DOI: 10.3390/healthcare14193217 ISSN: 2227-9032

Anemia and Its Associated Factors Among Children Aged 6–59 Months After Internal Displacement in Central Sudan: A Cross-Sectional Study

Hatim G. Altahir, Mohammad Alhasoon, Ebtihal E. Eltyeb, Abdullah Al-Nafeesah, Ashwaq AlEed, Ishag Adam

Background: The ongoing conflict in Sudan has caused internal displacement. While pre-war baselines have been established, a critical gap remains in the literature on pediatric health in post-conflict reclaimed urban centers. This study aimed to determine the prevalence of anemia and identify its associated factors among children aged 6–59 months in Singa, Central Sudan. Methods: A community-based, multistage stratified cross-sectional study was conducted in Singa, Central Sudan, between August and September 2025. Sociodemographic characteristics were collected through face-to-face interviews. Anemia was defined according to the 2024 WHO age-specific hemoglobin criteria. Multivariable binary logistic regression analysis was performed. Results: A total of 450 children aged 6–59 months were included in the study. The median age was 23.5 months (interquartile range [IQR]: 13.0–38.0), and 252 (56.0%) were male. Most children were delivered vaginally (65.6%), had mothers with at least secondary education (53.1%), and were completely immunized (76.7%). The prevalence of anemia was 74.4% (95% confidence interval [CI] = 70.4–78.4%). In the univariable binary logistic regression analysis, younger age, smaller family size, younger maternal age, lower body weight, and a recent history of diarrhea were associated with anemia. After adjustment for potential confounders, while maternal age was inversely associated with anemia (adjusted odds ratio (aOR) = 0.95, 95% CI: 0.92–0.99) a recent history of diarrhea (aOR = 1.97, 95% CI: 1.22–3.17) was positively associated with anemia. The multivariable model demonstrated good calibration (Hosmer–Lemeshow p = 0.177). Conclusions: Anemia is a major public health concern among children aged 6–59 months returning to post-displacement settings. Anemia is primarily driven by younger maternal age and recent acute infectious diarrhea. Integrated strategies focusing on maternal education and support, diarrhea prevention and management, and early identification of at-risk children are needed to reduce the burden of anemia in this population.