• Users Online: 264
  • Print this page
  • Email this page


 
 
Table of Contents
ORIGINAL ARTICLE
Year : 2015  |  Volume : 3  |  Issue : 2  |  Page : 8-13

Socio-demographic factors associated with anaemia among adolescents in Hajipur village of Katihar district, Bihar


1 Demonstrator, Department of Community Medicine, S.H.K.M, Govt. Medical College, Nalhar (Mewat), Haryana, India
2 Senior Resident, Department of Ophthalmology,S.H.K.M, Govt. Medical College, Nalhar (Mewat), Haryana, India
3 Assistant Professor, Department of Community Medicine, S.H.K.M, Govt. Medical College, Nalhar (Mewat), Haryana, India

Date of Web Publication24-Aug-2018

Correspondence Address:
S Rahman
Demonstrator, Department of Community Medicine, S.H.K.M, Govt. Medical College, Nalhar (Mewat), Haryana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-6486.239797

Rights and Permissions
  Abstract 


Aim: To study the various socio-demographic factors associated with anaemia among adolescents. Methodology: A Community based cross sectional descriptive study. Hajipur village, a rural field practice area of Department of Community Medicine, Katihar Medical College, Katihar, Bihar. Four hundred adolescents (213 boys and 187 girls). Systematic random sampling technique was used. Data collected was entered in Microsoft Office Excel and analysed by using SPSS version 20.0.
Results: Among 400 adolescents(213 boys and 187 girls) the largest number of adolescents 41.5% belonged to 10-14 years age group followed by 32.5% and 26% in the 15-17years and 18-19 years age groups respectively. Factors such as level of education of adolescents, mother's education, socioeconomic status, father's occupation, family type were found to be significantly associated (p<.0001) with the prevalence of anaemia in adolescents.
Conclusion: It was concluded that adolescent's illiteracy and mother's illiteracy, low socioeconomic status, father's occupation such as labourer, nuclear families were significantly associated (p<.0001) with high prevalence of anaemia among adolescents. It is essential to implement adolescent friendly health services as recommended by WHO to improve the nutritional status.

Keywords: Adolescents, education, socioeconomic status


How to cite this article:
Rahman S, Alam M M, Khan M H, Juneja K. Socio-demographic factors associated with anaemia among adolescents in Hajipur village of Katihar district, Bihar. J Integr Health Sci 2015;3:8-13

How to cite this URL:
Rahman S, Alam M M, Khan M H, Juneja K. Socio-demographic factors associated with anaemia among adolescents in Hajipur village of Katihar district, Bihar. J Integr Health Sci [serial online] 2015 [cited 2022 Dec 4];3:8-13. Available from: https://www.jihs.in/text.asp?2015/3/2/8/239797




  Introduction Top


Adolescence has been defined by WHO as the period of life spanning the ages between 10–19 years.[1] This is a vulnerable period in the human life cycle for development of nutritional anaemia, which has been constantly neglected by public health programs. Adolescents constitute about 23% of population in India. In India girls constitute 5.1% of adolescents in 10-14 years age group and 4.8% in 15-19 years age group.[2] Adolescence is a period where significant growth changes occur necessitating optimum nutritional requirements. The main nutritional problems affecting adolescent population include under nutrition and iron deficiency anaemia besides other factors. Adolescents make up roughly 20% of the total world population.

Prevalence of anaemia was maximum in adolescent girls whose mothers were educated up to primary level only (53.6%) and prevalence progressively decreased with an increase in education status of mother, being minimum in adolescent girls whose mothers were graduate and above (25.2%). (p<0.05).[3] Lower family income was an important predictor of underweight.[4] Prevalence of anaemia and iron deficiency was 39% and 62% respectively, in young women of low socio-economic status in Bangalore.[5]

So the present study was undertaken among adolescent girls and boys in the rural community of Katihar district with the objective to study the various socio-demographic factors associated with anaemia among adolescents in Hajipur village of Katihar district, Bihar.


  Methodology Top


The present population based, cross sectional, descriptive study was undertaken among adolescents (10-19 Years) in Hajipur village of Katihar district, Bihar. The population of the Hazipur village is about 10000. The number of houses is approximately 1800. Data was collected from adolescents (10 -19 Years) of Hajipur village in Katihar district, Bihar. The study was undertaken from January to December 2012.

