Prevalence and associated factors of anaemia among adolescents in a nationally representative survey : Uganda National Panel Survey 2018/2019

Abstract

Background: Previous data has suggested high rates of anemia among adolescents (ages 10 – 19 years) in low- and middle-Income countries. However, it is unclear whether the rates of anemia have significantly improved following temporal improvements in other health metrics and national investments by government and nutrition programs. It is also unclear whether the predictors of anemia in the contemporary period are consistent with what has been reported in prior literature. Aims: The overall aim of the study was to establish the prevalence and factors associated with anemia among adolescents aged 10 – 19 years in a nationally representative survey; Uganda National Panel Survey 2018/2019. Methods: This was a cross-sectional study to determine the prevalence and predictors of anemia in adolescents aged (10 -19 years). I used data in the Nutrition Module of 2018/2019 Uganda National Panel Survey (UNPS)that collected data on anemia and other health metrics. The study enrolled 1063 adolescents with hemoglobin measurements who participated in the 2018/2019 survey. Descriptive statistics were computed for prevalence of anemia (Aim 1). Modified Poisson with robust variance was used at bivariate and multivariate analysis to determine associated factors (Aim 2). QGIS software was used for spatial analysis (Aim 3). Results: Of the 119,148 participants in the 2018/2019 UNPS dataset, 24,856 were adolescents, 1063 of whom had Hb measurements were included in the analysis. Overall, 16.2 % (95% CI 14%- 19%) had anemia, 124 (11.7%) of whom had mild anaemia, 43 (4.1%) had moderate anaemia and 5 (0.5%) had severe anaemia. The prevalence of anaemia was 1.83 times high in males compared to females [95% CI =1.39-2.41, P <0.001]. Additionally, older adolescents 15-19 years were 1.97 times more likely to be anaemic compared to younger adolescents aged 10-14 years [95% CI 1.48-2.61), P <0.001]. Helicobacter pylori infection positivity increased anaemia prevalence [(aPR=1.87, 95% CI = 1.35-2.58), P <0.001). There were significant regional differences in anaemia prevalence with the highest burden in Eastern Uganda (Crude PR=1.41, 95% CI 0.94,2.1). Conclusion: This study demonstrated high prevalence of anemia in adolescents. Anemia was paradoxically more prevalent in male compared to females. Anemia screening and prevention should be integrated in adolescent and school health programs in Uganda.