Abstract:
Despite remarkable interventions that brought significant improvement, anemia
remained a major public health problem in Ethiopia. As part of these interventions, a school-
based iron folic acid supplementation program was implemented in Afar and Tigray regions
from November 2019 to August 2020. However, there is paucity of evidence on the effect of the
school-based supplementation of iron folic acid on the magnitude of anemia.
Objective: - To assess the prevalence of anemia and associated factors among school adolescent
girls in Afar and Tigray regions of Ethiopia.
Methods: - This is a secondary analysis of UNICEF data on level of anemia among school girls
11th
31st
in rural areas in Tigray and Afar regions, from October
–
2019. From the census
employed by UNICEF, a total of 616 adolescent girls (320 who received iron and folic acid for
six months and 296 who didn.t receive it) who had complete data records were included in the
analysis. In brief, a non-fasting venous blood sample (6 mL) was collected in BD vacutainer®,
Serum Separation Tubes (SST™), and few drops of blood were immediately taken to measure
hemoglobin using the HemoCue®, and the observed value was adjusted to altitude. Data were
analyzed by SPSS for windows version 25. Descriptive analysis was undertaken to describe
participants. characteristics. Bivariable and multivariable binary logistic regressions were fitted
to identify factors associated with anemia. Variables with p-value <0.25 in the bivariable binary
logistic regression analysis were fitted into the multivariable analysis to identify factors
independently associated with anemia. Adjusted odds ratio (aOR) along with 95% confidence
interval were estimated to measure the strength of association between variables of interest.
Level of statistical significance was declared at p-value <0.05.
Results: - The mean (±SD) age of the girls was 15.91 (± 1.10) years (15.96 versus 15.8 among
the exposed and unexposed group, respectively). One third (30%) of the exposed and 224 (70%)
of the unexposed groups have a family size of less than five (p=0.03), and about 47% of exposed
and 146 (50.2%) of unexposed groups were from food insecure households (p=0.04). The overall
prevalence of anemia was 9.2% (95% CI: 7.0% – 11.8%); 6% among the exposed versus 12.2%
among the unexposed, and the variation was significant (p<0.001). Anemia was more likely
among adolescents from large family size (aOR = 4.36; 95% CI (1.65, 8.58), food insecure
households (aOR = 3.38; 95% CI (1.48, 4.03), and those drinking from unprotected source
drinking water (aOR = 3.12; 95% CI (1.14, 8.45)] in both groups.
