Adokorach Gloria, Oyet Sunday Mark, Obai Gerald, Muggaga Christopher
Faculty of Agriculture and Environment, Department of Food Science and Postharvest Technology, P.O. Box 166, Gulu, Uganda.
Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
BMC Nutr. 2024 Dec 28;10(1):166. doi: 10.1186/s40795-024-00982-3.
Globally, iron deficiency anaemia is a widespread public health problem affecting vulnerable populations including adolescents. However, over the years, the Uganda Demographic Health Surveys mostly report the status of anaemia for women of reproductive age (15-49 years) and children up to 5 years, leaving out the focus on adolescents. Moreover, high prevalence of anaemia among children below five years could suggest that anaemia still persists at adolescence. Therefore, the study aimed at determining dietary quality, prevalence of anaemia and their associated factors among school-going adolescents.
A cross-sectional study involving 341 adolescent boys and girls aged 10-19 years was carried out in two rural schools in Gulu district. Prevalence of anaemia was determined by obtaining blood specimens from a finger prick into a microcuvette and analysed for haemoglobin (Hb) level using Haemoglobin analyser, whereas dietary quality was assessed using the Individual Dietary Diversity Score (IDDS). Socio-economic and demographic data were collected using a semi-structured questionnaire.
The overall prevalence of anaemia was 16.0% (Girls:18.1%; Boys:13.0%), while the mean Hb level was 13.2 ± 1.4 g/dl (Girls 13.0 ± 1.3 g/dl; Boys 13.5 ± 1.6 g/dl). The mean number of food groups consumed among the adolescents was 3.5 ± 2.1 for girls and 3.0 ± 1.8 for boys (p˃0.05). Animal source foods, fruits and vitamin A-rich vegetables, other fruits and vegetables were consumed by adolescent girls more than the boys. Similarly, a higher proportion of adolescent girls than boys consumed iron-rich foods: fish and meat, organ meat and dark green leafy vegetables. Further, all the socio-demographic factors in the study did not predict dietary diversity (p ˃ 0.05). On the other hand, education attainment by parent/guardian and nature of menstruation predicted the prevalence of anaemia amongst adolescents (p < 0.05).
The prevalence of anaemia was high among adolescents. Coupled with this, there, was low dietary diversity among the adolescents. The level of education of the parent/guardian and nature of the menstrual discharge were significant predictors of anaemia amongst girls. From this study, we recommend interventions by both health and agricultural-related practitioners to strengthen activities in rural schools such as health and nutrition education to create awareness about dietary diversity and promotion of agricultural practices such as school vegetable gardens, orchards poultry production and rearing of small ruminants to support consumption of diverse foods in schools with the view of reducing the burden from iron deficiency anaemia.
在全球范围内，缺铁性贫血是一个广泛存在的公共卫生问题，影响着包括青少年在内的弱势群体。然而，多年来，乌干达人口与健康调查大多报告的是育龄妇女（15 - 49岁）和5岁以下儿童的贫血状况，而忽略了对青少年的关注。此外，五岁以下儿童贫血患病率较高可能表明贫血在青少年时期仍然存在。因此，本研究旨在确定在校青少年的饮食质量、贫血患病率及其相关因素。
在古卢区的两所农村学校对341名年龄在10 - 19岁的青少年男孩和女孩进行了一项横断面研究。通过从手指采血到微量比色皿中获取血样，并使用血红蛋白分析仪分析血红蛋白（Hb）水平来确定贫血患病率，而饮食质量则使用个体饮食多样性评分（IDDS）进行评估。使用半结构化问卷收集社会经济和人口数据。
贫血的总体患病率为16.0%（女孩：18.1%；男孩：13.0%），而平均Hb水平为13.2±1.4g/dl（女孩13.0±1.3g/dl；男孩13.5±1.6g/dl）。青少年中女孩平均食用的食物种类数为3.5±2.1种，男孩为3.0±1.8种（p＞0.05）。青少年女孩食用动物源性食物、水果和富含维生素A的蔬菜、其他水果和蔬菜的量多于男孩。同样，食用富含铁的食物（鱼和肉、动物内脏和深绿色叶菜）的青少年女孩比例高于男孩。此外，研究中的所有社会人口因素均不能预测饮食多样性（p＞0.05）。另一方面，父母/监护人的教育程度和月经情况可预测青少年贫血的患病率（p＜0.05）。
青少年贫血患病率较高。与此同时，青少年的饮食多样性较低。父母/监护人的教育水平和月经情况是女孩贫血的重要预测因素。通过本研究，我们建议卫生和农业相关从业者采取干预措施，加强农村学校的活动，如开展健康和营养教育，以提高对饮食多样性的认识，并推广农业实践，如学校菜园、果园、家禽养殖和小型反刍动物饲养，以支持学校多样化食物的消费，从而减轻缺铁性贫血的负担。
