Anemia Prevalence and its Associated Risk Factors using Ten East African Countries: A Recent data from Demographic and Health Survey
Anemia Prevalence and its Associated Risk Factors using Ten East African Countries
-
Denekew Bitew Belay
,
Nigussie Adam Birhan
,
Tilahun Yemanu Birhan
,
Yegnanew A. Shiferaw
,
Ding-Geng Chen
Abstract
Background: Anemia is a condition characterized by a deficiency of hemoglobin in the blood and is a significant risk factor for poor health and nutrition in children. The main aim of this study was to assess the prevalence and contributing factors of anemia in children under five in Eastern Africa.
Method: The research was conducted between 2010 and 2023 across ten East African countries. To identify potential factors associated with anemia, a multilevel logistic regression model was utilized, with adjusted odds ratios at a 95% confidence interval.
Results: The prevalence of anemia in Eastern Africa was 54.26%, with the highest in Tanzania (70.32%) and the lowest in Rwanda (36.64%). A multilevel multivariable logistic regression model revealed that; months age, female, stunted, underweight, number of under-five children, birth order, having fever, having diarrhea, vitamin A supplementation, primary educated mother, anemic mother, toilet facility, middle wealth index, a mother had occupation and high community poverty were significantly associated with anemia in Eastern Africa.
Conclusions: The prevalence of anemia was still high in the region. The stakeholder should design and scale up comprehensive nutrition interventions, which may represent a potential consideration to reduce the burden of anemia. Moreover, interventions like improving household wealth index and nutritional education activities are important to decrease the prevalence of anemia.
References
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24. Joshi S, Pradhan MP, Joshi U. Prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Medical Journal of Shree Birendra Hospital. 2014;13(1):33-6.
25. Ughasoro MD, Emodi I, Okafor H, Ibe B. Prevalence and risk factors of anaemia in paediatric patients in South-East Nigeria. South African Journal of Child Health. 2015;9(1):14-7.
26. Getaneh T, Girma T, Belachew T, Teklemariam S. The utility of pallor detecting anemia in under five years old children. Ethiopian medical journal. 2000;38(2):77-84.
27. Gebereselassie Y, BirhanSelassie M, Menjetta T, Alemu J, Tsegaye A. Magnitude, Severity, and Associated Factors of Anemia among Under-Five Children Attending Hawassa University Teaching and Referral Hospital, Hawassa, Southern Ethiopia, 2016. Anemia. 2020;2020.
28. Gebreegziabiher G, Etana B, Niggusie D. Determinants of anemia among children aged 6–59 months living in Kilte Awulaelo Woreda, Northern Ethiopia. Anemia. 2014;2014.
29. Sumbele IU. Burden of moderate to severe anaemia and severe stunting in children≤ 3 years in conflict hit Mount Cameroon: a community based descriptive cross-sectional study. 2020.
30. Huang Z, Jiang F-x, Li J, Jiang D, Xiao T-g, Zeng J-h. Prevalence and risk factors of anemia among children aged 6–23 months in Huaihua, Hunan Province. BMC public health. 2018;18(1):1267.
31. Uddin M, Sardar M, Hossain M, Alam M, Bhuya M, Uddin M, et al. Prevalence of anaemia in children of 6 months to 59 months in Narayanganj, Bangladesh. Journal of Dhaka Medical College. 2010;19(2):126-30.
32. Melku M, Takele WW, Anlay DZ, Ekubagewargies DT, Getaneh Z, Abebe M, et al. Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis. Italian journal of pediatrics. 2018;44(1):1-11.
33. Gebremeskel MG, Tirore LL. Factors Associated with Anemia Among Children 6–23 Months of Age in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey. Pediatric Health, Medicine and Therapeutics. 2020;11:347.
34. Thomas MS, Demirchyan A, Khachadourian V. How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6–59 Months Old Children in India? Frontiers in Public Health. 2020;8.
35. Assefa S, Mossie A, Hamza L. Prevalence and severity of anemia among school children in Jimma Town, Southwest Ethiopia. BMC hematology. 2014;14(1):3.
