Micronutrients and sociodemographic factors were major predictors of anemia among the Ethiopian population.

Anemia is characterized by low hemoglobin (Hb) concentration. Despite being a public health concern in Ethiopia, the role of micronutrients and non-nutritional factors as a determinant of Hb concentrations has been inadequately explored. This study focused on the assessment of serum micronutrient and Hb concentrations and a range of non-nutritional factors; to evaluate their associations with the risk of anemia among the Ethiopian population (n=2046). It also explored the mediation effect of zinc (Zn) on the relation between selenium (Se) and Hb. Bivariate and multivariate regression analyses were performed to identify the relationship between serum micronutrients concentration, inflammation biomarkers, nutritional status, presence of parasitic infection and socio-demographic factors with Hb concentration. (n=2046). Sobel-Goodman test was applied to investigate the mediation of Zn on relations between serum Se and Hb. In total, 18.6% of participants were anemic, 5.8% had iron deficiency, 2.6% had iron deficiency anemia and 0.6% had tissue iron deficiency. Younger age, household head illiteracy, and low serum concentrations of ferritin, cobalt, Copper, and folate were associated with anemia. Serum Se had an indirect effect that was mediated by Zn, with a significant effect of Se on Zn (p<0.001) and Zn on Hb (p<0.001). The findings of this study suggest the need for designing a multi-sectorial intervention to address anemia based on demographic group.