Original ResearchPrevalence of iron-deficiency anaemia and risk factors in 1010 adolescent girls from rural Maharashtra, India: a cross-sectional survey
Introduction
Iron-deficiency anaemia (IDA) is the most common nutritional disorder observed in India particularly in under-five year old children, adolescent girls and pregnant women.1 About 56% of adolescent girls in India are affected by IDA.1, 2 During adolescence, IDA may lead to growth retardation, impaired physical and mental development and poorer reproductive outcomes continuing through childbearing years; thus, it is a serious public health issue in the country.3, 4 The government has emphasized the need for education programmes and national iron supplementation initiatives for adolescent girls. However, practical implementation has revealed important health services and infrastructural issues as well as inadequate iron tablet supplies for young girls; as a result, IDA prevalence remains much higher than predicted targets.3, 4
One of the largest surveys of adolescent girls reported an overall anaemia prevalence of 89% with substantial regional variation.5 This survey was described to be nationally representative and reported higher prevalence in older girls (15–19 years). Studies published in the past 10 years from Maharashtra state of India reported 40%–65% anaemia prevalence in western Maharashtra6, 7 and 35%–40% in eastern Maharashtra8 with a higher prevalence in deprived areas (up to 90%).9 However, evidence from central Maharashtra (the Marathwada region) is limited to a 2012 study of 385 adolescent girls, which reported 68% anaemia and assessed dietary preference, parents' education and menarche in addition to factors studied in the national survey.2
There are no published studies from rural areas particularly in the Marathwada region on anaemia prevalence in adolescent girls, and there is limited evidence on their sociodemographic, dietary and medical risk factors. Therefore, we conducted a cross-sectional study of 1010 adolescent girls; the first conducted in the Osmanabad district and largest from rural areas of Maharashtra state, India.
Section snippets
Study context
The Maharashtra Anaemia Study (MAS) was a joint collaboration between the Halo Medical Foundation (HMF), India, and the University of Nottingham, UK. The cross-sectional study was conducted to investigate anaemia prevalence in adolescent girls and associated risk factors in villages of Marathwada region of Maharashtra state. The target population was all unmarried girls aged 13–17 years from 34 villages (total population: 60,921) in the Tuljapur and Lohara blocks of Osmanabad district. We
Results
We approached 1035 adolescent girls from 34 villages, of which only 25 (2%) did not participate in full data collection (Fig. 2). Villages from the project had similar social and health infrastructure; all villages had government nurses [however, most of them were visiting only once a month (N = 29)], few had government health centres (N = 9), and only one had an established primary health centre (PHC). None had a centralized water purification facility, and all had limited private transport
Discussion
To our knowledge, this is the largest study from Marathwada region of the state where findings from a large representative rural adolescent population are presented. The prevalence of anaemia in adolescent girls in our study area of rural Maharashtra was extremely high (87%) with the majority of participants having moderate anaemia (65%).
Acknowledgements
The authors acknowledge the support of Ms Sandhya Rankhamb in data collection, data entry, verification, and recognize her contribution in the project. The authors thank HMF village health workers for providing field level support for this study. The authors dedicate our research to Dr Sulbha Hardikar and Professor (Mr) and Mrs Chawathe who supported the project and the PhD studies, respectively.
Ethical approval
The study was approved by the Institutional Ethics Committee of the Government Medical College
References (25)
- et al.
Issues in prevention of iron deficiency anemia in India
Nutrition
(2014) - et al.
A randomized trial of iron-biofortified pearl millet in school children in India
J Nutr
(2015) - et al.
Relationship between iron status and dietary fruit and vegetables based on their vitamin C and fiber content
Am J Clin Nutr
(2008) - et al.
Comparative analysis of nutritional compositions of transgenic high iron rice with its non-transgenic counterpart
Food Chem
(2013) - National Family Health Survey of India. Available at: http://rchiips.org/nfhs/. (last accessed 15 June...
- et al.
Prevalence and risk factors of anaemia among adolescent girls in rural area
Int J Recent Trends Tech
(2015) - et al.
Prevalence and severity of anaemia stratified by age and gender in rural India
Anemia
(2014) - et al.
Burden of anemia and its socioeconomic determinants among adolescent girls in India
Food Nutr Bull
(2009) - et al.
Effectiveness of weekly supplementation of iron to control anaemia among adolescent girls of Nashik, Maharashtra, India
J Heal Popul Nutr
(2008) - et al.
A study of anemia among adolescent females in the urban area of Nagpur
Indian J Community Med
(2008)
Prevalence of anemia among adolescent girls in an urban slum
Natl J Community Med
Cited by (28)
A systematic analysis and future projections of the nutritional status and interpretation of its drivers among school-aged children in South-East Asian countries
2023, The Lancet Regional Health - Southeast AsiaEvaluation of the barriers and facilitators of iron supplementation program among adolescent females
2023, Clinical Nutrition ESPENAccess to a piped water supply is positively associated with haemoglobin levels in females living in rural Maharashtra State, India
2021, Public HealthCitation Excerpt :Two models were built: analysing the association of environmental exposures with anaemia using logistic regression and with blood haemoglobin levels using linear regression. The initial analysis of the survey data4 had identified that age, mid-upper arm circumference, iron–folic acid intake and fruits/fruit juices consumption were independent risk factors for anaemia in this population; therefore, these were considered a priori potential confounding factors and adjusted for in all regression models, along with the use of robust standard errors to adjust for clustering of exposures at the village level. As socio-economic status (SES) in India is a potential confounding factor in analysis of the association between the environment and risk of anaemia, two additional sensitivity analyses using two separate measures of SES were applied to any community-level environmental exposures that were statistically significant in the final model.
Effect of education through video and packaging modifications of iron tablets on female adolescent behavior in the iron supplementation intake in SMPN 2 and SMPN 1 Parigi
2021, Gaceta SanitariaCitation Excerpt :The intensity of attention and perception over an object significantly affects the knowledge possessed as a result of the sensing carried out. This research is in line with previous research that found that knowledge given before intervention formed of video as media explanation in the pretest is enough, and knowledge after the posttest is good.3,19 As well revealed there is a significant influence on the knowledge and compliance of the iron supplementation intake using print media in the form of a monitoring card.12,16,20,21