36. Nambiema A, Robert A, Yaya I. Prevalence and risk factors of anemia in children aged from 6 to 59 months in Togo: analysis from Togo demographic and health survey data, 2013–2014. BMC public health. 2019;19(1):215.
1. Kawo KN, Asfaw ZG, Yohannes N. Multilevel analysis of determinants of anemia prevalence among children aged 6–59 Months in Ethiopia: classical and bayesian approaches. Anemia. 2018;2018.
2. Melku M, Takele WW, Anlay DZ, Ekubagewargies DT, Getaneh Z, Abebe M, et al. Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis. Italian journal of pediatrics. 2018;44(1):79.
3. CSACE I. Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF. 2016.
4. Melku M, Alene KA, Terefe B, Enawgaw B, Biadgo B, Abebe M, et al. Anemia severity among children aged 6–59 months in Gondar town, Ethiopia: a community-based cross-sectional study. Italian journal of pediatrics. 2018;44(1):107.
5. De Benoist B, Cogswell M, Egli I, McLean E. Worldwide prevalence of anaemia 1993-2005; WHO global database of anaemia. 2008.
6. Xin Q-Q, Chen B-W, Yin D-L, Xiao F, Li R-L, Yin T, et al. Prevalence of anemia and its risk factors among children under 36 months old in China. Journal of tropical pediatrics. 2017;63(1):36-42.
7. Dey S, Raheem E. Multilevel multinomial logistic regression model for identifying factors associated with anemia in children 6–59 months in northeastern states of India. Cogent Mathematics & Statistics. 2016;3(1):1159798.
8. Mohammed SH, Habtewold TD, Esmaillzadeh A. Household, maternal, and child related determinants of hemoglobin levels of Ethiopian children: hierarchical regression analysis. BMC pediatrics. 2019;19(1):113.
9. Ejigu BA, Wencheko E, Berhane K. Spatial pattern and determinants of anaemia in Ethiopia. PloS one. 2018;13(5):e0197171.
10. Kuziga F, Adoke Y, Wanyenze RK. Prevalence and factors associated with anaemia among children aged 6 to 59 months in Namutumba district, Uganda: a cross-sectional study. BMC pediatrics. 2017;17(1):25.
11. Woldie H, Kebede Y, Tariku A. Factors associated with anemia among children aged 6–23 months attending growth monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia. Journal of nutrition and metabolism. 2015;2015.
12. Gari T, Loha E, Deressa W, Solomon T, Atsbeha H, Assegid M, et al. Anaemia among children in a drought affected community in south-central Ethiopia. PloS one. 2017;12(3):e0170898.
13. Beletew B, Mengesha A, Ahmed M, Fitwi A, Wudu M. Determinants of Anemia among HIV-Positive Children on Highly Active Antiretroviral Therapy Attending Hospitals of North Wollo Zone, Amhara Region, Ethiopia, 2019: A Case-Control Study. Anemia. 2020;2020.
14. Abebe Z, Takele WW, Anlay DZ, Ekubagewargies DT, Getaneh Z, Abebe M, et al. Prevalence of anemia and its associated factors among children in Ethiopia: a protocol for systematic review and meta-analysis. Ejifcc. 2018;29(2):138.
15. Birhan TY, Birhan NA, Alene M. Pooled prevalence and determinants of prelacteal feeding practice in eastern Africa evidence from demographic and health survey data: a multilevel study. Risk management and healthcare policy. 2021:1085-95.
16. Tesema GA, Worku MG, Tessema ZT, Teshale AB, Alem AZ, Yeshaw Y, et al. Prevalence and determinants of severity levels of anemia among children aged 6–59 months in sub-Saharan Africa: A multilevel ordinal logistic regression analysis. PloS one. 2021;16(4):e0249978.
17. Weinbaum C, Williams I, Mast E, Wang S, Finelli L, Wasley A, et al. Centers for Disease Control and Prevention (CDC) Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep. 2008;57(RR-8):1-20.
18. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source code for biology and medicine. 2008;3(1):17.
19. Merlo J, Chaix B, Yang M, Lynch J, Råstam L. A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. Journal of Epidemiology & Community Health. 2005;59(6):443-9.
