INDIAN STUDIES:

Aabroo Talpur et al (2012) observed Prevalence of Anaemia in Adolescent Girls in the

age group of 14-19 yrs. 150 adolescent girls were selected in the age range of 14-19
yrs. The results shows that out of 75 girls of 17-19 yrs 60% were anaemic; out of
these 55.55% had mild anaemia (<12gm/dl), 22.22% had moderate anaemia (8-
10gm/dl),and an equal percentage (22.22%) of girls had severe anaemia (<8gm/dl).
Prevalence of the anaemia was the highest (93.33%) in the age group of 14-16 yrs.
Out of these, 57.14% were found to have mild anaemia, 14.28% had moderate
anaemia and 28.57% had severe anaemia. They found that association of severe
anaemia with decreased BMI (Body Mass Index).

Premalatha et al (2012) carried out a cross sectional study on Prevalence of Anaemia

and its Associated Factors among Adolescent School Girls (13-17 yrs) in Chennai.
The result of the prevalence of anaemia was found to be 78.75% and there is a
significant association (p<0.05) of anaemia is with type of family, socio economic
status and diet. 42.5% of girls with BMI<18 were found to be anaemic.

Bharathi C et al (2011) under taken an investigation to determine the Impact of

Nutrition Education Intervention on the Haemoglobin Status of 60 anaemic rural
adolescent girls aged between 13-16 years. The nutrition education intervention by
using Child to child nutrition education technique was carried out for three
months. Sixty adolescent girls were divided into two groups i.e. experimental group
(n=30) and control group (n=30). The pre and post test scores of experimental and
control group were assessed. The student t test showed significant difference between
the mean knowledge within the experimental group. When their haemoglobin level
was considered for three months of education intervention there was a significant
increase in the haemoglobin level among the experimental group was observed.
Finally they concluded that nutrition education is one of the appropriate, effective and
sustainable approach to combat iron deficiency anaemia.

A STUDY OF ANAEMIA AMONG ADOLESCENT GIRLS IN TIRUPATI RURAL AND URBAN

AREAS THROUGH GOVERNMENT HIGH SCHOOLS
T Jay;") Chandia Xaidu1. Sekar M N": Sasi kumar BJ. Hemavathi-\ Shankar Reddy Dudala4. Manorta:
B-.K Siva Ramudu2

Our study was planned to assess the magnitude of problem of anaemia in adolescent girls in rural and
urban areas of Tirupati and its association with various factors. The main objective was to study about
the prevalence, various risk factors and anthropometric data in relation to anemia in adolescent girls
who attended Government high schools in Tirupati rural and urban areas. A school based cross
-sectional study was carried out during the period of October 2013 to October 2014. 314 adolescent
girls from rural Government high schools and 314 adolescent girls from urban Government schools a
total of 628 school going adolescent girls were selected. SPSS software was used for the analysis of the
data. Chi-square test is used for the statistical analysis, the present study revealed anaemia is a major
health problem among the adolescent girls in both rural and urban areas in the present study area.
Majority of the adolescent girls were within mild to moderate anemia in both rural and urban groups.
There is no significant difference in the severity of anaemia between early adolescence and late
adolescence in both rural and urban groups. The prevalence of severity of anaemia was more among
girls who belong to lower socio economic status. The prevalence of severity of anemia was high among
post menarchial girls in both rural and urban groups. The prevalence of severity of anaerma was high
among post menarchial girls with menstrual problems in rural group.
Prevalence and Severity of Anaemia Stratified by Age and Gender in Rural India
Gerardo Alvarez-Uria, Praveen K. Naik, Manoranjan Midde, Pradeep S. Yalla, and
Raghavakalyan Pakam

Anaemia is a major public health problem in India. Although nearly

three quarters of the Indian population live in rural areas, the
epidemiology of anaemia in rural settings is not well known. We
performed a retrospective observational study using routine clinical
data from patients attending the out-patient clinics of a rural
hospital in India from June 2011 to August 2014. The study included
73,795 determinations of haemoglobin. 49.5% of patients were
female. The median haemoglobin concentration was 11.3g/dL
(interquartile range (IQR), 9.812.4) in females and 12.5g/dL (IQR,
10.614.2) in males. Anaemia was present in the majority of children
<10 years, women after puberty, and older adults. Children <5
years had the highest prevalence of anaemia, especially children
aged 1-2 years. The high proportion of microcytic anaemia and the
fact that gender differences were only seen after the menarche
period in women suggest that iron deficiency was the main cause of
anaemia. However, the prevalence of normocytic anaemia increased
with age. The results of this study can be used by public health
programmes to design target interventions aimed at reducing the
huge burden of anaemia in India. Further studies are needed to
clarify the aetiology of anaemia among older adults.

