Dietary quality, anaemia prevalence and their associated factors among rural school- going adolescents in Acholi sub -region of Uganda.

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.