Evidence map›Paper›PMID 42204515›Full record

ArticleBMC public health2026

Trends in prevalence and predictors of anemia among school-aged children in Tanzania: analysis of 2019-2023 cross-sectional surveys using a multilevel logistic regression model.

Frank Chacky, Susan F Rumisha, Mbaraka John Remiji, Sijenunu Aaron, Nyabasi Makori, Fabrizio Molteni, Patrick Gt Walker, Wiggins Aaron Kyatikila, Felista Mwingira, Bwire Wilson and 24 more

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Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

34 authors.

Frank ChackyMinistry of Health, Dodoma, Tanzania. frank.chacky@afya.go.tz.
Susan F RumishaIfakara Health Institute, Dar es Salaam, Tanzania.
Mbaraka John RemijiIfakara Health Institute, Dar es Salaam, Tanzania.
Sijenunu AaronMinistry of Health, Dodoma, Tanzania.
Nyabasi MakoriTanzania Food and Nutrition Centre, Dar es salaam, Tanzania.
Fabrizio MolteniSwiss Tropical and Public Health Institute, Dar-es-salaam, Tanzania.
Patrick Gt WalkerImperial College London, London, UK.
Wiggins Aaron KyatikilaDepartment of Statistics, University of Dar es salaam, Dar es Salaam, Tanzania.
Felista MwingiraBiological Sciences Department, Dar es Salaam University College of Education, Dar es Salaam, Tanzania.
Bwire WilsonDepartment of Statistics, University of Dar es salaam, Dar es Salaam, Tanzania.
Pendael MachafukoNational Institute of Medical Research, Tanga, Amani, Tanzania.
Agnes A MpingaCentre of Excellence in Health Monitoring and Evaluation, Mzumbe University, Morogoro, Tanzania.
Grace MoshiMinistry of Health, Dodoma, Tanzania.
Theresia JumbeSokoine University of Agriculture, Morogoro, Tanzania.
Nyamizi BundalaSokoine University of Agriculture, Morogoro, Tanzania.
Ester KawisheMorogoro Municipal Council, Morogoro, Tanzania.
Joseph T HicksImperial College London, London, UK.
Geofrey MchauTanzania Food and Nutrition Centre, Dar es salaam, Tanzania.
Samson KiwareIfakara Health Institute, Dar es Salaam, Tanzania.
Germana LeynaTanzania Food and Nutrition Centre, Dar es salaam, Tanzania.
Witness MchwampakaMinistry of Health, Dodoma, Tanzania.
Witness SaitotNational Malaria Control Programme, Dodoma, Tanzania.
Oliva KimaroDepartment of Statistics, University of Dar es salaam, Dar es Salaam, Tanzania.
Julieth SilaoNational Bureau of Statistics, Dodoma, Tanzania.
Samafilan AinanDepartment of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Geofrey MakengaNational Institute for Medical Research, Tanga Center, Tanga, Tanzania.
Humphrey MkaliPopulation Service International, Dar es Salaam, Tanzania.
Achyut KcDepartment of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden.
Prosper ChakiIfakara Health Institute, Dar es Salaam, Tanzania.
Billy NgasalaMuhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Samwel L NhigaMinistry of Health, Dodoma, Tanzania.
Robert W SnowKEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Jean-Pierre Van GeertruydenGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
Bruno P MmbandoNational Institute for Medical Research, Tanga Center, Tanga, Tanzania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnemia constitutes a major global public health challenge among school-aged children with documented impacts on psychomotor development, academic achievement, susceptibility to infections, and long-term economic productivity. This study presents nationally representative findings on the prevalence and determinants of anemia among school children aged 5-16 years in mainland Tanzania.

methodsData were collected as part of the cross-sectional Tanzania School Malaria Parasitological Survey (SMPS) in 2019, 2021, and 2023. Hemoglobin concentration was assessed using the HemoCue Hb 201 + analyzer, and anemia status was classified according to the 2024 WHO thresholds. Candidate predictors associated with anemia (p < 0.2 in univariable analyses) were included in a multivariable multilevel logistic regression model to assess the contribution of predictor variables to anemia prevalence and to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI).

resultsThe study surveyed 47,366 school-aged children from 810 schools across three survey rounds. Generally, anemia prevalence was 45.5% (mild: 18.5%, moderate: 25.4%, severe: 1.5%). On multivariable regression of anemia risk, a statistically significant interaction was observed between age and sex. While odds of anemia were similar between sexes in lower age groups (5-11 and 12-14 years), male children aged 15-16 years old had almost three times the odds of anemia compared to female children in the same age group (AOR 2.96 [95%CI 2.18-4.02]). Malaria infection significantly increased anemia odds (AOR 1.88 [95%CI 1.75-2.01]). Regional disparities were noted, with the Lake [AOR 1.77 (95%CI 1.38-2.26)] and Western [AOR 1.78 (95%CI 1.34-2.37)] zones having highest odds of anemia compared to the Central zone. Over time, anemia risk decreased, with a notable reduction in 2023 (AOR 0.75 [95%CI 0.70-0.80]) compared to reference year (2019).

conclusionsAnemia in school-aged children remains a severe public health problem in Tanzania, according to WHO classifications. Risk factors include older age, male sex, malaria infection, and living in moderate and high malaria transmission risk areas and zones like the Lake, West, and Southern. These findings highlight the need for collaborative efforts by stakeholders to address anemia not only in Tanzania but also in regions with similar challenges.

Indexed as

AnemiaAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHumansLogistic ModelsMalePrevalenceRisk FactorsTanzaniaAnemiaAnemia burdenAnemia prevalenceSchool age childrenSurveillanceTanzania malaria survey

Identifiers

PMID42204515
PMCPMC13440171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.