IRON, VITAMIN B12 AND FOLATE DEFICIENCY IN ADOLESCENTS

HAVING NUTRITIONAL ANAEMIA
Rajendra1, Sudha2, Sreekanthan3, Anil Vijayakumar4, Rajendran5, Manil
Mohammed6

ABSTRACT: BACKGROUND: Adolescence is the formative period of life when

the maximum amount of physical, psychological and behavioral changes takes place
and this is a vulnerable period in the human life cycle for the development of
nutritional anaemia, which has been constantly neglected by public health programs.
The prevalence of anaemia is disproportionately high in developing countries than
developed countries. It has mainly been ascribed to poverty, inadequate diet, certain
diseases, pregnancy and lactation, and poor access to health services in developing
countries Prevalence of anaemia in adolescents in India have been reported in limited
studies available from 16.25% to 96.5%. Nutritional anaemia constitutes the most
important cause of anaemia in adolescents. It is mainly due to deficiency of Iron,
Vitamin B12 and Folate. Megaloblastic Anaemia resulting from deficiency of folate
and B12 appears to be increasing over the last two decades. AIMS AND
OBJECTIVES: 1.To study the types of nutritional anemia in adolescents (10-18 yrs.)
attending the hospital and correlate severity of nutritional anemia with serum levels of
ferritin, Vit B12 & folate. 2. And also to determine demographic, socio-economic &
nutritional factors for nutritional anemia in adolescents. STUDY DESIGN: A cross
sectional study was conducted in selected sample of 200 subjects. SETTINGS: The
study was conducted in the Department of General Medicine, Azeezia Medical
College; during November 2011 to April 2013, as a cross-sectional observational
study. MATERIALS AND METHODS: Subjects were selected based on the
inclusion criteria set and evaluated with aid of laboratory investigation of blood
samples collected from subjects. RESULTS AND CONCLUSION: Present study
was undertaken to find out etiology and socio-demographic correlates of nutritional
anaemia in adolescents. And it was found out that Folate deficiency was the most
common followed by Vitamin B12 deficiency & then irons deficiency. Also low
intake of all the three nutrients is a significant determinant towards causing nutritional
anaemia. Other factors found to influence the prevalence of anaemia were history of
worm infestation, fathers occupation, calorie intake and folate intake.

A community based study on prevalence of anemia among adolescent

girls and its association with iron intake and their correlates

Swati Dixit, Surya kant, GG Agarwal, JV Singh

Indian Journal of Prev Soc Med, Vol 42, No: 4, 2011

Anemia is a serious health threat in adolescent girls. Iron intake is an important factor
of blood hemoglobin level in adolescent girls. Nutritional knowledge can influence
dietary iron intake of adolescent girls.
Objectives: To find prevalence of anemia in rural, urban and slum living girls and to
find out association of hemoglobin level with iron intake and its correlates. Methods:
This multistage observational study was conducted on 586 adolescent girls of age 10-
19 years in Lucknow district (151 from rural, 150 from slum and 286 from urban
area) of Uttar Pradesh, India. Information on nutritional knowledge was collected
with the help of pre-designed questionnaire. Iron intake was assessed by 24 hour
dietary recall method. Results: Overall 83.3% of recruited girls were anemic. Almost
all of the rural (100%) and slum (99.3%) girls were found anemic. Mean iron intake
and blood hemoglobin level was found 20.8 mg/day and 10.36 gm/dl respectively.
Iron intake was found adequate in only 20.3% girls. Nutritional knowledge was found
significantly associated with Iron intake but it was not associated with hemoglobin
level in girls. Conclusions: This study concludes that nutritional knowledge may
affect dietary intake of iron but its transformation in better hemoglobin level is
lacking due to other bio-social factors.
A study of anemia among adolescent girls in rural
area of Hassan district, south india

