Anemia during childhood impairs physical growth, cognitive development and school performance. Identifying the causes of anemia in specific contexts can help to prevent negative consequences of anemia among school age children. Objective: The objective of this study was to assess the magnitude of anemia and to identify its contributing factor among school children in south Ethiopia. Methods: Community based cross sectional study was conducted on 516 school age children on their caretakers from

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... arch 2016 to April 2016 in Mihur aklil district, Gurage Zone, south Ethiopia. Systematic simple random sampling technique was implemented to select students from 13 primary schools, stool and blood sample were collected in health posts. Information on the families' socioeconomic conditions and the children's health Variables were obtained through interviews with parents or guardians. HemoCue 301 was used to determine hemoglobin level. Direct stool examination using saline smear was used to investigate intestinal protozoa and helminthes. Rapid diagnostic kit was also used for detection of malaria infection. Bivariate and multivariate regression analysis was used to identify contributing factor for the development of anemia. P value below 0.05 was considered for statistically significance. Result: The overall prevalence of anemia was 21.71% (95% CI: 17.95, 25.07) children residing in mild food insecure households (AOR=5.15, 95% CI: (2.45-10.82), moderate food insecure (AOR=4.47, 95%CI: (1.38-14.48) and severe food insecure (AOR=11.71, 95% CI: (3.49-39.25), and who had Ascaris lumbricods and hook worm parasites (AOR=2.64,95% CI:(1.18-5.92), (AOR=4.75,95% CI:(1.87-12.05) respectively and infected with malaria (A0R=68.13, 95% CI: (7.02- 660). showed strong odds of being anemic than their counter parts. Conclusion: In conclusion anemia among school age children in this study is of moderate public health significance. The magnitude of anemia was strongly associated with malaria, food insecurity and intestinal parasite [...]