Prevalence of anemia and associated factors among adolescent girls in Afar and Tigray regions: a comparative cross-sectional study

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.