Authors:Dr. Siddharam S Metri, Dr. GM Venketsh, Dr. Thejeshwari HL

Int J Biol Med Res. 2011; 2(4): 922 924 | PDF File
Abstract
Abstract: To estimate the prevalence of anemia among adolescent girls and to
study the socio-demographic factors associated with anemia. Materials and
methods: A cross sectional survey was conducted in selected Anganwadi
centres of rural area of Hassan district. Three and Fourteen adolescents girls
(10-19 yrs old) were included in the study. The study was conducted from
February to April 2011 (3 months).Data analysis was done by using
proportions and Chi-square test. Results: Prevalence of anemia was found to
be 45.2%. A statically significant association was found with iron deficiency
anemia, weight loss and anemia, pallor and anemia. In the present study it
was seen that among the 45.2% of anaemic adolescent girls 40.1% had mild
anaemia, 54.92% had moderate anaemia and 4.92% had severe anaemia.
Conclusion: A high prevalence of anemia among adolescent girls was found,
which was higher in low economic strata. It was seen that anemia affects
overall nutritional status of adolescent girls.

FOREIGN STUDIES:

Knowledge, attitude and practice of balanced diet and correlation with

hypochromic microcytic anemia among adolescent school girls in maros
district, South Sulawesi, Indonesia.

Sitti Patimah1*, Ida Royani2, Ansar Mursaha3, Abdul Razak Thaha4

Anemia among adolescent girls is remaining a public health problem in

Indonesia. This study was aimed to assess the association of balanced diet
behavior and microcytic-hypochromic anemia among adolescent girls. A
cross-sectional study has been conducted among 200 adolescent girls in
five senior high schools in Maros regency on March to April 2015.
Assessment of anemia was performed by Flow Cytometry and SLS-
hemoglobin method, data of balanced diet behavior was collected using
structured questionnaire. Data was analyzed by using chi- square test with
SPSS software for windows. The prevalence of microcytic-hypochromic
anemia was 19.5%. There were 41% subjects had low knowledge about
balanced diet, more than a half (55.5%) had negative attitude to balanced
diet, and 46.5% had a poor practice of balance diet. Knowledge and
attitude about balanced diet had no association with microcytic-
hypochromic anemia. In contrast, the practices of balanced diet had a
significant association with microcytic-hypochromic anemia (p=0.048). It
is suggested to conduct an intervention for balanced diet education among
adolescent schoolgirls to improve their balanced diet behavior

Iron deficiency anemia in adolescents; a literature review

AUTHOR(S)
Castro de Andrade Cairo, Romilda; Rodrigues Silva, Luciana; Carneiro
Bustani, Nadya; Ferreira Marques, Cibele Dantas

PUB. DATE
June 2014
SOURCE
Nutricion Hospitalaria;jun2014, Vol. 29 Issue 6, p1240

SOURCE TYPE
Academic Journal

DOC. TYPE
Article

ABSTRACT
Introduction: Anemia is one of the most important nutritional deficiencies
affecting various social and socioeconomic strata. It is more common in
developing countries, with children and adolescents being at a
significantly higher risk for the condition. Objective: To perform a
literature review on iron deficiency anemia in adolescence as a public
health issue and on the risk factors that may contribute towards
nutritional deficiencies, stunted growth and development in this age
group, emphasizing the physiopathology and causes of anemia, the
different diagnostic approaches, and its clinical characteristics, prevention
and treatment. Methodology: The LILACS-BIREME, SCIELO and
PUBMED databases were consulted for the study. Scientific papers
published in Spanish, Portuguese or English between 2000 and 2013 on
the subject of iron deficiency anemia in adolescents were selected for
inclusion. A total of 102 studies published between January 1st, 2000 and
June 30th, 2013 were identified and evaluated. Forty-two articles meeting
the inclusion criterion (adolescents with anemia) were selected for this
review. Finally, an analysis was conducted and the papers were evaluated
in accordance with the study objectives. Results and Discussion: The
studies reviewed revealed a prevalence of iron deficiency anemia of
around 20% in adolescents and described the harmful effects of anemia in
this age group. Conclusion: Preventive action is required with respect to
iron deficiency anemia. Healthcare professionals should be aware of the
need for early diagnosis, prophylaxis and treatment.

