Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Melody Ryan

Committee Member

Dr. Steven Fleming

Committee Member

Dr. Wayne Sanderson


BACKGROUND: Shoulder to Shoulder Global (STSG) recognizes anemia as a cause of morbidity among patients in Santo Domingo, Ecuador. Little research has been done to assess targetable anemia risk factors to serve as a foundation for future pharmacotherapeutic interventions. This study sought to identify risk factors for anemia in this population.

METHODS: Data obtained from existing patient records from January 1, 2010 to August 31, 2016 included hemoglobin/hematocrit, age, sex, pregnancy status, and presenting community. Chi-square tests compared means to examine risk factors associated with anemia. Poisson regression and incidence rate ratios (IRR) were used to estimate risk factors associated with anemia.

RESULTS: Of the 1145 subjects with complete data for analysis, 67.2% were female, 33% were children under five, 1.6% were pregnant, and 42.8% were anemic. Subjects were distributed throughout the seven communities with 11.2% presenting from an indigenous community. Risk factors for anemia were age <5 years and presenting from the communities of Plan de Vivienda, Los Naranjos, or El Bua. Neither sex, nor pregnancy were significantly associated risk factors with anemia.

CONCLUSION: Risk factors for anemia in this population have not previously been determined. In this study, risk factors were age group <5 years and presentation from three different communities. A limitation of the study is its observational design. Additional research should evaluate the effectiveness of STSG health interventions on anemia.

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