Epidemiological factors affecting anaemia prevalence in rural adolescents in South India

Objectives: To find out the prevalence of anaemia in adolescents of rural area and correlate it with anthropometric, social and physiological variables like gender, BMI, height for age, stage of adolescence, attainment of menarche in girls and social class.Subjects: Adolescents (age 10-19 years) from the selected area, who do not have any chronic illness or recent hospital stay, and who consent for participation in the study.Method: Two camps were conducted in April 2010 in a rural area (Panchayat) 10 km from our Medical College, and the adolescents were motivated to attend.The attendance was cross checked with the previously prepared list.Socio economic status as well as growth parameters were recorded in a pretested proforma.Capillary blood was collected from each adolescent and haemoglobin was estimated by cyanmethaemoglobin method on the same day.Anaemia was defined according to WHO definition (Hb <11.5g/dl upto 12 years; Hb <12g/dl for girls 12 to 19 years and boys 12 to 14 years; Hb <13g/dl for boys 14 to 19 years).The results were entered in master chart along with other social and growth parameters.Chi square test was used to find out significant correlations with variables like sex, stage of adolescence, low BMI, low height for age, attainment of menarche.Results: 269 adolescents participated in the study, of which 172 were girls and 97 were boys.Total 88 were found to be anaemic (32.71%).72 girls out of the total 172 (41.86%), and 16 boys out of 97 (16.49%) were anaemic.The increased prevalence of anaemia in adolescent girls compared to boys was found significant (p<0.001).Though there was an apparently increased prevalence of anaemia in early adolescence (53 out of 143, 37.06%), compared to mid (24 out of 84, 28.57%) and late adolescence (11 out of 42, 26.19%), this was not found to be statistically significant (p>0.05).There were rd 49 girls below the 3 centile for BMI (thinness), of which 32 had anaemia (65.31%), and among the 123 girls with normal BMI, 40 had anaemia (32.52%).The increased prevalence in adolescent girls with lower BMI was found to be statistically significant (p=0.001).In girls with stunting also, there was statistically significant increase in the prevalence of anaemia (p <0.0001).The present study could not find out any statistically significant increase in the prevalence of anaemia in boys with either thinness or stunting.Out of 62 girls who had attained menarche, 27 were anaemic (43.55%) whereas 45 were anaemic among 110 girls who had not attained it (40.91%), the difference was not statistically significant.On socioeconomic categorization of the participants, 15 out of 27 in Modified Kuppuswamy's class V were anaemic (55.56%), whereas only three out of 19 in class II were anaemic (15.79%).On comparing prevalence of anaemia in class II and class V, the low socioeconomic status was found to significantly correlate with the prevalence of anaemia (p=0.005).The prevalence was comparable in class III and IV (36.14% in class III and 37.85% in class IV) Conclusions: Anaemia is prevalent in the adolescent population of rural Kerala.Girls are significantly more affected than boys.Low socioeconomic status is a risk factor for anaemia.rd Anaemia prevalence is significantly more in girls, whose BMI is < 3 centile and rd height for age is <3 centile.Attainment of menarche has no direct correlation with prevalence of anaemia.