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Prevalence and Predictors of Anaemia Among Adolescent Girls in Rural Hadero Tunto District, Southern Ethiopia: Community Based Study

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Prevalence and Predictors of Anaemia Among Adolescent Girls in Rural Hadero Tunto District, Southern Ethiopia: Community Based Study International Journal of Nutrition and Food Sciences 2020; 9(1): 16-24 http://www.sciencepublishinggroup.com/j/ijnfs doi: 10.11648/j.ijnfs.20200901.14 ISSN: 2327-2694 (Print); ISSN: 2327-2716 (Online) Prevalence and Predictors of Anaemia Among Adolescent Girls in Rural Hadero Tunto District, Southern Ethiopia: Community Based Study Tsegaye Alemu 1, *, Samson Gebremedhin 2, * 1Maternal and Child Health, John Snow Inc. Research & Training Institute/Last Ten Killo Meters, South Nation National Region, Hawassa, Ethiopia 2Department of Public and Environmental Health, College of Health Science, Hawassa University, Hawassa, Ethiopia Email address: *Corresponding author To cite this article: Tsegaye Alemu, Samson Gebremedhin. Prevalence and Predictors of Anaemia Among Adolescent Girls in Rural Hadero Tunto District, Southern Ethiopia: Community Based Study. International Journal of Nutrition and Food Sciences . Vol. 9, No. 1, 2020, pp. 16-24. doi: 10.11648/j.ijnfs.20200901.14 Received : August 5, 2019; Accepted : March 2, 2020; Published : March 23, 2020 Abstract: Introduction: During adolescent anaemia has negative consequence on cognitive, work performance and economic productive. However, there is limited evidence on the prevalence and factors associated with anaemia among adolescent girls. Objectives: To assess the prevalence and associated factors of anaemia among rural adolescent girls in Hadero Tunto zuria district, Southern Ethiopia. Methods: A community based comparative cross-sectional study was conducted among adolescent girls 10-19 years. A total of 406 subjects were randomly selected. A structured questionnaire was used to collect the data. Blood haemoglobin level was determined from capillary blood using the Haemocue method. Data were entered into computer and analyzed using SPSS versions 20.0. Bivariate and multivariate logistic regression analyses were conducted to examine the factors associated with anaemia. Result: The mean (±SD) of haemoglobin concentration adjusted for altitude was 13.7+1.2 (SD) and ranged from 8 to 16.6g/dl. Over all prevalence of anaemia was found to be 15.2% [95%CI: 11.68%, 18.72%]. Out of the total 406 adolescent girls 13.7% [95% CI: 10.33%, 17.06%] and 1.5% [95%CI: 0.3%, 2.7%] had mild and moderate anaemia, respectively. Low dietary diversity, (AOR= 10.0, 95% CI: 1.70, 60.0), long menstrual duration (AOR=5.10, 95% CI: 1.43, 18.15), malaria attack history (AOR=3.50, 95%CI: 1.40, 8.57), and less frequent consumption of legumes (AOR=3.20, 95%CI: 1.17, 8.74) were significantly associated with anaemia. Furthermore, the prevalence of stunting and thinness was 21.3% and 16.8%, respectively. Conclusion: Anaemia is a public health problem in the study area; which require integrated governmental and NGO intervention to tackle the burden; enhance dietary diversity, promote Insecticide Treated Bednets (ITNs) utilization and adolescent nutrition education are important strategies to reduce the burden of anaemia. Keywords: Rural Community, Adolescent Anaemia, Hadero Tunto District myoglobin in muscles and haemoglobin in the blood [3]. 1. Introduction According to WHO [4] Iron-deficiency anaemia is one of the World Health Organization (WHO) defines ‘adolescents’ top five leading cause of global adolcescent disability are individuals in the age range of 10-19 years [1, 2]. adjusted life year (DALYS) lost, by sex and age group. Adolescents are crucial period for growth and development, Anaemia and under nutrition is a major public health most of the existed literature witness adolescent is among problem among adolescent gilrs [5, 6]. Globally, the common high risk groups for iron deficiency Anaemia due to cause of anaemia is iron deficiency, consequential from enhanced increase in requirements for iron, this due to rapid extended negative iron balance, affected by inadequate pubertal growth with sharp rise in lean body mass, blood dietary iron intake and estimated 50% of anaemia in women volume and red cell mass, which increases iron needs for worldwide is due to iron deficiency [7, 21]. In developing International Journal of Nutrition and Food Sciences 2020; 9(1): 16-24 17 country, Anaemia affects large number of population [8]. n= (207+ (207*10% non -response rate)) * 1.5 considering Anaemia is a global public health problem with serious a design effect of 1.5 and a non-response rate of 10%, the consequences for human health and development [21]. The total sample size was widespread prevalence of Anaemia, both in the developed n= 342 adolescent girls. and developing worlds its of great concern [9]. In Africa a For the second objective: study report from 34 countries revealed that the estimated The sample size calculation for second objective, double prevalence of anemia among adolescent and young females population proportion formula used with Epi info version 7 ranges from 15% to over 50% [10]. software, with the assumption