Prevalence and factors associated with anemia among children aged 2–59 months admitted to Gulu Regional Referral Hospital, Northern Uganda: A hospital-based cross-sectional study

Abstract Background Anemia remains a global public health concern affecting several populations and continues to contribute to significant preventable morbidity and mortality. Unaddressed anemia is associated with long-term effects including poor cognitive and motor development, and behavioral problems. Despite these documented effects, the burden of anemia in Northern Uganda remains underreported. The study therefore aimed to assess the prevalence and factors associated with anemia among children aged 2–59 months admitted to Gulu Regional Referral Hospital (GRRH), in Northern Uganda. Methods This was a hospital-based cross-sectional study conducted from May to August 2025. A total of 384 eligible participants were enrolled into the study. Semi-structured questionnaires were used to collect social demographic data and clinical history of participants. Additional medical information was obtained from hospital records and laboratory reports. Data was analysed using STATA version 15.0. Data was summarized using frequencies, percentages, median, and interquartile ranges. Modified Poisson regression, with robust standard errors and a 95% CI were used to assess associated factors. A p < 0.05 was considered for statistical significance. Results Of the 384 participants, majority 51.3% (n = 197) were aged 24–59 months and 58.1% (n = 223) were male. The median hemoglobin level was 9.20 g/dL (Inter-quartile ranges (IQR): 6.85–10.80). The prevalence of anemia was 79.2% (95% CI:0.75–0.83), [n = 304/384]. Of these, 25% (n = 76) had severe anemia, 39.1%(n = 119) had moderate anemia and 35.9% (n = 109) had mild anemia. Factors significantly associated with anemia were: non-consumption of vegetables (aPR = 1.22, 95% CI: 1.02–1.46, p = 0.032), and children with more than 2 episodes of respiratory tract infection (aPR = 1.18, 95% CI: 1.07–1.31, p = 0.001). Meanwhile, prevalence of anemia was 21% lower among children of caregivers with monthly income above UGX 500,000 (aPR = 0.79, 95% CI: 0.63–0.98, p = 0.031). Conclusion About four in five children had anemia in this study. Non-consumption of vegetables and recurrent respiratory tract infections were significantly associated with anemia. Meanwhile, prevalence of anemia was 21% lower among children of caregivers with high monthly income. Empowering families to get out of poverty, parental nutritional advise and prompt seeking of care for childhood illnesses could significantly contribute to addressing anemia in this population.