Magnitude and associated factors of anemia among adolescent girls in Ethiopia: a systematic review and meta-analysis

Abstract

Background: In Ethiopia, there are primary studies on adolescent anemia with imprecise and inconclusive findings. Besides, there was no meta-analysis pooled the magnitude and associated factors of anemia among adolescent girls in Ethiopia. Estimating the pooled magnitude and associated factors of anemia among adolescent girls is helpful for evidence-based interventions in Ethiopia.

Methods: The authors used a preferred reporting item for systematic reviews and meta-analysis (PRISMA). We included articles and survey reports published until May 2021 using searching engines of Google, Google Scholar, PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature. To assess the quality of studies, we used Newcastle-Ottawa quality assessment scale for non-randomized. Two authors independently assessed the quality of the studies. We computed the pool magnitude and odds ratio of the associated factors with their 95%CI using Comprehensive Meta-Analysis software. Publication bias assessed using funnel plots and Egger's test.

Result: In this review, we included a total of 15 studies with 9,669 adolescent girls. Using the random-effects model, the pooled magnitude of anemia among the Ethiopian adolescent girls was 19.1% (95%CI: 16.1%, 24.6%). The associated factors were attained menarche (adjusted odds ratio (AOR) = 1.96), ≥ 5 days of blood flow during menses (AOR = 6.21), food insecurity (AOR = 1.48), inadequate diet diversity score (AOR = 2.81), presence of intestinal parasite (AOR = 3.51), low body mass index (AOR = 2.49), and rural residence (AOR = 1.79).

Conclusion: The pooled magnitude of anemia among adolescent girls in Ethiopia was 19.1% depicting a mild public health problem; while attained menarche, ≥ 5 days' blood flow during menses, food insecurity, inadequate diet diversity score, intestinal parasites, low body mass index, and rural residence were the associated factors. Hence, addressing health and nutrition wellness of adolescent girls should be center of concern in health, nutrition, agriculture, research, strategies and policies in Ethiopia.

Keywords: Adolescent girls; Anemia; Associated factors; Ethiopia; Magnitude.

Fig. 1

Flow diagram of the studies included in the systematic review and meta-analysis for magnitude and associated factors among adolescent girls in Ethiopia, 2021

Fig. 2

Forest plot for the pooled magnitude of anemia among adolescent girls in Ethiopia, 2021

Fig. 3

Forest plot for the subgroup analysis by study type, Ethiopia, 2021

Fig. 4

Forest plot for attained menarche, Ethiopia, 2021

Fig. 5

Forest plot for ≥ 5 days of blood flow during menses, Ethiopia, 2021

Fig. 6

Forest plot for food insecurity, Ethiopia, 2021

Fig. 7

Forest plot for inadequate diet diversity score, Ethiopia, 2021

Fig. 8

Forest plot for presence of intestinal parasite, Ethiopia, 2021

Fig. 9

Forest plot for low BMI (< 18.5 kg/m.²), Ethiopia, 2021

Fig. 10

Forest plot for rural residence, Ethiopia, 2021

Fig. 11

Funnel plot for publication bias of studies included to pooled magnitude of anemia among adolescent girls of Ethiopia, 2021

Fig. 12

Funnel plot for publication bias of studies included for low body mass index, Ethiopia, 2021

Fig. 13

Funnel plot for publication bias of studies included for rural residence, Ethiopia, 2021

Fig. 14

Funnel plot for publication bias of studies included for food insecurity, Ethiopia, 2021