Prevalence and determinants of anaemia, underweight, and iodine status among adolescent girls living in Northern rural Bangladesh

In developing countries including Bangladesh, adolescent girls are susceptible to nutritional deficiencies from inadequate dietary intake. However, there is limited evidence on their nutritional status in Northern rural Bangladesh, a region particularly vulnerable to seasonal poverty and food insecurity. This study aimed to assess the prevalence and determinants of anaemia, underweight, and iodine status among adolescent girls in Northern rural Bangladesh. Using a multistage cluster random sampling approach, a total of 420 adolecent girls from four subdistricts of Northern Bangladesh were surveyed in the post-monsoon (dry season: September–October, 2022) and pre-monsoon (wet season: March–April, 2023) seasons. Generalized estimating equations (GEE) with a log link and Poisson distribution were used to estimate adjusted prevalence ratios (APR) for anaemia and underweight, accounting for within-individual correlation across survey rounds and robust standard errors. Iodine status was analysed as continuous, log-transformed urinary iodine concentration (UIC) using GEE with a Gaussian family and identity link, yielding ratios of geometric means (RGM). During the wet season, 59% of the girls consumed diversified diet, whereas 23% in the dry season. Approximately one-third were underweight in both seasons. Anaemia prevalence was 47% (wet) and 38% (dry), and the median UIC was 108.9 µg/L (dry) and 130.5 µg/L (wet). Underweight was more prevalent among late adolescents (APR: 1.27) and girls from moderately food-insecure households (APR: 1.23), and lower among Hindu girls (APR: 0.64). Anaemia was higher in the wet season (APR: 1.30) and among Hindu girls (APR: 1.32), while medium fish consumption (APR: 0.80), iron–folic acid supplementation (APR: 0.82), and knowledge about anaemia (APR: 0.82) were associated with lower anaemia prevalence. For iodine status, late adolescents (RGM: 1.22) and girls with media exposure (RGM: 1.26) had higher UIC, while non-iodised salt use was associated with lower UIC (RGM: 0.55). Underweight and anaemia remained highly prevalent among adolescent girls, whereas population iodine status, based on mUIC, was adequate in both seasons. Targeted, context-specific nutrition interventions are needed to improve adolescent nutritional status in this vulnerable region, and continued monitoring of salt iodisation coverage is warranted to sustain adequate population iodine status.