20. Goldstein H, Browne W, Rasbash J. Partitioning variation in multilevel models. Understanding statistics: statistical issues in psychology, education, and the social sciences. 2002;1(4):223-31.
21. Aheto JM, Alhassan Y, Puplampu AE, Boglo JK, Sedzro KM. Anemia prevalence and its predictors among children under‐five years in Ghana. A multilevel analysis of the cross‐sectional 2019 Ghana Malaria Indicator Survey. Health Science Reports. 2023;6(10):e1643.
22. Asresie MB, Fekadu GA, Dagnew GW. Determinants of anemia among children aged 6–59 months in Ethiopia: Further analysis of the 2016 Ethiopian demographic health survey. Advances in Public Health. 2020;2020.
23. Heckman J, Samie A, Bessong P, Hamandi H, Ntsieni M, Kohler M, et al. Anaemia among clinically well under-fives attending a community health centre in Venda, Limpopo Province. South African Medical Journal. 2010;100(7):445-8.
24. Joshi S, Pradhan MP, Joshi U. Prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Medical Journal of Shree Birendra Hospital. 2014;13(1):33-6.
25. Ughasoro MD, Emodi I, Okafor H, Ibe B. Prevalence and risk factors of anaemia in paediatric patients in South-East Nigeria. South African Journal of Child Health. 2015;9(1):14-7.
26. Getaneh T, Girma T, Belachew T, Teklemariam S. The utility of pallor detecting anemia in under five years old children. Ethiopian medical journal. 2000;38(2):77-84.
27. Gebereselassie Y, BirhanSelassie M, Menjetta T, Alemu J, Tsegaye A. Magnitude, Severity, and Associated Factors of Anemia among Under-Five Children Attending Hawassa University Teaching and Referral Hospital, Hawassa, Southern Ethiopia, 2016. Anemia. 2020;2020.
28. Gebreegziabiher G, Etana B, Niggusie D. Determinants of anemia among children aged 6–59 months living in Kilte Awulaelo Woreda, Northern Ethiopia. Anemia. 2014;2014.
29. Sumbele IU. Burden of moderate to severe anaemia and severe stunting in children≤ 3 years in conflict hit Mount Cameroon: a community based descriptive cross-sectional study. 2020.
30. Huang Z, Jiang F-x, Li J, Jiang D, Xiao T-g, Zeng J-h. Prevalence and risk factors of anemia among children aged 6–23 months in Huaihua, Hunan Province. BMC public health. 2018;18(1):1267.
31. Uddin M, Sardar M, Hossain M, Alam M, Bhuya M, Uddin M, et al. Prevalence of anaemia in children of 6 months to 59 months in Narayanganj, Bangladesh. Journal of Dhaka Medical College. 2010;19(2):126-30.
32. Melku M, Takele WW, Anlay DZ, Ekubagewargies DT, Getaneh Z, Abebe M, et al. Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis. Italian journal of pediatrics. 2018;44(1):1-11.
33. Gebremeskel MG, Tirore LL. Factors Associated with Anemia Among Children 6–23 Months of Age in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey. Pediatric Health, Medicine and Therapeutics. 2020;11:347.
34. Thomas MS, Demirchyan A, Khachadourian V. How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6–59 Months Old Children in India? Frontiers in Public Health. 2020;8.
35. Assefa S, Mossie A, Hamza L. Prevalence and severity of anemia among school children in Jimma Town, Southwest Ethiopia. BMC hematology. 2014;14(1):3.
36. Nambiema A, Robert A, Yaya I. Prevalence and risk factors of anemia in children aged from 6 to 59 months in Togo: analysis from Togo demographic and health survey data, 2013–2014. BMC public health. 2019;19(1):215.
| Files | ||
| Issue | Vol 11 No 4 (2025) | |
| Section | Articles | |
| Keywords | ||
| Anemia Children Multilevel analysis Prevalence | ||
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How to Cite
1.
Belay DB, Birhan NA, Birhan TY, Shiferaw YA, Chen D-G. Anemia Prevalence and its Associated Risk Factors using Ten East African Countries: A Recent data from Demographic and Health Survey. J Biostat Epidemiol. 2026;11(4):415-435.
