Anemia Among School Children in Ernakulam District, Kerala, India

  • P. S. RakeshEmail author
  • Leyanna Susan George
  • Teena Mary Joy
  • Sobha George
  • B. A. Renjini
  • K. V. Beena
Original Article


Anaemia has significant negative impact on the health of school children including poor scholastic performance and cognitive impairment. The present study was done with the objective to estimate the prevalence of anemia among school going children in Ernakulam district, Kerala and to determine a few factors associated with anemia. Hemoglobin of 880 students of 6th to 9th standard in 11 randomly selected schools of Ernakulam district was estimated using HemoCue 201 photometer. Prevalence of anaemia was expressed using frequencies and percentages. Univariate analysis for factors associated with anemia was done. Selected variables were entered into a logistic regression model. The prevalence of anemia was estimated to be 44% (95% CI 40.67–47.33). Among them 0.8% had severe anemia, 3.5% had moderate anemia and 39.7% had mild anemia. Among them 21.3% and 52.6% reported not in the habit of consuming green leafy vegetables and citrus fruits respectively, at least three times on a usual week. Anemia among children was associated with female gender (adjusted OR 1.53, 95% CI 1.16–2.04), higher age group (adjusted OR 2.24, 95% CI 1.69–2.91) and regular intake of tea/coffee along with major meals (adjusted OR 1.62, 95% CI 1.20–2.04). Anemia among school going children in Ernakulam remains a public health problem and was more among females, higher age groups (12–15 years) and those reported regular intake of tea/coffee along with major meals. The consumption of iron rich foods among the students was poor. Behavior change communication for dietary modification and universal supplementation of iron is warranted.


Adolescent anemia Anemia Hemoglobin Iron deficiency anemia 



We acknowledge Interns, Mr Retheeshkumar, Health Inspector and team at Amrita Urban Health Centre Kaloor and Dr Midhun Rajiv, Mr Arunkumar, Dr Carmel Regeela and Dr Devika Babu, MPH students of AIMS for help in co-ordinating data collection.

Author Contribution

We declare that the manuscript has been read and approved by all the authors, that the requirements for authorship have been met, and that each author believes that the manuscript represents honest work.


Institutional Funding by Amrita Institute of Medical Sciences.

Compliance with Ethical Standards

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Permission was obtained from school Principal; consent was obtained from parents and assent from all children included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  1. 1.Department of Community Medicine, Amrita Institute of Medical SciencesAmrita UniversityKochiIndia
  2. 2.Centre for Public Health, Amrita Institute of Medical SciencesAmrita UniversityKeralaIndia

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