Abstract
There are limited data on the prevalence of anaemia and iron deficiency (ID) in Somalia. To address this data gap, Somalia's 2019 micronutrient survey assessed the prevalence of anaemia and ID in children (6–59 months) and non‐pregnant women of reproductive age (15–49 years). The survey also collected data on vitamin A deficiency, inflammation, malaria and other potential risk factors for anaemia and ID. Multivariable Poisson regressions models were used to identify the risk factors for anaemia and ID in children and women. Among children, the prevalence of anaemia and ID were 43.4% and 47.2%, respectively. Approximately 36% and 6% of anaemia were attributable to iron and vitamin A deficiencies, respectively, whereas household possession of soap was associated with approximately 11% fewer cases of anaemia. ID in children was associated with vitamin A deficiency and stunting, whereas inflammation was associated with iron sufficiency. Among women, 40.3% were anaemic, and 49.7% were iron deficient. In women, ID and number of births were significantly associated with anaemia in multivariate models, and approximately 42% of anaemia in women was attributable to ID. Increased parity was associated with ID, and incubation and early convalescent inflammation was associated with ID, whereas late convalescent inflammation was associated with iron sufficiency. ID is the main risk factor of anaemia in both women and children and contributed to a substantial portion of the anaemia cases. To tackle both anaemia and ID in Somalia, food assistance and micronutrient‐specific programmes (e.g. micronutrient powders and iron supplements) should be enhanced.
Highlights
Anaemia is characterized by a shortage of functional haemoglobin (Kassebaum et al, 2016)
iron deficiency (ID) in children was associated with vitamin A deficiency and stunting, whereas inflammation was associated with iron sufficiency
Increased parity was associated with ID, and incubation and early convalescent inflammation was associated with ID, whereas late convalescent inflammation was associated with iron sufficiency
Summary
The SMS 2019 was a nationwide cross-sectional stratified survey based on a probability sample. Following the completion of the household questionnaire, interviewers administered the child questionnaire to the caretakers of all children 0–59 months of age and the woman questionnaire to non-pregnant women in every second household. Serum folate and vitamin B12 were analysed in a subsample of women by the Swiss Vitamin Institute (Epalinges, Switzerland) using microbiological assays with Lactobacillus casei (ATCC 7469) and Lactobacillus leichmannii (ATCC 7830) as test organisms, respectively, following the turbidimetric reference method performed in microtitre plates (O'Broin et al, 1997) Both VitMin Lab and the Swiss Vitamin Institute participate in the Vitamin A Laboratory – External Quality Assurance (VITAL-EQA) programme (US CDC, 2021) and demonstrated minimal imprecision and bias in the VITAL-EQA rounds prior to analysing samples from the SMS 2019. Inflammation-adjusted serum ferritin concentrations of
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