A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia|
Gebrie, Alemu & Alebel, Animut
Background: Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration
and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of
children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia
and its predictor factors among children in Ethiopia.
Method: The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar,
Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to
retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion
criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using
STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis,
considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled
prevalence of anemia. Moreover, the predictor factors of anemia were examined.
Results: The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in
Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in
Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age
group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic
status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence:
3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children.
Conclusion: In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children
in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of
the children were found to be predictors of anemia in the children. Community and school-based interventions should be
strengthened to improve the problem.
Anemia; prevalence; predictors; children; Ethiopia; systematic review; meta-analysis.