Predictors of Anaemia Amomg Adolescents. A Case Study of Makoni District, Manicaland 2021

Abstract

Anaemia is the third and final stage of iron deficiency, a reduction in circulating haemoglobin (Hb) concentration. Adolescents are at high risk of anaemia due to rapid growth and maturation. Globally anaemia is a major contributor to the burden of disease with a prevalence of 32.9% as at 2010, and resulting in 68.4 million years lived with disability. In Zimbabwe, anaemia has been rising among adolescent boys from 13,5% in 2005 to 20.4% in 2015. Trends have remained static in girls ranging from 26.2% in 2005 to 26.5% in 2015. A case study to identify predictors of anaemia among school going adolescents was conducted using secondary data involving 411 school going adolescents aged 10-19 years. The study setting was 10 primary and secondary schools in Makoni district that appear in the IFA database. SPSS was used to perform logistic regression for binary outcomes and general regression for continuous variables. The prevalence of anaemia was 9.3% and the prevalence of underweight was 8.0%, and both were higher in boys than girls (10.3% vs 8.4% and 12.6% vs 3.8%; respectively). The prevalence of stunting was 11.2% and also higher among boys compared to girls (18.1% vs 4.7%). Having < 5 household members had a 60% protective effect on anaemia compared with a household size > 5 people [(OR: 0.4: 95% CI 0.2-0.9) p value = 0.02]. Staying in urban was protective against anaemia by more than 90% compared with living in the peri-urban [OR: 0.0, 95% CI: (0.0-0.6) p value=0.02]. Odds of anaemia increased by 50% as height increased by 1 meter [OR 1.5: 95% CI (1.0, 2.1) p value = 0.03]. The odds of anaemia decreased by 50% as weight increased by 1kg [OR: 0.5 95% CI (0.3, 0.8) p value = 0.01]. Hb level is 0.4g/dL lower in adolescents who live in households with solar or electricity [β = -0.4: 95% CI (-0.7,-0.0) p value = 0.02]. 15.8% of the adolescents had ever heard of anaemia and the majority (89.3%) had low knowledge on anaemia. Prevalence of anaemia among adolescents in Makoni is not within the normal levels and is of mild public health concern. The Ministry of Health and Child Care, Provincial Medical Director of Manicaland to consider household size, residence in peri-urban settings and underweight for selecting adolescents for targeted interventions that address anaemia in Makoni District. The Ministry of Primary and Secondary Education in Makoni district has to promote knowledge on anaemia and behaviour change communication through school health clubs, strengthen home grown school feedings programs in secondary schools, and avail weight scales and height meters in schools for constant monitoring of learners’ nutritional status. Increase in weight had a protective effect on anaemia, residence in peri urban settings and having household members >5 are important predictors of anaemia. 9 in 10 school going adolescents have a knowledge gap on anaemia.