Burden and determinants of anaemia among in-school young adolescents in Ethiopia, Sudan and Tanzania.

Journal: Maternal & child nutrition

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Affiliated Institutions:  Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. School of Health Sciences, Ahfad University for Women, Omdurman, Sudan. Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany. Africa Academy for Public Health, Dar es Salaam, Tanzania. United Nations Children's Fund, New York, New York, USA. DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa. Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

Abstract summary 

Anaemia among adolescents is a global health problem. However, evidence regarding its burden and risk factors, particularly for younger adolescents and in sub-Saharan Africa (SSA), remains scarce. We aimed to assess the prevalence and potential determinants of anaemia among urban and semi-urban in-school young adolescents in Ethiopia, Sudan and Tanzania. We conducted a school-based survey among 3558 adolescents aged 10-14 years. A capillary blood sample was used to assess haemoglobin concentration. We assessed anaemia prevalence and examined associations between measures at the individual, household and school levels and anaemia using Poisson regression models adjusted for school and country-level clustering. The prevalence of anaemia was 32.0% overall, and 10.8% in Ethiopia, 25.0% in Sudan and 58.3% in Tanzania. Being a boy [adjusted risk ratio (RR): 1.11, 95% confidence interval (CI): 1.08-1.15, p < 0.001], poorer diet quality (RR: 1.12, 95% CI: 1.02-1.23 p = 0.015), no school handwashing stations (RR: 1.26, 95% CI: 1.20-1.32, p < 0.001) and food insecurity (RR for moderate/severe anaemia: 1.06, 95% CI: 1.02-1.10, p = 0.002) were associated with increased anaemia risk. Younger age (RR: 0.91, 95% CI: 0.86-0.96, p < 0.001) and increasing height-for-age z-score (RR: 0.93, 95% CI: 0.91-0.95, p < 0.001) were associated with decreased anaemia risk. Associations were consistent for moderate or severe anaemia. There was no evidence of effect modification by sex. This study highlights anaemia as a public health problem and identified nutritional, dietary and hygiene measures as key risk factors of anaemia among young adolescents in SSA. School-based interventions addressing these factors could reduce the burden of anaemia in adolescence.

Authors & Co-authors:  Partap Uttara U Tadesse Amare W AW Shinde Sachin S Sherfi Huda H Mank Isabel I Mwanyika-Sando Mary M Sharma Deepika D Baernighausen Till T Drysdale Roisin R Worku Alemayehu A Tinkasimile Amani A Fawzi Wafaie W WW

Study Outcome 

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Statistics
Citations :  Azupogo, F., Aurino, E., Gelli, A., Bosompem, K. M., Ayi, I., Osendarp, S., Brouwer, I. D., & Folson, G. (2019). Agro-ecological zone and farm diversity are factors associated with haemoglobin and anaemia among rural school-aged children and adolescents in Ghana. Maternal & Child Nutrition, 15(1), 12643. https://doi.org/10.1111/mcn.12643
Authors :  12
Identifiers
Doi : 10.1111/mcn.13439
SSN : 1740-8709
Study Population
Boy
Mesh Terms
Other Terms
Ethiopia;Sudan;Tanzania;adolescent;anaemia;diet, food, and nutrition;hygiene
Study Design
Study Approach
Country of Study
Tanzania
Publication Country
England