Sociodemographic Factors, Malaria Infection and Haemoglobinopathies as Drivers of Haemoglobin Levels and Anaemia in Rural Northern Ghana

Background: Anaemia is a major public health problem globally. District and community estimates of anaemia burden are crucial for appropriate targeted interventions. We described the prevalence and risk factors of low haemoglobin (Hb) levels and anaemia in a cross-sectional survey in the Navrongo Health and Demographic Surveillance. Methods: We recruited participants aged < 1 to > 40 years from the Kassena-Nankana districts in Northern Ghana. We estimated distributions of Hb concentrations by age, sex, district and Hb variant status. We defined anaemia based on the WHO threshold of Hb < 11.0 g/dL for children under 5 years, < 11.5 g/dL for children between 5 and 12 years, < 13 g/dL for men and < 12 g/dL for women. We then performed covariate-adjusted logistic and linear regression models to investigate predictors of anaemia and Hb concentrations. Results: The prevalence of anaemia was 53.2% (95% CI: 50.7–55.7) and was significantly higher in participants below 18 years. The lowest mean Hb levels (11.0 g/dL ± 1.32) were observed in children less than 5 years who contributed 84.1% of the anaemia. Participants with sickle cell condition had the highest prevalence of anaemia (68.2%). Male gender, positive malaria status and living in the Kassena-Nankana West (KNW) were significantly associated with increased odds of anaemia. Conclusions: Malaria, sickle cell conditions and male gender are some of the risk factors for anaemia in the study area. Health education should be continuous in the districts. Interventions to reduce anaemia should also target males, since it has clearly shown that male gender increases the risk of anaemia.