Prevalence of anemia and effectiveness of iron supplementation in

anemic adolescent schoolgirls at Amravati City (Maharashtra)

Introduction: In India, the prevalence of anemia in adolescent girls is

estimated at 56%. The underlying sociodemographic factors and menstrual
practices need to be studied in adolescent girls and a way to reduce the
anemia not only by supplementation of iron and folic acid tablets and
deworming but ensuring its regular consumption. Hence, the present study
was undertaken to know the effectiveness of deworming and iron and folic
acid supplementation in reducing the prevalence and severity of anemia in
adolescent school girls. Aims and Objectives: To study the prevalence of
anemia in adolescent girls in urban area and effectiveness of iron
supplementation in them. Materials and Methods: The present interventional
study was conducted at Sharada Kanya Vidyalaya, in Amravati city. Total 350
adolescent girls were selected by random sampling from August 2013 to
November 2013. All the girls were given a single dose anthelminthic and the
girls who were anemic were given iron and folic acid tablets for daily
consumption. The hemoglobin was again assessed after three months.
Statistical Analysis: Chi-square test of significance and standard error of
difference between two means using SPSS version 16 software. Results: The
overall prevalence of anemia in adolescent girls was found to be 55%. Mean
and standard deviation of Hb% in adolescent girls significantly increased from
10.57 (1.09) before to 11.78 (0.99) after intervention. Conclusion: The
contributing factors of anemia found in the present study were low
socioeconomic status, onset of menarche, small family size, and vegetarian
diet.

PREVALENCE OF ANAEMIA AMONG ADOLESCENTS UNDER

IBSY IN RURAL BLOCK OF A DIST. OF NORTHERN INDIA (2013)

ABSTRACT:

Research Question: What is the prevalence of Anaemia among adolescents under

Indira Bal Swasthya Yojna in rural block of a dist. of northern India?

Objective: To determine prevalence of Anaemia among adolescents under Indira Bal

Swasthya Yojna in rural block of a dist. of northern India

Study design: Cross-sectional, descriptive

Settings: Government schools under CHC Chiri block of Dist. Rohtak. Statistical
analysis: Percentage, simple proportion, chi square test Participants: 1650 participants
covered under IBSY.

Results: The overall prevalence of anaemia was 67.7%. 1116 out of 1650 students had
varying severity of anaemia while anaemia was absent in 534 participants. Out of the
1650 students, 663 (40.2%) were mildly anaemic, 450 (27.3%) were moderately
anaemic and 3 (0.2%) were severely anaemic.

Conclusion: the present study revealed anaemia to be a major public health problem
among adolescents.

Effect of socio-demographic characteristics on the prevalence of anemia among

school going adolescent girls in Lucknow district, India
Beena Sachan1, MZ Idris2, Ashutosh Singh3

Anemia is a serious public health concern in most developing countries and the prevalence of anemia is
quite high among adolescent girls. A cross-sectional descriptive study was carried out among school
going adolescent girls in urban as well as rural schools of the Lucknow district, Uttar Pradesh, India
from October 2008 to September 2009 with the objectives of studying the prevalence of anemia and
the various socio-demographic characteristics in relation to anemia. Multistage random sampling was
used to select the requisite number of girls. A total of 847 school going adolescent girls between 10-
19 years of age were interviewed. Information regarding their socio-demographic characteristics was
collected and the girls were also examined for presence or absence of pallor for anemia. Statistical
analyses were done using percentage, Chi-square test, and odds ratio. The prevalence of anemia was
found to be 55.6% and 57.9% in urban and rural school going adolescent girls respectively and
significant association of anemia was observed with religion, caste and socioeconomic status (p
value<0.05). There is need to develop strategies for intensive adult education, nutrition education and
dietary supplementation including anemia prophylaxis.

PREVALENCE OF ANEMIA AND ITS CORRELATION TO BODY

MASS INDEX: STUDY AMONG UNMARRIED GIRLS
ABSTRACT

Anemia among women causes many serious health problems and is pervasive in developing
country. In a country like India, adolescent girls face serious health problems due to
socioeconomic, environmental conditions, nutrition and gender discrimination. A vast
majority of girls in India are suffering from either general or specific morbidities. Aim of
study was to provide information to youth about their nutritional clinical picture and changing
physical biological and health needs. It was designed to include all eligible aged 16 to 30
years non pregnant, unmarried college going girls. Demographic and socioeconomic data on
the subjects (775 girls) were collected using a standard questionnaire. Hemoglobin estimation
was done with Sahalis method. Lectures on nutrition, good eating habits and anemia were
organized for these girls. Out of 750 girls 155 girls were urban and 620 were rural. In urban
girls mean age 19.431.94yrs, weight 47.697.66kg, height 156.05 cm, BMI 19.452.85
and Hb was 9.351.06 gm%. In rural girls mean age 19.291.43yrs, weight 46.875.66kg,
height156.054cm, BMI 19.022.10 and Hb was 9.40.90gm%. All statistical analysis,
correlation coefficient and p-value assessed with the help of SYSTAT version 12 in three BMI
groups separately for urban and rural girls. Negative association of BMI to Hb concentration
was observed in overweight and obese groups. High prevalence of anemia is found in both
urban and rural girls in all BMI groups. Reason for high prevalence of anemia in these girls
could be due to age, socioeconomic condition, low food intake, increase tendency to loose
weight for zero size combined with menstrual loses.

