Morphological classes of anemia are associated with hematological parameters but not parasitic infections among women of reproductive age in Kwale, coastal Kenya

Abstract Anemia disproportionately affects women of reproductive age (WRA) and children below the age of five. Iron deficiency is the major cause of anemia followed by other underlying causes such as malaria, chronic kidney disease, and neglected tropical diseases. This study aimed to determine the morphological classes of anemia and their association with schistosomiasis, malaria, and soil transmitted Helminthes (STH) among WRA in Kwale county, Kenya. Using a cross-sectional study design, parasitic infections and anemia were analyzed from 534 WRA. Frequencies and proportions with 95% confidence intervals were determined. Multilevel mixed-effect logistic regression models were performed to identify variables associated with morphological classes of anemia. The prevalence of normocytic, microcytic and macrocytic anemia was 54%, 43% and 2.3% respectively. The prevalence of Schistosomiasis among women with Normocytic and Microcytic anemia was 4.2% and 3.5%, respectively (P-value=0.72). Microcytic (adjusted Odds Ratio (aOR) 0.65 (95%CI 0.15‒2.78)) compared to normocytic were not associated with Schistosomiasis. The prevalence of malaria among women with Normocytic, Microcytic, and Macrocytic was 5.2%, 4.4%, and 8.3% respectively (P-value=0.78). Microcytic (aOR 1.76 (95%CI 0.43‒7.23)) and macrocytic (aOR 1.75 (95%CI 0.11‒28.0)) compared to normocytic were not associated with malaria. The prevalence of STH among women with Normocytic, Microcytic, and Macrocytic was 7.0%, 3.9%, and 8.3% respectively (P-value=0.31). Microcytic (aOR 0.51 (95%CI 0.13‒2.01)) and macrocytic (aOR 0.72 (95%CI 0.06‒9.39)) compared to normocytic were not associated with STH. Anemia severity (P-value<0.001), RBCs (P-value=0.0001), HCT (P-value=0.0001), platelets (P-value=0.006) MCH (P-value=0.0001) and MCHC (P-value=0.0001) were significantly different across the morphological classes of anemia. In conclusion, the prevalences of normocytic and microcytic anemias were high but not associated with parasitic infections, indicating the possibility of other contributing factors for these morphological classes of anemia in this population.