Anaemia is one of the major public health problems worldwide and is associated with morbidity and mortality. Anaemic adolescent girls are at high risk of having physical and cognitive functional disorders. According to the WHO global database, anaemia affects 46% of school children globally. Because of health and socioeconomic problems, the prevalence of anaemia is higher in developing countries than in developed ones with 50% in Africa where children, adolescent girls and pregnant women are the most vulnerable groups to anaemia. In Rwanda, there is little national data on anaemia and its likely causes amongst adolescent girls. This study aimed to assess the extent of anaemia and associated risk factors among adolescent girls aged between 10-19 years old attending St Therese Clinic located in Eastern province of Rwanda. A cross sectional study design was conducted at St Therese Clinic and included 231 adolescent girls aged between 10-19 years old who were conveniently selected from the consented participants. The hemocue apparatus which uses a modified azide-methaemoglobin reaction was used to measure Haemoglobin (Hb) level in the whole blood. Pre-tested structured questionnaires were used to collect data on anticipated risk factors. The prevalence of anaemia was found to be 29% among adolescents girls. Among 67 anaemic girls (29%), 45 girls (19.47%) had mild anaemia while 18 girls (7.79%) had moderate anaemia and 4 grils (1.73%) had severe anaemia. It was found that malaria, menarche, educational status of their parents and meal intake frequency are significantly associated with anaemia, p value <0.05. Anaemia is highly prevalent in adolescent girls. Thus, policy makers has to prevent and control anaemia in this particular vulnerable group through but not limited to Iron/folic acid supplement, malaria eradication and promoting nutrition education programme targeting adolescent girls and their mothers, heads of primary and secondary schools mainly on the utilisation of easily available and affordable iron rich diet.

Background: The Diarrhoeal diseases remain to be a public health concern despite the existence of preventive measures and developing are the most affected. It affects more children less than five years compared to the rest of the population. The burden of childhood diarrhoea varies with geographical area and time bound. A part from this variation, the link between climate change and diarrhoea among under-five children has not been well understood. This study aims to determine the trends, spatial temporal and seasonal characteristics of diarrhoea diseases among Rwandan under-five children using routine Health Management Information System (HMIS) data from 2014 to 2018. Methods: Data on cases of diarrhoeal diseases in children under-five years were extracted from HMIS for a period of 5 years. The Rwanda Meteorology Agency provided climatology data including daily minimum and maximum temperature, and daily rainfall. Incidence rate were calculated to examine the trend, and excess hazard was assessed to determine the risk and likelihood for the occurrence of cases. Linear regression was used to assess relationship between climatology variables and the occurrence of diarrhoea. Results: 1,012,827 new diarrhoeal diseases episodes were reported. Excess risk was noticed in 40% of country’s districts. We found a statistically significant positive and negative relationship between diarrhoeal disease, and maximum temperature and mean monthly rainfall respectively (p<0.001). Increase in one millimeter of rainfall was associated with decrease of 14 cases of diarrhoea while increase of one degree Celsius of maximum temperature was associated with an increase of 15 diarrhoea cases. Conclusion: More districts with risk of diarrhoea were remarked which require targeted control intervention. Furthermore, significant association between diarrhoea case and climate dynamics was observed. This call for the public attention to climate changes which affect health especially children aged less than five years. Key words: Diarrhoeal, children under five, spatiotemporal, temperature, rainfall

Background: The Diarrhoeal diseases remain to be a public health concern despite the existence of preventive measures and developing are the most affected. It affects more children under five years compared to the rest of the population. The burden of childhood diarrhoea varies with geographical area and time bound. A part from this variation, the link between climate change and diarrhoea among children under five years has not been well understood. This study aims to determine the trends, spatial temporal and seasonal characteristics of diarrhoea diseases among Rwandan children under five years using routine Health Management Information System (HMIS) data from 2014 to 2018.Methods: This was an ecological study using retrospective data analysis. Incidence were used to examine the trend, and excess hazard was assessed to determine the risk and likelihood for the occurrence of cases. Retrospective Discrete Poisson model was used to identify spatial, temporal and spatial-temporal clusters of diarrhoea. Linear regression was used to assess relationship between climatology variables and the occurrence of diarrhoea. Results: In total, 1,012,827 new diarrhoeal diseases episodes were reported during 2014-2018 with an annual incidence rate of 12,669/100,000 children under five years. Excess risk was noticed in 12/30 (40%) of country’s districts (RR>1). Most significant spatial clusters of diarrhoea were observed in the northern province (RR=1.66, p<001). We found a statistically significant positive and negative relationship between diarrhoeal disease, and temperature and rainfall respectively (p<0.001). Increase in one millimeter of rainfall was associated with decrease of 14 cases of diarrhoea while increase of one degree Celsius of temperature was associated with an increase of 17 diarrhoea cases.Conclusion: More districts were remarked with risk of diarrhoea which require targeted control intervention. Furthermore, significant association between diarrhoea case and climate dynamics was observed. This call for the public attention to climate changes which affect health especially children aged less than five years