Anaemia among school-aged adolescent boys in the Sagnarigu District of Northern Ghana

Abstract

Background: The increased nutritional requirement in pregnancy and that associated with growth spurt in adolescence has skewed nutritional interventions towards pregnant women and girls. Among school-aged adolescents, physical and cognitive development peaks. This affects both males and females but overall nutritional deficiency in males has not been fully described. We assessed prevalence of anaemia and its predictors among school-aged adolescent boys in the Sagnarigu district, Northern Region. Method: We used cross-sectional design with multi-stage sampling involving 349 adolescents in eleven (11) public JHSs. We included adolescent girls for comparison on the prevalence of anaemia and to answer the question whether anaemia in the boys was any different from their female colleagues. We estimated household wealth using Principal Component Analysis (PCA). We assessed Dietary Diversity and food security using 24-hour recall and FANTA-USAID Household Hunger Scale (HHS) module respectively. We analysed capillary blood samples using HaemoCue (Hb-301) to determine anaemia. We measured weight and height and determined nutritional status using the WHO 2007 growth reference. We conducted data analysis using STATA Version 15 and used Two-sample t-test to determine mean differences and Chi-square (χ2) or fisher’s exact tests for associations. We fitted logistic regression models to the data to determine factors associated with anaemia among boys. Findings: We found overall mean haemoglobin concentration of 13.3±1.7g/dl and anaemia prevalence of 25.2%. We found no statistical difference between anaemia in boys and girls (24.2% for boys vs. 26.8% for girls, p=0.59). Low dietary diversity was 29.5%, medium dietary diversity was 33.5%, high dietary diversity was 37.5% and food insecurity was (21.2%). In total, 14.3% of children had nutritional challenges, with 8.5% underweight, 5.8% Overweight/obese and 9.9% stunted. Among boys, anaemia was predicted by wealth (OR=0.5, 95% CI=0.2 -1.0, P=0.049) and stunting (OR=2.7, 95%CI=1.1 - 6.8, p=0.034). Living in upper 60% household wealth was a protective factor with 50% less odds of anaemia as compared to their counterparts living in the lower 40%. Similarly, stunted boys had 2.7times odds of anaemia as compared to those not stunted. Conclusion: We concluded that anaemia equally affects boys and girls in the Sagnarigu district. Family/household circumstances may determine anaemia among these adolescents rather than biology (menstruation in girls). Indeed, irrespective of the age, educational level of parents and household food security, anaemia among boys in the district was predicted by household wealth and stunting.