{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:39:16Z","timestamp":1791409156057,"version":"4.3.3"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-017271"],"award-info":[{"award-number":["INV-017271"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Iron deficiency anaemia in pregnancy is a significant contributor to maternal and perinatal morbidity and mortality globally. Despite international and national guidelines for its screening and treatment, knowledge and prescription practices of healthcare providers vary.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To determine maternal healthcare workers\u2019 screening and treatment practices for iron deficiency in anaemic pregnancy women in two states in Nigeria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>This cross-sectional study sampled maternal healthcare workers from 84 randomly selected public health facilities in Lagos and Kano States. Data on methods of diagnosis and prescription practices for iron deficiency anaemia were collected using a self-administered questionnaire. Means and percentages were reported using probability weights, and a comparison of practices of anaemia treatment between doctors and nurses\/midwives was done using Chi-square test or Fishers exact.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 467 maternal healthcare workers surveyed (232 from Lagos, 235 from Kano), 40.0% were doctors, 54.0% nurses or midwives and 6.0% community health extension workers. In the sample, 27.6% always and 58.7% sometimes screened anaemic pregnant women for iron deficiency; among these, 84.7% screened using complete blood count. Oral iron for treatment of iron deficiency anaemia was prescribed by 96.9%. Intravenous iron for treatment was prescribed by 30.2%, but by only by 18.6% as first-line drug (as iron dextran by 69.3% and as iron sucrose by 31.5% of intravenous iron prescribers). Commonest reasons for low usage of intravenous iron were cost and need for venepuncture. Fifty-three percent of maternal healthcare workers\u2019 prescribed iron supplements for anaemia during concomitant infection, with the prescription practice similar among doctors versus nurse\/midwives (p = 0.074).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We found suboptimal levels of screening for iron deficiency among anaemic pregnant women. Iron deficiency anaemia in pregnancy is almost exclusively treated with oral iron by maternal healthcare workers in the two Nigerian states, similarly between doctors and nurses\/midwives. Further research into potential reasons for low screening for iron deficiency and low use of intravenous iron are needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310912","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T18:30:09Z","timestamp":1732213809000},"page":"e0310912","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Screening and treatment practices for iron deficiency in anaemic pregnant women: A cross-sectional survey of healthcare workers in Nigeria"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6680-3242","authenticated-orcid":true,"given":"Ochuwa Adiketu","family":"Babah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Be\u0148ov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajibola Ibraheem","family":"Abioye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin C.","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bosede Bukola","family":"Afolabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"pone.0310912.ref001","article-title":"WHO Global Anaemia Estimates, 2021 Edition","author":"WHO","year":"2021"},{"issue":"5","key":"pone.0310912.ref002","doi-asserted-by":"crossref","first-page":"e627","DOI":"10.1016\/S2214-109X(22)00084-5","article-title":"National, regional, and global estimates of anaemia by severity in women and children for 2000\u201319: a pooled analysis of population-representative data","volume":"10","author":"GA Stevens","year":"2022","journal-title":"Lancet Glob Health"},{"key":"pone.0310912.ref003","volume-title":"Global nutrition targets 2025: policy brief series","author":"WHO","year":"2014"},{"issue":"2","key":"pone.0310912.ref004","doi-asserted-by":"crossref","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","article-title":"The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health.","volume":"36","author":"NM Abu-Ouf","year":"2015","journal-title":"Saudi Med J"},{"issue":"8","key":"pone.0310912.ref005","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.1007\/s00277-023-05279-2","article-title":"Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000\u20132019).","volume":"102","author":"E Araujo Costa","year":"2023","journal-title":"Annals of Hematology"},{"issue":"4","key":"pone.0310912.ref006","first-page":"295","article-title":"Anaemia in pregnancy: a survey of pregnant women in Abeokuta, Nigeria.","volume":"5","author":"OA Idowu","year":"2005","journal-title":"African health sciences."