Factors associated with anaemia among adolescent boys and girls 10–19 years old in Nepal

Abstract

We used data from the 2016 Nepal National Micronutrient Status Survey to evaluate factors associated with anaemia (World Health Organization cut-points using altitude-and smoking-adjusted haemoglobin [Hb]) among nationally representative samples of adolescents 10-19 years. Hb, biomarkers of micronutrients, infection and inflammation were assessed from venous blood. Sociodemographic and household characteristics, dietary diversity, pica and recent morbidity were ascertained by interview. We explored bivariate relationships between candidate predictors and anaemia among boys (N = 967) and girls (N = 1,680). Candidate predictors with P < 0.05 in bivariate analyses were included in sex-specific multivariable logistic regression models. Anaemia prevalence was 20.6% (95% confidence interval [CI] [17.1, 24.1]) among girls and 10.9% (95% CI [8.2, 13.6]) among boys. Among girls, living in the Mountain and Hill ecological zones relative to the Terai (adjusted odds ratio [AOR] 0.28, 95% CI [0.15, 0.52] and AOR 0.42, 95% CI [0.25, 0.73], respectively), ln ferritin (μg/L) (AOR 0.53, 95% CI [0.42, 0.68]) and ln retinol binding protein (RBP) (μmol/L) (AOR 0.08, 95% CI [0.04, 0.16]) were associated with reduced anaemia odds. Older age (age in years AOR 1.19, 95% CI [1.12, 1.27]) and Janajati ethnicity relative to the Muslim ethnicity (AOR 3.04, 95% CI [1.10, 8.36]) were associated with higher anaemia odds. Among boys, ln RBP [μmol/L] (AOR 0.25, 95% CI [0.10, 0.65]) and having consumed flesh foods (AOR 0.57, 95% CI [0.33, 0.99]) were associated with lower anaemia odds. Open defecation (AOR 2.36, 95% CI [1.15, 4.84]) and ln transferrin receptor [mg/L] (AOR 3.21, 95% CI [1.25, 8.23]) were associated with increased anaemia odds. Anaemia among adolescents might be addressed through effective S Chitekwe, S Rijal and N Paudyal are United Nations Children's Fund staff members. The opinions and statements in this article are those of the authors and may not reflect official United Nations Children's Fund policies. Use of trade names is for identification only and does not imply endorsement by the US Department of Health and Human Services. The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the US Agency for International Development, the Centers for Disease Control and Prevention, or the US government.

Prevalence and predictors of anaemia among adolescents in India: An exploration from Understanding the Lives of Adolescents and Young Adults Survey

“…Furthermore, severe anaemia was higher among late adolescents, adolescents without schooling, adolescents without media exposure, and rural adolescents. Strategies to improve iron status among adolescent boys and girls might reduce anaemia among adolescents [15]. However, in our study, the association between IFA tablets and anaemia among female adolescents was not on the expected lines.…”

“…Higher wealth was associated with a reduced risk of anaemia. Previously available literature also noticed that increased household wealth reduces the risk of anaemia among adolescents [15], [50]. Children belonging to rich households tend to have improved nutritional status, which may be attributed to better anaemia levels than their counterparts in poor households [24].…”

“…The sample distribution of the study population was presented in Table 1. A higher proportion of adolescents were from the late adolescent group (15)(16)(17)(18)(19); about one-fourth of adolescent boys and onethird of girls had 10 & above years of schooling, respectively. Nearly 27 percent of adolescent boys and 17 percent of girls were working.…”

“…Female adolescents need around 455 mg of iron per year after menarche, while males need 350 mg of iron per year [13]. Studies have also shown that socio-economic factors such as low economic status [14], adolescent level of education [15], housing condition, and hygiene practices [16] in uence the risk of anaemia. Evidence from the population-based study on anaemia among adolescent girls shows that as the household income increased from the lowest to the highest quartile, the prevalence of anaemia and iron de ciency anaemia decreases, and the daily iron intake signi cantly increases with income level [17].…”

Impacts of Acquired Iron Deficiency on Adolescent Health

“…Iron is an essential micronutrient for all tissues of the developing body and iron deficiency (ID) from mild forms to more severe cases of anemia, is the most prevalent nutritional deficiency worldwide, affecting mainly populations from less developed countries, of all age groups, including adolescents [1]. Recent studies show that the prevalence of (ID) among adolescents has varied between 8.06% in Kuwait [2], 10.9% in Nepal [3], 13.3% in Spain [4], 21.3% in India [5] and 23% in Indonesia [6], which confirms the current worldwide extent of this public health problem. Currently, there are more than 1.2 billion adolescents worldwide who, due to their physical and emotional characteristics, constitute an age group of high vulnerability in relation to iron deficiency and its consequences [7].…”