{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:40Z","timestamp":1782496540966,"version":"3.54.5"},"reference-count":59,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,16]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the prevalence and associated factors of anaemia and its association with the academic performance of schoolchildren in Kandahar, Afghanistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a cross-sectional analytical study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>This was a school-based study conducted among 1866 schoolchildren aged 6\u201314 years in Kandahar city from September to December 2023. Haemoglobin concentration was measured using a portable HemoCue Hb 301 analyser, while the WHO age-adjusted cut-off for haemoglobin was used to classify anaemia. Data were analysed by using descriptive statistics, the \u03c7\u00b2 test and multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this study, the mean age of the children was 9.1 years, 61.1% (1138\/1866) were boys, 83.6% (1560\/1866) had illiterate mothers, and 81.3% (1517\/1866) belonged to poor families. Prevalence of anaemia among schoolchildren was 64.1% (1196\/1866), while 20.8% (388\/1866), 41.7% (778\/1866), and 1.6% (30\/1866) were suffering from mild, moderate and severe anaemia, respectively. Main associated factors of anaemia were being male (adjusted OR (AOR) 1.4, 95%\u2009CI 1.1 to 1.7, p=0.003), unemployed father (AOR 1.5, 95%\u2009CI 1.1 to 2.2, p=0.020), poor family (AOR 2.3, 95%\u2009CI 1.8 to 2.9, p&lt;0.001), large family (AOR 1.2, 95%\u2009CI 1.0 to 1.6, p=0.048), history of intestinal helminths (AOR 1.3, 95%\u2009CI 1.0 to 1.6, p=0.017) and decreased meat consumption (AOR 2.0, 95%\u2009CI 1.6 to 2.5, p&lt;0.001). Children with anaemia had significantly lower academic performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prevalence of anaemia was very high and is a severe public health problem in schoolchildren of Kandahar. Based on the known consequences of anaemia on academic performance, the education and health authorities of Afghanistan should take serious steps to alleviate this problem. Periodic iron supplementation and deworming, as well as daily iron-rich mid-day meal programmes, should be started for both boys and girls in schools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109409","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:41:20Z","timestamp":1770219680000},"page":"e109409","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, factors and association with academic performance of anaemia in Kandahar schoolchildren: a cross-sectional analytical study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-5742","authenticated-orcid":false,"given":"Bilal Ahmad","family":"Rahimi","sequence":"first","affiliation":[{"name":"Pediatrics, Kandahar University, Kandahar, Afghanistan"},{"name":"Public Health, Afghan Interantional Islamic University, Kabul, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wais Mohammad","family":"Lali","sequence":"additional","affiliation":[{"name":"Research Centre, Kandahar University, Kandahar, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khwaja Mir Islam","family":"Saeed","sequence":"additional","affiliation":[{"name":"Afghanistan Field Epidemiology Training Program, Eastern Mediterranean Public Health Network, Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharif Ahmad Habib","family":"Ahmadzai","sequence":"additional","affiliation":[{"name":"Primary Health Care Directorate, Afghanistan Ministry of Public Health, Kabul, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Akbari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Paktia University Faculty of Medicine, Gardez, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Hakim","family":"Mukhlis","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Kabul University of Medical Sciences Abu Ali Ibn Sina, Kabul, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoodullah","family":"Azimi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Kabul University of Medical Sciences Abu Ali Ibn Sina, Kabul, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026062610405177000_16.2.e109409.1","unstructured":"World Health Organization . 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