PREVALENCE OF ANEMIA AND ITS CORRELATION TO BODY

MASS INDEX AMONG SCHEDULED CASTE SCHOOL CHILDREN
IN FATEHABAD DISTRICT OF HARYANA (2014)

Kumar R, Sangwan L, Peter R

Anemia is a very common problem in paediatric age group in many developing countries with
an estimated prevalence of 43% of the Worlds children. School children constitute 20.25% of
total population in India and those are more vulnerable to this disease due to their rapid
growth need of high iron. Aim was to study the prevalence of anemia among scheduled caste
school children aged 6-12 years of government primary school of Bhima basti in Fatehabad
city of Haryana and also to assess its correlation to variable such as Gender and Body Mass
Index (BMI). Total 133 children (including both boys and girls) between the ages of 6-12
years formed the study group. Relevant history was taken and a complete physical
examination done. Hemoglobin estimation was done using Sahlis Acid-Hematin methods.
With clinical symptoms and hemoglobin estimation, the prevalence of anemia was detected.
With measurements of height and weight, the prevalence of undernutrition was also detected.
The overall prevalence of anemia among scheduled caste children in the age group of 6 to 12
years was 85.72 % (114/133). The highest prevalence of anemia was present in the girls
(94.52 %) than boys (75.0 %). It is concluded that anemia still constitutes a health problem
among school children belonging to scheduled caste with the present prevalence of 85.72%.

UTTARPRADESH

Anemia and undernutrition among preschool children

in Uttar Pradesh, India.
Awasthi S1, Das R, Verma T, Vir S.

This study was conducted to assess the prevalence of anemia among

preschool children (3-5 years) and its association with malnutrition in
rural Barabanki district of Uttar Pradesh, India. Three out of 18 sub-
centers in Nindura block, Barabanki, each with six villages, were
randomly selected for this survey and 654 boys and 546 girls were
included. Mean hemoglobin level in g/dL among boys and girls was 10.1
(SD: 1.66) and 9.9 (SD: 1.67) (P <0.06) respectively. The proportion of
anemic children (Hb <11 g/dL) was 70%. Boys were heavier and taller
as compared to girls. Among the 67.3% underweight children the mean
hemoglobin level was 9.85 (SD: 1.67) as compared to 10.39 (SD: 1.62)
in those without malnutrition (P <0.0001). Likewise, stunted children
(87.6%) had statistically significantly lower mean hemoglobin levels
than those not stunted. The odds ratio of an underweight and stunted
child having moderate to severe anemia was 1.66. While more than half
caretakers knew about the term "anemia " and associated physical
weakness with it, only very few (2.5%) knew that iron intake will improve
it. They relied on "doctors" (86.7%) for anemia prevention.

HAEMOGLOBIN ESTIMATION

Methods for Hemoglobin Estimation: A Review of

What Works

Anemia is widely prevalent in developing world and is a public

health challenge in India. Hb assessment is a reliable indicator for
anemia screening. However, there are multiple techniques with
different applications available for Hb estimation. The present work
was undertaken to review Hb assessment methods that can work
best from the developing country perspective. We reviewed
published literature through the PubMed database for studies
comparing different techniques of Hb estimation. A search for
reports on prevalence of anemia both at the global and national
level was also undertaken. A total of 74 articles were included in this
review. It was realized that even though there are multiple
techniques for Hb estimation, a method which is quick, valid and
reliable is needed to detect anemia. Direct cyanmethemoglobin
method has been the gold standard for hemoglobin estimation but
other methods like hemoglobin color scale, Sahli technique,
Lovibond-Drabkin technique, Tallqvist technique, copper-sulfate
method, HemoCue and automated haematology analyzers are also
available. Each method has a different working principle and its own
advantages and disadvantages. Despite con icting reports, it has
been observed that HemoCue is the method of choice for initial
screening of anemia because it is reliable, portable, does not require
power supply and easy to use in poor resource settings without
requiring extensive training of health workers. Hemoglobin color
scale developed by HCS is another potential method that can be
used in eld situations. However, such methods should be further
investigated through larger studies before actual implementation.