Getaneh Zegeye, Enawgaw Bamlaku, Engidaye Getabalew, Seyoum Masresha, Berhane Muruts, Abebe Zegeye, Asrie Fikir, Melku Mulugeta
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Debre Birhan Referral Hospital Laboratory, Debre Birhan, Ethiopia.
PLoS One. 2017 Dec 28;12(12):e0190151. doi: 10.1371/journal.pone.0190151. eCollection 2017.
Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia.
A school-based cross sectional study was conducted on a total of 523 SC aged from 6-14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children's caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant.
Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10-13) years, and 332 (63.5%) of them were in the age group 11-14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia.
Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.
贫血是一个全球性的公共卫生问题，影响着全球3.05亿学童。它对学童有有害影响，包括因认知发展和身体发育受损导致学业成绩下降、疲劳和注意力不集中，以及由于对感染的抵抗力降低而发病率增加。因此，本研究的目的是评估埃塞俄比亚西北部贡德尔镇公立小学学童贫血的患病率及其相关因素。
对总共523名6至14岁的学童进行了一项基于学校的横断面研究。采用多阶段抽样后再进行系统随机抽样技术来选择研究参与者。通过对儿童照料者进行面对面访谈，使用预先测试的结构化问卷收集有关社会人口学和社会经济特征以及儿童饮食状况的数据。进行了人体测量。使用HemoCue 301+分析仪测定血红蛋白（Hb）浓度。在学校场所采集粪便和血液样本，分别检测肠道寄生虫和血液寄生虫。数据录入Epi Info 3.5.3版本，并转移到SPSS 20版本进行分析。采用二元和多元二元逻辑回归模型来确定贫血的相关因素。P值<0.05被认为具有统计学意义。
参与研究的学童中，269名（51.4%）为男性。年龄中位数（四分位间距（IQR））为12岁（10 - 13岁），其中332名（63.5%）在11 - 14岁年龄组。其中约81名（15.5%；95%置信区间：12.4%，18.7%）贫血：其中56名（69.1%）为轻度贫血，25名（38.9%）为中度贫血。母亲教育程度低（调整后比值比（AOR）= 2.30；95%置信区间：1.11，4.78）、发育迟缓（AOR = 2.22；95%置信区间：1.30，3.80）、严重粮食不安全（AOR = 5.11；95%置信区间：1.53，17.13）和土源性蠕虫（STH）感染（AOR = 7.13；95%置信区间：3.16，16.86）被发现与贫血显著相关。
学童贫血被发现是一个轻度的公共卫生问题。它与母亲教育程度低、粮食不安全、发育迟缓和肠道蠕虫感染密切相关。应制定针对上述因素的重点政策和策略，以减少学童中的贫血现象。
