Prevalence and Factors Associated with Iron Deficiency Anemia among School-Age Children in Primary Schools in Burao City, Somaliland, 2020

Background: Anemia is a global public health problem affecting the majority of the population of the world in both developed and developing countries with major consequences on human health as well as social and economic development. It is the world’s second leading cause of disability of the whole global disease burden. It affects 1.62 billion (24.8%) of the population, among them, it is affecting 305 million (25.4%) school-age children (SAC). Objectives: The main objective of this study was to assess the prevalence and factors associated with anemia among school-age children in primary schools in Burao city, Somaliland, 2020. Materials & Methods: A school-based cross-sectional study design was done in four primary schools in Burao, Somaliland. About 285 school-age children in the age group between 6 - 14 years were selected with a respondent rate of 93.4%. Random sampling was used to select schools and systemic random sampling was used to identify children from the selected schools. Socio-demographic data was collected by using a questionnaire & interviews of respondents in addition to anthropometric measurements, hemoglobin measurement, and stool examination. Complete Blood Counting (CBC) was used to determine the mean corpuscular (kor-PUS-kyu-lar) volume (MCV) and hematocrit (HMC) levels to detect hemoglobin status of the children. Data was entered and analyzed using SPSS statistical software for Windows version 21. Anthropometric data was analyzed using ANTHRO Plus. Bivariate logistic regression and multivariable logistic regression were used to identify independent predictors of anemia in school adolescent girls. Statistical significance was set at p < 0.05. Results: A total of 285 school-age children were included in this study. The overall prevalence of anemia was (23.1%) (CI: 18.1%, 28.1%) with the mean and standard deviation of (12.7 ± 1.59). Out of the anemic children, 20.4% were mild and 2.3% and 0.4% of them were moderate and severe, respectively. Children’s from illiterate mothers (AOR = 2.37; 95% CI: 1.14, 4.94. P-value = 0.020), consuming organ meat less than once a week (AOR = 2.19; 95% CI: 1.05, 4.43. P-value = 0.036) and having parasites in stool (AOR = 5.21; 95% CI: 1.10, 24.6. P-value = 0.037) were identified as statistically independent associated factors with prevalence of anemia in school-age children’s from Burao, Somaliland. Conclusion: Prevalence of anemia in Burao city, Somaliland primary schools was a moderate public health problem in the current study area. Nutrition education, iron folic acid supplementation program, deworming, good hygiene, and sanitation are playing an important role in the prevalence of anemia and we recommend to give them more attention from ministry of education and ministry of health in Somaliland.