Iron deficiency anemia among children aged 2-5 years in southern Ethiopia: a community-based cross-sectional study

Alemselam Zebdewos Orsango; Wossene Habtu; Tadesse Lejisa; Eskindir Loha; Bernt Lindtjørn; Ingunn Marie S Engebretsen

doi:10.7717/peerj.11649

Iron deficiency anemia among children aged 2-5 years in southern Ethiopia: a community-based cross-sectional study

PeerJ. 2021 Jun 28:9:e11649. doi: 10.7717/peerj.11649. eCollection 2021.

Authors

Alemselam Zebdewos Orsango^{1

2}, Wossene Habtu³, Tadesse Lejisa³, Eskindir Loha^{1

2

4}, Bernt Lindtjørn^{1

2}, Ingunn Marie S Engebretsen²

Affiliations

¹ School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
² Centre for International Health, University of Bergen, Bergen, Norway.
³ Ethiopian Public Health Institute, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ Chr. Michelsen Institute, Bergen, Norway.

Abstract

Background: Iron-deficiency anemia (IDA) is a common type of nutritional anemia in low-income countries, including Ethiopia. However, there is limited data on iron deficiency anemia prevalence and associated factors in Ethiopia, particularly for children aged 2 to 5 years.

Objectives: To establish the prevalence of iron deficiency anemia and associated risk factors, focusing on iron-rich food consumption among children aged 2 to 5 years in southern Ethiopia.

Methods: A community-based cross-sectional study was conducted in southern Ethiopia in 2017, involving 331 randomly selected children aged 2 to 5 years old. A structured questionnaire was used to collect information about the children and the households. Venous blood was collected from each child in a test tube to measure hemoglobin, ferritin, and C-reactive protein (CRP). Hemoglobin levels were determined using Hemocue^®301 and adjusted for altitude. Anemia was defined as hemoglobin levels <11 g/dl. Ferritin was adjusted for inflammation based on CRP concentration and low ferritin concentration defined as adjusted ferritin concentration <12 µg/L. IDA was considered when a child had both hemoglobin level <11g/dl and low ferritin concentration. Bi-variable and multivariable logistic regression models were performed to identify factors associated with IDA and iron-rich food consumption.

Results: The prevalence of iron deficiency anemia was 25%, and the total anemia prevalence was 32%. Only 15% of children consumed iron-rich foods in the preceding 24 h, and 30% of children consumed iron-rich foods at least once in the preceding week. IDA decreased as the height for age z-score increased (Adjusted Odds Ratio 0.7; 95% CI [0.5-0.9]). Mothers with increased educational level (AOR 1.1; 1.0-1.2) and households with increased dietary diversity (AOR 1.4; 1.2-1.6) consumed more iron-rich foods.

Conclusions: Iron deficiency anaemia was a moderate public health problem in southern Ethiopia, and the iron-rich food consumption was low. Interventions should focus on food supplementation and fortification, food diversification and nutritional education, and promoting women's education.

Keywords: C-reactive protein; Dietary diversity; Iron deficiency anemia; Iron-rich food consumption; Serum ferritin.

Grants and funding

This work supported by the Norwegian Programme for Capacity Development in Higher Education and Research for Development (NORHED) and the South Ethiopia Network Universities in public health (SENUPH No. ETH-13/0025). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.