Prevalence and predictors of anemia in children under 5 years of age in sub-Saharan Africa: a systematic review and meta-analysis

Abstract

BackgroundAnemia is a significant public health challenge in Sub-Saharan Africa, particularly affecting children under five years old and posing serious health and developmental consequences. This systematic review and meta-analysis aim to quantify the prevalence and identify the predictors of anemia in this vulnerable age group across the region.MethodsA systematic review and meta-analysis were conducted in adherence to PRISMA guidelines. Observational studies reporting on the prevalence and predictors of anemia among children under five in Sub-Saharan Africa were included. Comprehensive searches were performed in PubMed, Scopus, Web of Science, and Embase databases. The Joanna Briggs Institute (JBI) tools were used for critical appraisal. A random-effects model was applied to estimate pooled prevalence, while heterogeneity and publication bias were assessed using R software.ResultsA total of 32 studies comprising 93,388 children were included. The pooled prevalence of anemia was 55%, reflecting a widespread public health issue, with significant heterogeneity (I² = 99.7%). Key predictors included younger age (particularly 0–23 months), male gender, and indicators of poor nutritional status such as stunting. Socioeconomic and environmental factors, including rural residency and low maternal education, were also strongly associated with higher anemia rates. The observed variability across studies highlights the multifaceted nature of anemia’s determinants in the region.ConclusionThe consistently high prevalence of anemia among children under five in Sub-Saharan Africa underscores the need for integrated public health strategies. Efforts to address nutritional deficiencies, improve maternal education, and enhance living conditions are essential to mitigate the burden of anemia and improve child health outcomes in the region.