Burden and Associated Factors of Anaemia Among Rural School-Going Adolescent Girls in North Coastal Andhra Pradesh, India: A Cross-Sectional Study

Background Anaemia remains a major public health problem among adolescent girls, particularly in low- and middle-income countries. Adolescence is associated with increased iron requirements due to rapid growth and the onset of menarche. In India, anaemia prevalence remains high despite ongoing national nutrition programmes, and district-level data remain limited in several regions. Methods A school-based cross-sectional study was conducted among 278 adolescent girls aged 13-17 years in Srikakulam district, Andhra Pradesh. Data on socio-demographic, dietary, and menstrual factors were collected using a semi-structured questionnaire. Haemoglobin levels were measured using a point-of-care haemoglobinometer. For consistency across the study population, anaemia was defined as haemoglobin <12 g/dL using the World Health Organization (WHO) criteria for non-pregnant adolescent females. Bivariate analysis and multivariable logistic regression were performed. Results The mean age of participants was 15.1 ± 1.4 years, and the mean haemoglobin level was 10.9 ± 1.8 g/dL. The prevalence of anaemia was 66.9% (95% confidence interval (CI): 61.4%-72.4%). In multivariable analysis, inadequate iron intake (adjusted odds ratio (AOR): 3.0; 95% CI: 1.8-5.2), tea consumption with meals (AOR: 2.0; 95% CI: 1.2-3.6), low green leafy vegetable intake (AOR: 1.8; 95% CI: 1.1-3.0), lower socioeconomic status (AOR: 1.6; 95% CI: 1.0-2.7), prolonged menstrual flow (AOR: 2.0; 95% CI: 1.2-3.4), and irregular menstrual cycles (AOR: 1.5; 95% CI: 1.0-2.8) were independently associated with anaemia. Conclusions Anaemia was highly prevalent among rural school-going adolescent girls in this study population. Inadequate iron intake, tea consumption with meals, low green leafy vegetable intake, lower socioeconomic status, prolonged menstrual flow, and irregular menstrual cycles were independently associated with anaemia. These findings highlight the multifactorial nature of anaemia and suggest that school-based programmes should address dietary practices, behavioural factors, and menstrual health in an integrated manner. Such approaches may contribute to reducing the burden of anaemia among adolescent girls.