of 95% CL, 80% power, 1:1 Even though recently additional emphasis is being given to ratio of control to case and 10% non -respondent rate. the nutritional status of adolescents, most of the existing The first sample size which was 342, for adequacy, studies are limited to macro nutritional status. as initiatives representativeness and to meet the objective 406 adolescent gives attention only to prevent anaemia commonly target girls was recruited. In order to, assess the prevalence and infants, young children and pregnant and lactating women, associated factors of anaemia among adolescent girls. and not adolescents, the needs of adolescents may remain Sampling technique: First of all, all kebeles in the district unmet, and the consequences of anaemia in adolescents was listed and stratified into 3 ecological zones: Highland, continued. And also most of the existed studies are school midland and lowland. The sample size was allocated to the and health facility based, so this study conducted at strata proportional to the population size. For each stratum 2 community level aims to assess the prevalence and associated kebeles was selected at random. So, the sample size was factor of anaemia among adolescent girls. distributed to the selected kebeles proportional to their population size. A sampling frame of adolescent girls were 2. Methods and Materials generated by identifying the number of adolescent girls living in each kebele using family folder (community health Context: This study was conducted in Hadero Tunto Zuria information system) from health extension workers who had (HTZ) district which was located 32 km from Zonal town the information in their respective kebeles. Then simple Durame, 192km from regional capital city of SNNPR random sampling method was used to select 10-19 year Hawassa and 292 km from the capital city of Ethiopia Addis adolescent girls from the frame. Ababa. HTZ district is one of the 7 districts which are found Data collection Technique: structured pretested questionarie in Kembata Tembaro Zone. The district has 14 rural kebeles was used to collected data. The socio-demographic aspected of and 02 urban kebeles. Based on projection from 2007 the questionnaire was taken from EDHS 2011 [13] and Population and Housing Census report, the total population household dietary diversity (DD) was measured by using Food in 2014/15 is estimated to be 127,059 among these 62,767 and Nutrition Techinical Assistance (FANTA) III tool and the are males and 64,292 are females. From this, 74% of DD was asked by using 24 hour recall method [14]. For that population resides in rural area and the rest 26% reside in the subject should be asked whether she had taken any food town. Concerning to the health service facilities, there are 04 from 12 food categories on the last day [15]. The questionnaire health centers and also 20 health posts on behalf of was developed based on the conceptual framework of the government and there are also 02 medium, 11 Junior clinic, study. The questionnaire was developed in English and later 02 drug vendor and 02 drug store facilities owned by private translated into Amharic language and back translated to owners. On the side of government, the health facilities English to check its consistency. covered by 10 health officers, 98 all types of nurses, 10 The data collection was conducted by 4 clinical nurses, 1 midwives and 48 health extension workers to access the laboratory technician and 1 laboratory technologist from the service to the respective communities. From those 04 health existing health system that were easily familiarize with the centers 01 HC is giving youth friendly service for adolescent tool while conducting the training and actual data collection. and health coverage of the district was 90% [11]. The close follow-up by the very experienced supervisors, Sample size: sample size was determined using single and who was health professional from district health office after double population proportion formula. Sample size was taking training about the purpose and method of calculated by assuming the prevalence of adolescents girls administering the questionnaire together with data collectors. anemia is 7.1% that was taken from previous study [12] with One immediate supervisor for three kebeles was assigned to 95% confidence level, 3.5% margin of error and design effect the selected kebeles. Supervisors had checked whether the of 1.5. questionnaires were appropriately filled by the trained For the first objective: interviewers during the house-to-house survey. Adolescent Assumption: Based on the previous study, the prevalence girls were first informed about the study and its aim, and of anaemia among adolescent is 7.1% [12] those agreeing to participate had given a written consent. Where: n= Sample size, α = Level of significance (set at Haematology: Blood haemoglobin concentration was 0.05), z = the standard normal deviate with 95% CI (1.96), measured using a HemoCue Hb 301 [16], (Angelhom, p= Expected prevalence, d= Degree of precision (0.035) Sweden). Capillary blood was taken, through microcuvettes, and inserted into the HemoCue and the result was recorded, (/)() n = done by experienced laboratory technician.
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