Abstract
Introduction
Adolescence is a critical period of rapid growth, second only to infancy, when nutritional needs are heightened. Malnutrition and micronutrient deficiencies are the result of complex interactions among poor diet, hygiene, and illness and affect physical and mental growth and development. Iron and zinc deficiencies are pressing public health concerns that significantly affect both the physical and cognitive development of adolescents, particularly in developing countries, including Cambodia. They are often overlooked among adolescents since many programs have focused on women and children. Therefore, this study aims to identify the factors associated with iron and zinc deficiency among school-aged adolescents aged 10-17 years in Cambodia.
Methods
This cross-sectional study used 2015 data from the FIDR, which surveyed children and adolescents from 136 schools in 23 provinces via two-stage cluster sampling. A total sample of 1526 adolescents aged 10–17 years was extracted from the original data of the 2020 samples. Iron and zinc deficiencies were the dependent variables. The independent variables included demographic characteristics, sociodemographic characteristics, household characteristics, school adolescent characteristics, and WASH. We used the chi-square test and logistic regression to assess the associations between iron and zinc deficiencies and sociodemographic characteristics and WASH questions among school-aged adolescents. The data analysis was performed with Stata V15.
Results
Most adolescents were from rural areas (80.5%), and 60.8% reported being sick in the past month. Overall, iron deficiency was 22.0% and higher in provinces such as Preah Vihear (39.1%) and Stung Treng (39.3%). The associated factors included younger age (10-12 years), female sex, lower education, recent illness, and non-water treatment practices. These factors are linked to higher iron deficiency rates. After adjustment, only those aged 13–15 and 16–17 years had significantly lower odds than those aged 10–12 years did, with AOR = 0.65 (95% CI: 0.46–0.92) and AOR = 0.47 (95% CI: 0.29–0.74). However, nearly all adolescent students had zinc deficiency (99.9%).
Conclusion
Iron and zinc deficiencies are prevalent among Cambodian adolescents, with iron deficiency rates varying significantly by province, age, sex, education level and health status, particularly among younger adolescent students. However, zinc deficiency is consistently high across all demographics, highlighting a widespread nutritional gap in zinc intake. Therefore, interventions should focus on early dietary education, emphasizing iron-rich foods (meat, beans, leafy greens) and zinc-rich foods (nuts, whole grains).