Dietary Quality and Micronutrient Adequacy, Iron Deficiency Anaemia and their Associated Factors among Adolescent Students in Acholi Sub-region of Uganda

Background: Globally, iron deficiency anaemia is a widespread nutrition problem, a concern for public health that affects nearly 2 billion people, mostly adolescents, young children, infants and the elderly, women of reproductive age and people with chronic inflammatory diseases. As far as Acholi sub-region is concerned, the available information is on women of reproductive age, concealing that of adolescents in regards to iron deficiency. This inadequacy prompted the study to examine status of dietary quality and micronutrient adequacy, iron deficiency anaemia and their associated factors among adolescents in secondary schools of Gulu district. Methods: Using cross sectional study, 341 adolescent boys and girls aged 10-19 years from two schools in rural of Gulu district were recruited for the study. HemoCue method was used to measure the prevalence of iron deficiency anaemia where as individual dietary diversity as an indicator of micronutrient adequacy was measured using the Individual Dietary Diversity Score (IDDS), Results: The prevalence of iron deficiency anaemia was found to be 16% (Girls:18.1%; Boys:13.0%). In addition, the mean measure of haemoglobin (Hb) level was 13.21 g/dl, and was slightly higher in boys (13.46±1.55 g/dl) compared to girls (13.02±1.30 g/dl). Individual Dietary Diversity Score (IDDS) was not significantly different (p˃0.05) between adolescent girls and boys, with mean individual dietary diversities measures of 3.47±2.143 and 2.98±1.785, respectively, indicating low dietary diversity. Among all food groups, animal source foods, fruits and vegetables rich in vitamin A, other fruits and vegetables were the most consumed by adolescent girls compared to boys. The analysis from binary logistic regression showed that, all the socio-demographic factors in the study did not predict dietary diversity as presented by the p value of (p ˃ 0.05). On the other hand, analysis from linear regression revealed that high 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 found to be high and characterised with low dietary diversity among adolescents in Gulu district. This study recommends the need for health education and promotion of agricultural practices that support good nutrition in schools with the view of reducing the burden from iron deficiency anaemia.