Global prevalence of anemia in displaced and refugee children: A comprehensive systematic review and meta-analysis

Background Anemia due to living condition disproportionally affects the global refugee children. Nutritional deficiency particularly iron deficiency is the primary causes of anemia. Hence, we conducted a systemic review and meta-analysis on the prevalence of anemia among refugee children. Methods We searched systematically all relevant studies on the prevalence of anemia among refugee children including under the age of 18 years, which were conducted between 2009 and 2023 in English from PubMed, Embase, Scopus, Cochran library and other gray literatures such as google scholar. Two researchers independently screened articles based on their title and abstract. The Joana Brigg's Institute (JBI) checklist was used to assess the quality of studies. Random effect model was utilized to calculate the pooled estimate of anemia. Higgins I2 statistics and Egger's test were analyzed to check heterogeneity and publication bias, respectively. Subgroup analysis by continent, age group of the children and year of study was employed to identify the source of heterogeneity. Result A total of 14 studies were included in the final meta-analysis. Most of the studies were from Asian countries followed by African countries. The pooled prevalence of anemia among global refugee children was 36.54 with (95% CI: 23.79, 49.28). There was moderate level of heterogeneity between the studies (I2 = 68.91, P<0.001). The highest pooled prevalence of anemia in refugee children was reported in African, it was 56.1%, whereas the lowest pooled prevalence of anemia was in N. America, it was 12.66%. The prevalence of anemia was highest (53.88) in studies done among under-five refugee children. Conclusion The global prevalence of anemia among refugee children is found to be moderate public health problem. Anemia prevalence is more common in African refugee children. Intervention and prevention for should be focused especially for refugees found in low- and middle-income countries.