Anemia among Under-Five Children in Internally Displaced Camps in Mogadishu, Somalia: A Cross-Sectional Study on Prevalence, Severity, and Associated Risk Factors

Abstract Background: Globally, 269 million children under the age of five (39.8%) are anemic, with 60.2% of these children residing in Africa. Despite its serious health and social implications, anemia remains a significant public health challenge. Given the limited evidence on the prevalence and determinants of anemia among children under five in Somalia, this study aimed to assess the prevalence, severity and associated factors of anemia among internally displaced children under five years old in the Daynile IDP camps, Somalia. Method and materials: A community-based cross-sectional study was conducted in the Daynile IDP camps in Mogadishu, Somalia, from October 2022 to September 2023, involving a total of 435 children under five years of age. Socio-demographic data and other predisposing factors were collected through a structured questionnaire. Venous blood samples were drawn and analyzed for complete blood count (CBC) using a Mindray auto-hematology analyzer. Data were entered and analyzed using IBM SPSS Statistics version 29. Binary and multiple logistic regressions were performed to assess factors associated with anemia. Adjusted Odds Ratios (AOR) with their corresponding 95% Confidence Intervals (CI) were calculated. A p-value of less than 0.05 was considered statistically significant. Results: The prevalence of anemia was found to be 62.5% (95% CI: 58.5–67.5%), with the majority of anemic children (33.8%) classified as having moderate anemia. Microcytic hypochromic anemia was present in 89.3% of the cases. The prevalence of anemia was found to be 62.5% (95% CI: 58.5–67.5%), with the majority of anemic children (33.8%) classified as having moderate anemia. Microcytic hypochromic anemia was present in 89.3% of the cases. Significant predictors of anemia among under five children in these IDP camps included age ≤ 24 months (AOR = 2.326, 95% CI = 1.540-3.513), male gender (AOR = 1.734, 95% CI = 1.168-2.574), home delivery (AOR = 4.281, 95% CI = 1.901-9.639), non-exclusive breastfeeding (AOR = 2.018, 95% CI = 1.327-3.068), early introduction of complementary foods (AOR = 2.085, 95% CI = 1.356-3.206), lack of iron supplementation (AOR = 2.447, 95% CI = 1.596-3.751), diarrhea in last two weeks (AOR = 3.201, 95% CI = 2.132-4.806), fever in last two weeks (AOR = 2.781, 95% CI = 1.846-4.192), and lack of deworming medication (AOR = 1.600, 95% CI = 1.073-2.385). Conclusion: The study reveals a very high prevalence of anemia among children under five, reflecting a serious public health issue according to WHO classification. Preventive measures such as exclusive breastfeeding, timely introduction of complementary foods, periodic deworming, promotion of dietary diversity, iron supplementation, and strong government commitment to child welfare are essential for reducing under-five anemia and improving overall child health.