Abstract
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.
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References
World Health Organization (2011) Anaemia prevention and control [Internet] WHO, Geneva. Available at www.who.int/medical_devices/initiatives/anaemia_control/en. Accessed 20 Aug 2017
Gupta S, Taraphdar P, Roy TG, Haldar D, Dey SK, Purkait B (2012) The silent burden of anemia in school age children: a community based study in West Bengal. Indian J Med Sci 66:163–168
Rawat CMS, Garg SK, Singh JV, Bhatnagar M, Chopra H (2001) Sociodemographic correlates of anemia among adolescent girls in rural area of district Meerut (U.P). Indian. J Community Med 26:173
Rakesh PS, Rajeswaran T, Rakesh R, Mathew G, Sheeja AL, Subhagan S et al (2015) Anaemia among school children from southern Kerala, India: a cross-sectional study. Nat Med J Ind. 28(5):225–230
Kaur S, Deshmukh PR, Garg B (2010) Epidemiological correlates of nutritional anemia in adolescent girls of rural Wardha. Indian J Community Med 31:4
Singh Rita (2008) Sociodemographic factors causing anemia in adolescent girls in Meerut. Health Popul-Perspect Issues 38:198–203
Chaudhary SM, Dhage VR (2008) A study of anemia among adolescent females in the urban area of Nagpur. Indian J Community Med 33:243–245
Grantham-McGregor S, Ani C (2001) A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr. 131(2S-2):649S–666S
Oski FA (1979) The non hematologic manifestations of iron deficiency. Am J Dis Child 133(3):315–322
Brownlie T, Utermohlen V, Hinton PS, Giordano C, Haas JD (2002) Marginal iron deficiency without anemia impairs aerobic adaptation among previously untrained women. Am J Clin Nutr 75(4):734–742
Government of Kerala (2015) Economic Review 2014. State Planning Board, Thiruvananthapuram, Kerala, India. http://spb.kerala.gov.in/images/er/er14/index.html#p=1
National Health Mission (2013) Weekly Iron Folic Acid Supplementation (WIFS) [Internet]. New Delhi:MOHFW. http://nrhm.gov.in/nrhm-components/rmnch-a/adolescent-health/weekly-iron-folic-acid-supplementation-wifs/background.html. Accessed 20 Aug 2014
Rakesh PS (2017) Prevalence of Anaemia in Kerala State, Southern India—a systematic review. J. Clin Diagn Res 11(5):01–04. https://doi.org/10.7860/jcdr/2017/24681.9951
Census 2011. Ernakulam district. https://www.census2011.co.in/census/district/278-ernakulam.html
HemoCue. Hb 201 System. [Internet]. HemoCue America, USA. http://www.hemocue.us/en-us/products/hemoglobin/hb-301-system. Accessed 31 Dec 2014
Lardi AM, Hirst C, Mortimer AJ, McCollum CN (1998) Evaluation of the HemoCue® for measuring intra operative haemoglobin concentrations: a comparison with the Coulter Max M®. Anaesthesia 53(4):349–352
Schenck H, Falkensson M, Lundberg B (1986) Evaluation of HemoCue- a new device for determining hemoglobin. Clin Chem 32(3):526–529
Nkrumah B, Blay NS, SarpongN Dekker D, Idriss A, May J et al (2011) Hemoglobin estimation by the HemoCue® portable hemoglobin photometer in a resource poor setting. BMC Clin Pathol 11:5
World Health Organization (2001) Iron Deficiency Anaemia: Assessment, Prevention, and Control. A guide for program managers [Internet]. WHO, Geneva. http://www.who.int/nutrition/publications/en/ida.pdf. Accessed 20 Aug 2014
International institute for population sciences. District Level Household and Facility survey -4. State Fact Sheet. Kerala. Mumbai; IIPS:2012-13
Agarwal KN, Gomber S, Bisht H, Som M (2003) Anemia prophylaxis in adolescent school girls by weekly or daily iron-folate supplementation. Indian Pediatr 40:246–301
Cook JD, Reddy MB (1995) Efficacy of weekly compared with daily iron supplementation. Am J Clin Nutr 62:117–120
Disler PB, Lynch SR, Charlton RW, Torrance JD, Bothwell TH (1975) The effect of tea on iron absorption. Gut 16:193–200
Disler PB, Lynch SR, Torrance JD, Sayers MH, Bothwell TH, Charlton RW (1975) The mechanism of the inhibition of iron absorption by tea. S Aft J Med Sci 40:109–116
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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.
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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.
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Rakesh, P.S., George, L.S., Joy, T.M. et al. Anemia Among School Children in Ernakulam District, Kerala, India. Indian J Hematol Blood Transfus 35, 114–118 (2019). https://doi.org/10.1007/s12288-018-1001-6
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DOI: https://doi.org/10.1007/s12288-018-1001-6