ArticlePloS one2026
Anemia and its associated factors among women of reproductive Age in Zambia: A multilevel mixed-effects analysis.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Anaemia Among Women in Lesotho: Findings From 2023 to 2024 Demographic and Health Survey.Health science reports · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnemia remains a major global health crisis, affecting over 500 million women of reproductive age, with high burdens in resource-limited regions like Sub-Saharan Africa. Despite ongoing interventions such as iron supplementation programs, 49% of women of reproductive age in Zambia are anemic. Thus, the purpose of this study was to establish the national and subnational prevalence of anemia and identify its determinants among women of reproductive age in Zambia.
methodsData were drawn from the 2018 Zambia Demographic and Health Survey (ZDHS), a nationally representative survey employing a stratified two-stage cluster sampling design across 545 enumeration areas. A multilevel mixed-effects logistic regression model was used to identify individual- and community-level factors associated with anemia among women aged 15-49 years (n = 13,055). Four hierarchical models were constructed (null, individual-level, community-level, and full) to assess fixed and random effects, with model selection guided by Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) criteria. Spatial analysis was conducted using Quantum Geographic Information System (QGIS), incorporating displaced GPS coordinates in accordance with Demographic Health Survey (DHS) protocols. All analyses applied sampling weights and assessed multicollinearity (Variance Inflation Factor -VIFs < 5).
resultsThe national prevalence of anemia among women of reproductive age was 31% (95% Confidence Interval [CI]: 29-33%), with the highest rates observed in Western (38%) and Lusaka (36%) provinces, and the lowest in Central Province (24%). In adjusted analyses, pregnancy (Adjusted Odds Ratio [AOR] = 1.76; 95% CI: 1.52-2.03), Human Immunodeficiency Virus (HIV) positivity (AOR = 2.21; 95% CI: 1.97-2.49), and breastfeeding (AOR = 1.15; 95% CI: 1.02-1.30) were significantly associated with increased odds of anemia. Conversely, being married (AOR = 0.78; 95% CI: 0.68-0.90) and age 25-29 years (AOR = 0.84; 95% CI: 0.71-0.97) were protective. Spatial mapping identified Western Province as a high-burden hotspot. Community-level variance was notable (Intraclass Correlation Coefficient [ICC] = 6%, Median Odds Ratio [MOR] = 1.52), with 5% residual clustering persisting after adjusting for both individual and contextual factors, suggesting the influence of unmeasured ecological determinants.
conclusionAnemia remains a significant public health issue among Zambian women of reproductive age, shaped by both individual- and community-level factors. These findings highlight the need for integrated, targeted interventions focusing on high-risk groups in high-prevalence areas. Strengthening clinical services and implementing community-based strategies to address healthcare access and environmental determinants are essential to reducing the burden of anemia in Zambia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.