},{"key":"pone.0310912.ref007","first-page":"268","article-title":"Nigeria Demographic and Health Survey [FR359]","volume":"174","author":"NDHS","year":"2018"},{"key":"pone.0310912.ref008","volume-title":"Iron Supplementation","author":"M Nguyen","year":"2023"},{"issue":"2","key":"pone.0310912.ref009","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ejh.13892","article-title":"The role of oral iron in the treatment of adults with iron deficiency","volume":"110","author":"JO Lo","year":"2023","journal-title":"Eur J Haematol"},{"key":"pone.0310912.ref010","volume-title":"Antenatal iron supplementation","author":"WHO","year":"2022"},{"key":"pone.0310912.ref011","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience.","author":"WHO","year":"2016"},{"issue":"3","key":"pone.0310912.ref012","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1093\/heapol\/14.3.291","article-title":"Rationality of Drug Prescriptions in Rural Health Centres in Burkina Faso.","volume":"14","author":"G Krause","year":"1999","journal-title":"Health Policy and Planning."},{"key":"pone.0310912.ref013","doi-asserted-by":"crossref","first-page":"100308","DOI":"10.1016\/j.rcsop.2023.100308","article-title":"A cross-sectional study on the knowledge, attitude, and practice of pregnant women regarding medication use and restriction during pregnancy.","volume":"11","author":"OC Obi","year":"2023","journal-title":"Exploratory Research in Clinical and Social Pharmacy"},{"issue":"1","key":"pone.0310912.ref014","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12884-023-06169-1","article-title":"Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study.","volume":"24","author":"OA Babah","year":"2024","journal-title":"BMC Pregnancy and Childbirth"},{"key":"pone.0310912.ref015","first-page":"4","article-title":"Clinical audit of drug prescriptions in Nigeria: An urgent and lifesaving need","author":"BA Animasahun","year":"2019","journal-title":"Journal of Xiangya Medicine"},{"issue":"1","key":"pone.0310912.ref016","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1186\/s13063-022-06690-2","article-title":"Intravenous versus oral iron for iron deficiency anaemia in pregnant Nigerian women (IVON): study protocol for a randomised hybrid effectiveness-implementation trial.","volume":"23","author":"BB Afolabi","year":"2022","journal-title":"Trials."},{"key":"pone.0310912.ref017","doi-asserted-by":"crossref","first-page":"1915231","DOI":"10.1155\/2020\/1915231","article-title":"Prevalence, Severity, and Correlates of Anaemia in Pregnancy among Antenatal Attendees in Warri, South-Southern Nigeria: A Cross-Sectional and Hospital-Based Study.","volume":"2020","author":"V Omote","year":"2020","journal-title":"Anemia."},{"issue":"5","key":"pone.0310912.ref018","doi-asserted-by":"crossref","first-page":"451","DOI":"10.3109\/01443615.2013.771158","article-title":"Anaemia in pregnancy: a public health problem in Enugu, southeast Nigeria.","volume":"33","author":"EC Ezugwu","year":"2013","journal-title":"J Obstet Gynaecol"},{"issue":"1","key":"pone.0310912.ref019","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3109\/01443615.2015.1025727","article-title":"Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care.","volume":"36","author":"AI Adanikin","year":"2016","journal-title":"J Obstet Gynaecol"},{"issue":"5","key":"pone.0310912.ref020","doi-asserted-by":"crossref","first-page":"594","DOI":"10.3109\/01443615.2015.1116500","article-title":"A retrospective study of the prevalence of anaemia in pregnancy at booking in Niger Delta, Nigeria.","volume":"36","author":"DA Okoh","year":"2016","journal-title":"J Obstet Gynaecol"},{"key":"pone.0310912.ref021","doi-asserted-by":"crossref","first-page":"849080","DOI":"10.1155\/2014\/849080","article-title":"Prevalence of Anaemia among Pregnant Women at Booking in the University of Uyo Teaching Hospital, Uyo, Nigeria.","volume":"2014","author":"OA Olatunbosun","year":"2014","journal-title":"BioMed Research International"},{"issue":"7","key":"pone.0310912.ref022","doi-asserted-by":"crossref","first-page":"889","DOI":"10.4103\/njcp.njcp_197_19","article-title":"Iron deficiency anemia in pregnancy in Nigeria&#8212;A systematic review.","volume":"23","author":"N Ugwu","year":"2020","journal-title":"Nigerian Journal of Clinical Practice."},{"issue":"1","key":"pone.0310912.ref023","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s41043-016-0066-9","article-title":"Anaemia is typical of pregnancies: capturing community perception and management of anaemia in pregnancy in Anambra State, Nigeria.","volume":"35","author":"NG Onyeneho","year":"2016","journal-title":"Journal of Health, Population and Nutrition."},{"issue":"1","key":"pone.0310912.ref024","doi-asserted-by":"crossref","first-page":"e0227965","DOI":"10.1371\/journal.pone.0227965","article-title":"Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria.","volume":"15","author":"AA Ajepe","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"pone.0310912.ref025","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1186\/s12913-020-05700-w","article-title":"Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003\u20132017.","volume":"20","author":"C Okoli","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"pone.0310912.ref026","volume-title":"NDHS.Nigeria","year":"2018"},{"issue":"1","key":"pone.0310912.ref027","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1186\/s12884-020-03363-3","article-title":"The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians.","volume":"20","author":"S Smith-Wade","year":"2020","journal-title":"BMC Pregnancy Childbirth."