{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:57:38Z","timestamp":1789102658501,"version":"build-2803163510"},"reference-count":77,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"SAMRC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"crossref"}]},{"name":"South African Treasury"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Anaemia is a critical public health challenge in Sub-Saharan Africa (SSA), particularly among adolescents. The objective was to estimate the pooled prevalence of anaemia among adolescents in SSA and synthesise evidence on its nutritional and contextual determinants. Methods: A systematic search of databases including PubMed, CINAHL and Web of Science was conducted for studies published from January 2000 to October 2025. The methodological approach was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled prevalence estimates were computed using random-effects models, and heterogeneity was assessed using the I2 statistic and Cochran\u2019s Q test. Subgroup and meta-regression analyses were performed to explore sources of variation. Determinants were synthesised as pooled odds ratios with 95% confidence intervals. Publication bias was evaluated through funnel plot asymmetry and Egger\u2019s regression test. Results: Forty-eight (n = 48) studies involving 76,596 adolescents met the inclusion criteria. The pooled prevalence of anaemia was 33% (95% CI: 0.28\u20130.39), with substantial heterogeneity across studies. Factors associated with higher odds of anaemia included low dietary diversity (OR 1.74, 95% CI: 1.10\u20132.74) and poor iron or micronutrient supplementation adherence or lack of supplementation (OR 1.94, 95% CI: 1.25\u20133.01). Infection-related exposures (OR 3.03, 95% CI: 1.99\u20134.61) and environmental determinants (OR 2.23, 95% CI: 1.41\u20133.55) were also significantly associated with anaemia. Socio-demographic factors associated with anaemia included menstrual factors among girls (OR 2.51, 95% CI: 1.58\u20133.99), household size (OR 3.32, 95% CI: 1.61\u20136.85), awareness (OR 1.71, 95% CI: 1.08\u20132.70), and age group (OR 2.37, 95% CI: 1.47\u20133.83). Conclusions: Anaemia among adolescents in SSA remains an important public health concern, although the pooled estimates should be interpreted cautiously because of substantial heterogeneity and methodological differences across studies. The findings suggest that adolescent anaemia is associated with multiple nutritional and contextual factors, but more consistent and context-specific research is needed to refine regional estimates and guide interventions.<\/jats:p>","DOI":"10.3390\/nu18152404","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:11:42Z","timestamp":1784787102000},"page":"2404","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Factors Associated with Anaemia Among Sub-Saharan African Adolescents: A Systematic Review and Meta-Analysis of Nutritional, Socio-Demographic, Environmental, and Infectious Factors"],"prefix":"10.3390","volume":"18","author":[{"given":"Sisa H.","family":"Martins","sequence":"first","affiliation":[{"name":"Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa"},{"name":"School of Public Health, University of the Western Cape, Bellville 7535, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1041-7941","authenticated-orcid":false,"given":"Mamakase G.","family":"Sello","sequence":"additional","affiliation":[{"name":"School of Public Health, University of the Western Cape, Bellville 7535, South Africa"},{"name":"Department of Nutrition, Faculty of Health Sciences National University of Lesotho, Maseru 100, Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5901-6766","authenticated-orcid":false,"given":"Musawenkosi","family":"Ndlovu","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Rhodes University, Makhanda 6140, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marakiya T.","family":"Moetlediwa","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa"},{"name":"Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Observatory 7925, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7715-2147","authenticated-orcid":false,"given":"Samukelisiwe S.","family":"Madlala","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Choshi","sequence":"additional","affiliation":[{"name":"Department of Physiology and Environmental Health, University of Limpopo, Sovenga 0727, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5965-3610","authenticated-orcid":false,"given":"Phiwayinkosi","family":"Dludla","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa"},{"name":"School of Medicine, University of KwaZulu-Natal, Durban 4000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-131X","authenticated-orcid":false,"given":"Andr\u00e9 P.","family":"Kengne","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa"},{"name":"Department of Medicine, University of Cape Town, Cape Town 7700, South Africa"},{"name":"African Population and Health Research Center, Nairobi P.O. Box 10787-00100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zandile J.","family":"Mchiza","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa"},{"name":"School of Public Health, University of the Western Cape, Bellville 7535, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8388-132X","authenticated-orcid":false,"given":"Sihle E.","family":"Mabhida","sequence":"additional","affiliation":[{"name":"Health Systems Research Unit, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","unstructured":"WHO (World Health Organization) (2025). 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