thalassaemia.

The WHO defines anaemia in pregnant women as a haemoglobin concentration <110 g/L at sea level, warning that it increases the risk of maternal and child morbidity and death rates.

Already, Nigeria has one of the highest maternal mortality rates in the world, with an estimated 512 deaths per 100,000 live births according to the Nigeria Demographic and Health Survey 2018.

The minister, on behalf of President Bola Tinubu, expressed gratitude to the Bill and Melinda Gates Foundation for funding “this laudable project.”

Pate further congratulated the Principal Investigator, Professor Bosede Afolabi and her team for a job well done.

He said, “Anaemia in pregnancy is highly prevalent in African countries. Globally, anaemia is the commonest medical condition affecting pregnant women and in Africa, about 50 percent of all pregnant women are affected. In Nigeria, the most populous country in Africa, about three in five pregnant women have anaemia.

“The condition, which is mostly caused by iron deficiency, is associated with increased risk of maternal and perinatal morbidity and mortality. It is recognised as a major global health problem with an indicator dedicated to tracking reduction efforts of anaemia in women 15–49 years of age, including pregnant women, added to the United Nations 2030 Agenda for Sustainable Development in 2020.

“Therefore, IVON clinical trial is a significant milestone in global efforts to reduce maternal and child morbidity and mortality, and the contributions of IVON trial team cannot be over emphasised.”

The minister reiterated his commitment to the four point agenda of the Federal Ministry of Health and Social Welfare which are, “improving quality of Governance and Leadership of hospitals, regulatory capacity of agencies under the ministry, improving population health outcomes, promoting medical industrialisation, improving Health Security/investment in Public Health.”

Pate stated that the outcome of the trial would change clinical obstetrics practice and reduce maternal and child mortality and morbidity rate.

On her part, Afolabi said anaemia was recognised as a major global health problem with an indicator dedicated to tracking reduction efforts of anaemia in women 15–49 years of age, including pregnant women.

Speaking on the background of the study, the Principal Investigator stated that oral iron drugs for anaemia in pregnancy was often poorly tolerated and adhered to.

She further noted that the study was conducted to investigate the effectiveness and safety of intravenous iron drug, ferric carboxymaltose, to address tolerance and adherence issues of oral iron drugs.

“Oral iron is widely used as treatment; however, this is fraught with diverse gastro-intestinal symptoms, which limit adherence. Alternative therapy is intravenous iron, which exists in different formulations, many of which could trigger severe reactions and require multiple doses.

“In recent times, there has been increasing interest in using a novel intravenous treatment, Ferric Carboxymaltose, which has no identified safety issues except transient hypophosphatemia, in Africa.

“However, evidence on the relative effectiveness of the intervention is extremely limited on the continent, with only one clinical trial recently published in The Lancet.

“To address this gap, we conducted the largest trial to date, of 1,056 pregnant women, to investigate the comparative effectiveness and safety of FCM versus oral iron, ferrous sulphate, in pregnant Nigerian women. We did this in a trial conducted in Nigeria dubbed The IVON Trial which was fully funded by Bill & Melinda Gates Foundation (Investment ID INV-017271),” Afolabi said.