},{"key":"pone.0310912.ref028","first-page":"1","article-title":"Determining sample size.","author":"Israel GD","year":"2003","journal-title":"University of Florida IFAS extension"},{"key":"pone.0310912.ref029","first-page":"2021","article-title":"Number of doctors in Nigeria from 2017 to 2019, by gender2021 Sep 1","author":"Statista"},{"key":"pone.0310912.ref030","article-title":"Achievements of the secretary-general\/ registrar nursing and midwifery, October 2016\u2014June 2020","author":"NMCN","year":"2020"},{"key":"pone.0310912.ref031","volume-title":"Distribution of hospitals and clinics in Nigeria","author":"FMOH","year":"2019"},{"issue":"2","key":"pone.0310912.ref032","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.apmr.2005.09.021","article-title":"Understanding the use of weights in the analysis of data from multistage surveys","volume":"87","author":"MA Ciol","year":"2006","journal-title":"Arch Phys Med Rehabil"},{"key":"pone.0310912.ref033","article-title":"Construction and use of sample weights.","author":"IS Yansaneh","year":"2003"},{"key":"pone.0310912.ref034","volume-title":"Anaemia","author":"WHO","year":"2023"},{"issue":"8","key":"pone.0310912.ref035","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s10995-016-2252-1","article-title":"Screening and Treatment for Iron Deficiency Anemia in Women: Results of a Survey of Obstetrician-Gynecologists.","volume":"21","author":"LH Marcewicz","year":"2017","journal-title":"Matern Child Health J."},{"issue":"Suppl 1","key":"pone.0310912.ref036","doi-asserted-by":"crossref","first-page":"e008317","DOI":"10.1136\/bmjgh-2021-008317","article-title":"The health workforce status in the WHO African Region: findings of a cross-sectional study","volume":"7","author":"A Ahmat","year":"2022","journal-title":"BMJ Global Health"},{"issue":"12","key":"pone.0310912.ref037","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s00277-008-0518-4","article-title":"Prepartum anaemia: prevention and treatment","volume":"87","author":"N. Milman","year":"2008","journal-title":"Annals of Hematology"},{"issue":"6","key":"pone.0310912.ref038","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1093\/ndt\/gfh185","article-title":"On the relative safety of parenteral iron formulations.","volume":"19","author":"GM Chertow","year":"2004","journal-title":"Nephrol Dial Transplant"},{"issue":"6","key":"pone.0310912.ref039","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/bjh.14593","article-title":"Anaemia, iron deficiency and susceptibility to infection in children in sub-Saharan Africa, guideline dilemmas","volume":"177","author":"FAM Jonker","year":"2017","journal-title":"Br J Haematol"},{"key":"pone.0310912.ref040","doi-asserted-by":"crossref","first-page":"100864","DOI":"10.1016\/j.mam.2020.100864","article-title":"Iron in infection and immunity.","volume":"75","author":"M Nairz","year":"2020","journal-title":"Molecular Aspects of Medicine."},{"key":"pone.0310912.ref041","first-page":"4","article-title":"Risk of Infection Associated With Administration of Intravenous Iron: A Systematic Review and Meta-analysis","author":"AA Shah","year":"2021","journal-title":"JAMA Network Open"},{"issue":"11","key":"pone.0310912.ref042","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.34453","article-title":"Intravenous Iron and Infection Risk\u2014Still an Unanswered Question","volume":"4","author":"D. Rund","year":"2021","journal-title":"JAMA Network Open"},{"issue":"6","key":"pone.0310912.ref043","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/bjh.14584","article-title":"Safety and benefits of antenatal oral iron supplementation in low-income countries: a review","volume":"177","author":"MN Mwangi","year":"2017","journal-title":"Br J Haematol"},{"issue":"9\u201310","key":"pone.0310912.ref044","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1111\/jocn.13628","article-title":"Newly graduated nurses\u2019 use of knowledge sources in clinical decision-making: an ethnographic study","volume":"26","author":"SL Voldbjerg","year":"2017","journal-title":"Journal of Clinical Nursing"},{"issue":"3","key":"pone.0310912.ref045","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/pubmed\/fdi031","article-title":"Mode of questionnaire administration can have serious effects on data quality.","volume":"27","author":"A. Bowling","year":"2005","journal-title":"J Public Health (Oxf)."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T18:30:27Z","timestamp":1732213827000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310912"}},"subtitle":[],"editor":[{"given":"Blessing","family":"Akombi-Inyang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":45,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310912","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}