BURDEN AND DETERMINANT FACTORS OF ANEMIA AMONG ELEMENTARY SCHOOL CHILDREN IN NORTHWEST ETHIOPIA: A COMPARATIVE CROSS SECTIONAL STUDY

Anemia and Associated Factors among Public Elementary School Children in Asella Town, Southeast Ethiopia: A Facility-Based Cross-Sectional Study

Background

Anemia has a negative impact on school children, including poor physical growth and reduced mental performance. Children show poor attentiveness, behavior, and memory and reduced school performance. There is limited evidence of the magnitude of anemia and associated factors in school-age children in Ethiopia, including the study area.

Objective

To assess the magnitude of anemia and associated factors among public elementary school children in Asella Town, Southeast Ethiopia, in 2022.

Methods

A school-based cross-sectional study was conducted in Asella Town from April 5 to May 5, 2022. A total of 442 school children aged 7-14 years were included in the study using the multistage sampling method. Data were collected using a pretested and semistructured questionnaire through a face-to-face interview technique. The hemoglobin concentration was determined by using the HemoCue 301+ analyzer. Anthropometric data and stool examinations were collected from participants. Data were entered into EpiData version 4.6, transported, and analyzed by Statistical Package for Social Sciences version 26. Bivariable and multivariable logistic regression analyses were carried out. Adjusted odds ratios along with their 95% confidence interval were used, and a p value of ≤0.05 was used for declaring statistical significance.

Results

A total of 435 students with a mean age and standard deviation of 10.77 ± 2.21 years participated in the study. The magnitude of anemia was 78 (17.9%), with a 95% CI (14.3, 21.47). Of the participants, 63 (14.5%) were mild anemic and 15 (3.4%) were moderately anemic. Children whose mothers have no formal education (AOR = 3.94, 95% CI: 1.89, 8.21), underweight children (AOR = 3.83, 95% CI: 1.98, 7.40), and parasites in their stool (AOR = 3.72, 95% CI: 1.50, 9.20) were significantly associated with anemia in school-age children.

Conclusion

Anemia among school-age children was found to be a mild public health problem. Uneducated mothers, intestinal parasite infections, and underweight children were found to be determinants of anemia among school-age children. Health professionals should provide health education for mothers about child-feeding practices and the consumption of dietary sources of iron.

Prevalence and Predictors of Anemia Among Children Aged 6-23 Months in Dodota District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

Background

Globally, anemia is a public health problem affecting children living in both developed and developing countries with bad consequences on children’s cognitive, social, and economic development.

Objective

To assess the prevalence and predictors of anemia among children aged 6–23 months residing at Dodota district, Southeast Ethiopia.

Methods

A community-based cross-sectional study was conducted from January–July 2019, at Dodota district, in Southeast Ethiopia. Multistage, random, and systematic sampling techniques were employed to recruit households and study participants. Trained community health extension workers were involved in the data collection. Data were entered into Epi_info 7.2.2 for clean-up and exported to SPSS 21 for analysis. Frequency and proportion were used to describe nominal and ordinal variables. Mean with SD were used to describe continuous variables. Pearson correlation coefficient was used to assess correlation between numeric variables. Regressional analysis was used to assess factors predicting the occurrence of anemia. P<0.05 with 95% CI was considered significant.

Results

A total of 917 children were included and the prevalence of anemia was found to be 407 (44.4%, 95% CI=41.1–47.4). When stratified to age category, the prevalence of anemia was highest among the age group of 6–12 months. Lack of ANC visits, lack of iron supplementation during pregnancy, untimely initiation of complementary feeding, and initiation of cow’s milk before 1 year of age were factors associated with anemia.

Conclusion

The prevalence of anemia was at the level of major public health problems. Antenatal and obstetric factors as well as child feeding practices were risk factors associated with anemia; and utilizing obstetric and childcare practices is highly recommended to mitigate this public health problem.

A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia

Background

Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia.

Method

The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined.

Results

The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children.

Conclusion

In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem.

Soil-transmitted helminth infections, anemia and undernutrition among schoolchildren in Yirgacheffee, South Ethiopia

Objective

Current data on soil-transmitted helminth infections, anemia and malnutrition that are largely neglected is vital to the control and management of them in a specific setting. This study was, therefore, aimed at determining the status of the three health concerns in one of the high-risk groups, schoolchildren, in South Ethiopia.

Results

Among the 443 sampled schoolchildren, 54% were infected with soil-transmitted helminths (STHs) and 15.4% of them had anaemia, while the prevalence rate of undernutrition was 28.9%. Species-wise, prevalence of STH infections was 21.7, 16.7, 7.2 and 8.4% for Ascaris lumbricoides, the hookworms, Trichuris trichiura and mixed infections, respectively. Untreated drinking water, high frequency of sucking fingernails and open defecation were significantly associated with risk of getting STH infections. Child positivity for STH infection didn’t show any significant association with undernutrition of the children. Anaemia was significantly correlated with hookworm (adjusted odds ratio (AOR) = 2.96, 95% confidence interval (CI) = 2.15, 4.86), A. lumbricoides (AOR = 1.93, 95% CI = 1.13, 3.01) and polyparasitism (AOR = 1.54, 95% CI = 1.04, 2.64). In addition, children with heavy intensities of hookworm infections and those undernourished were more likely to suffer from anaemia with P = 0.001 and P = 0.007, respectively.

Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Anemia is one of the global public health problems affecting more than one-third of the world population. It has been strongly associated with limited psychomotor development; and poor growth and performance in cognitive, social, and emotional function in children. Despite published data revealed that anemia is a public health problem among children in Ethiopia, there is no a pooled national estimate on the prevalence and associated risk factors of anemia.

METHODS

Published articles until December 31, 2017, were searched using comprehensive search strings through PubMed/Medline, EMBASE, SCOPUS, HINARI, Web of Science, Google Scholar and Google. Reference probing of published articles and hand searching were employed for grey literature. Two groups of review authors independently appraised the studies for eligibility and extracted the data. The quality of articles was assessed using Joana Brigg's institute critical appraisal checklist for prevalence and analytical studies. The pooled estimates were determined using random effect model. Heterogeneity between the included studies was assessed using the I2 statistics. Subgroup analysis was employed in the evidence of heterogeneity. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression test statistic.

RESULTS

Of the total 871 articles retrieved, 34 articles which involved 61,748 children were eligible for meta-analysis. The overall pooled prevalence of anemia using random effect model was 31.14% (95% CI: 24.62, 37.66%). In subgroup analysis, the pooled prevalence of anemia was higher among preschool-aged children (44.17%; 95% CI: 37.19, 51.15%) than school-aged children (22.19%; 95% CI: 17.54, 26.83%). Furthermore, the odds of anemia was higher among children who were male (OR = 1.11; 95% CI: 1.03, 1.19), stunted (OR = 1.95; 95% CI: 1.52, 2.51), and wasted (OR = 2.05; 95% CI: 1.36, 3.10).

CONCLUSION

The pooled prevalence of anemia among children was high, indicating that it had been continuing to be a public health problem. Therefore, there is a need to design a comprehensive prevention and control strategies to reduce its burden.