Folate deficiency among women of reproductive age in Ethiopia: A systematic review and meta-analysis

Article


Gebremichael, Berhe, Roba, Hirbo Shore, Getachew, Alemeshet, Tesfaye, Dejene and Asmerom, Haftu. 2023. "Folate deficiency among women of reproductive age in Ethiopia: A systematic review and meta-analysis ." PLoS One. 18. https://doi.org/10.1371/journal.pone.0285281
Article Title

Folate deficiency among women of reproductive age in Ethiopia: A systematic review and meta-analysis

ERA Journal ID39745
Article CategoryArticle
AuthorsGebremichael, Berhe, Roba, Hirbo Shore, Getachew, Alemeshet, Tesfaye, Dejene and Asmerom, Haftu
Journal TitlePLoS One
Journal Citation18
Number of Pages22
Year2023
PublisherPublic Library of Science (PLoS)
Place of PublicationUnited States
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0285281
Web Address (URL)https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285281
Abstract

Background
Folate deficiency (FD) can cause adverse health outcomes of public health significance. Although FD is a significant micronutrient deficiency in Ethiopia, concrete evidence is limited. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of FD among women of reproductive age (WRA).

Methods
A systematic literature search was performed using MEDLINE, Embase, CINAHL, Google Scholar, African Journals Online (AJOL), The Vitamin and Mineral Nutrition Information System (VMNIS) of the World Health Organization (WHO), Global Health Data Exchange (GHDx), and institutional repositories of major universities and research centers. Additionally, we scanned the reference lists of relevant articles. Two authors independently selected the studies, extracted the data, and the study risk of bias. Heterogeneity was assessed using the I2 statistic. We used a random-effects model to estimate the pooled mean serum/plasma folate and the pooled prevalence of FD. Begg’s and Egger’s tests were used to check publication bias.

Results
Ten studies—nine cross-sectional and one case-control—with a total of 5,623 WRA were included in the systematic review and meta-analysis. Four (WRA = 1,619) and eight (WRA = 5,196) cross-sectional studies were used to estimate the pooled mean serum/plasma folate and prevalence of FD, respectively. The pooled mean serum/plasma folate concentration estimate was 7.14 ng/ml (95% CI: 5.73, 8.54), and the pooled prevalence of FD was estimated to be 20.80% (95% CI: 11.29, 32.27). In addition the meta-regression analysis showed that the sampling technique was significantly associated with mean serum/plasma folate concentration.

Conclusions
FD is a significant public health issue among WRA in Ethiopia. Therefore, the public health strategies of the country should focus on promoting the consumption of folate-rich foods, strengthening the coverage of folic acid supplementation and its adherence, and swift translation of the mandatory folic acid fortification into action.

KeywordsFolate deficiency; women of reproductive age
ANZSRC Field of Research 20204299. Other health sciences
Byline AffiliationsHaramaya University, Ethiopia
School of Health and Medical Sciences
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