Risk factors of anemia among selected countries experiencing higher rate of under-5 mortality in sub-Saharan Africa: a three-way interaction model

Background: Over 1.8 million under-five mortality could be avoided each year if anemia is dealt with. No adequate information on the determinants of anemia among the sub-Saharan countries experiencing a higher after prevalence under-5 mortality. This study identified the risk factors of anemia among three sub-Saharan countries (Benin, Guinea and Nigeria).Methods: A total of 24137 records from the 2018 demographic and health survey. The outcome variable was anemia status (Anemic=1, not anemic=0). Measures of effects (AOR) were assessed using binary logistic regression and random-effect generalized linear model. Stata MP 16 was used for the data analysis.Results: Anemia was found to be common among children in Nigeria (ENREF 59.4%), Benin (58.2%), and Guinea (46.0%). Children (<6 months) had higher risk of anemia (AOR: 1.20, 95% CI: 1.05-1.37). Intake of drugs for the treatment of intestinal parasites during pregnancy was found to be protective against anemia in Nigeria (AOR: 0.85, 95% CI: 0.89-0.97) and Guinea (AOR: 0.76, 95% CI: 0.63-0.91). Main cooking fuel: Kerosene (AOR: 1.32, 95% CI: 1.05-1.65) and firewood (AOR: 1.46, 95% CI: 1.17-1.81) were associated with a higher risk of anemia.Conclusions: Children of younger age (<6 months) deserve priority attention in the battle against anemia. Intake of drugs for intestinal parasites during pregnancy presents a potentially impactful strategy for anemia prevention among under-5 children in addition to routine deworming and treatments. Also, rural residents, users of kerosene and firewood as main cooking fuel, and users of unprotected well as main source of drinking water needs attention in the awareness and campaigns against under-5 anemia.