Prevalence, factors and association with academic performance of anaemia in Kandahar schoolchildren: a cross-sectional analytical study.

Abstract

This study aimed to investigate the prevalence and associated factors of anaemia and its association with the academic performance of schoolchildren in Kandahar, Afghanistan. This was a cross-sectional analytical study. This was a school-based study conducted among 1866 schoolchildren aged 6-14 years in Kandahar city from September to December 2023. Haemoglobin concentration was measured using a portable HemoCue Hb 301 analyser, while the WHO age-adjusted cut-off for haemoglobin was used to classify anaemia. Data were analysed by using descriptive statistics, the χ² test and multivariate logistic regression. In this study, the mean age of the children was 9.1 years, 61.1% (1138/1866) were boys, 83.6% (1560/1866) had illiterate mothers, and 81.3% (1517/1866) belonged to poor families. Prevalence of anaemia among schoolchildren was 64.1% (1196/1866), while 20.8% (388/1866), 41.7% (778/1866), and 1.6% (30/1866) were suffering from mild, moderate and severe anaemia, respectively. Main associated factors of anaemia were being male (adjusted OR (AOR) 1.4, 95% CI 1.1 to 1.7, p=0.003), unemployed father (AOR 1.5, 95% CI 1.1 to 2.2, p=0.020), poor family (AOR 2.3, 95% CI 1.8 to 2.9, p<0.001), large family (AOR 1.2, 95% CI 1.0 to 1.6, p=0.048), history of intestinal helminths (AOR 1.3, 95% CI 1.0 to 1.6, p=0.017) and decreased meat consumption (AOR 2.0, 95% CI 1.6 to 2.5, p<0.001). Children with anaemia had significantly lower academic performance. Prevalence of anaemia was very high and is a severe public health problem in schoolchildren of Kandahar. Based on the known consequences of anaemia on academic performance, the education and health authorities of Afghanistan should take serious steps to alleviate this problem. Periodic iron supplementation and deworming, as well as daily iron-rich mid-day meal programmes, should be started for both boys and girls in schools.