Sample Size: On the basis of this prevalence of under nutrition among adolescents the sample size of the present study was calculated by adopting the formula:



Where,

P = Prevalence rate of the disease =50 % = 0.50 Q = 1 - P, = 0.50

α = level of Significance ( at α = 0.05)= Z2 α / 2= 4 Σ = Allowable error 10% of P = 0.05 Σ2 = 0025

Then



Hence the required study sample size was 400 adolescents (10-19 Years).

Sampling technique: Houses having at least one adolescent or more were numbered serially. Then the houses were selected by systematic random sampling technique.

Inclusion Criteria: The study was conducted on adolescents of both the genders (Adolescent boys and girls), willing to participate in the study and apparently healthy on general physical examination.

Exclusion Criteria: The study excluded adolescents who were above 19 years of age and below 10 years of age, not willing to participate in the study, with chronic illness or receiving long term allopathic or indigenous drugs and with history of any severe illness within the past 2 weeks for which they required hospitalization.

Data Collection Method: Written informed consent was taken from the head of the household of adolescents who were below eighteen years. A direct written informed consent was taken from girls who were eighteen years and above. After establishing good rapport with the family, detailed information about socio-demographic characteristics/profile (age, education and occupation of parents, socio-economic status of the family, types of family, family size) in relation with health were recorded in the predesigned and pretested questionnaire. Subjects suffering from severe morbidity symptoms like URTI, ENT, Eye problems were referred to Katihar Medical College, Katihar for proper treatment.

Haemoglobin Estimation: Hemoglobin (Hb) estimation was done by cyanomethemoglobin method using Sahli's haemoglobinometer.[6] The subjects were categorized as per WHO standards for anaemia into mild, moderate and severe categories. Subjects having haemoglobin level between 10.1-12.0 gm/dl were considered to be suffering from mild anaemia,7- 10 gm/dl from moderate anaemia and below 7 gm/dl from severe anaemia.[7],[8]

Socio economic status: Socio economic status was measured according to modified B.G. Prasad classification of socio-economic status, considering consumer price index Rs.741/- in July 2009.

Literacy Status: Literacy status was categorized as illiterate (IL) who could not read or write the basic alphabets of their own language. They were taken to be just literate (JL) in cases where they could at least read and write with under-standing in any language and it is determined for persons aged 7 years and above. Those who had attended classes up to the fifth standard were classified as Primary School (PS) educated, and those who had attended class up to eight standard, were classified as Middle School (MS) while those who had attended schooling up to the twelfth standard were High School (HS) educated. No Graduates, post graduate or professional mother was encountered in this series.

Father's Occupation: Father's occupation was categorized as Labourer (LA), private service (PRI), Agriculturer (AG) and Business (BU).No one was found in the professional and government service.

Ethical consideration: Permission for the study was obtained from the College authorities prior to commencement

Data analysis: Data collected was entered in Microsoft Office Excel and analysed by using SPSS version 20.0. Dependent variable frequencies, percentage, mean, range and proportion were calculated. Chi-square test and Yate's correction were used for statistical analysis. The differences were considered as significant at a p value of<0.05.


  Results Top


Out of 400 adolescents, 53.25% were boys and 46.75% were girls. The total number of illiterate girls and boys were 54(13.5%) and 30(7.5%) respectively. 18.25% girls and 29.5% boys were educated up to primary school and least number of girls were just literate [Table 1].
Table 1: Distribution of Adolescent Boys and Girls According to Education

Click here to view


21% adolescents were found illiterate and 79% were literate. Prevalence of anaemia among illiterate was found to be 15.75%. The prevalence of anaemia among literate was 24.25%, 7.25% and 3% in adolescents who were educated up to primary school, middle school and high school respectively. The prevalence of anaemia decreased as the education level increased in girls. It was observed that a significant relation existed between adolescent's education and anaemia (P<.05). [Table 2]
Table 2: Prevalence of Anaemia According to Adolescent's Education

Click here to view


The largest number of anaemics (29%) were found in those adolescents whose mothers were illiterate, followed by the number of anemics in those adolescents whose mothers were just literate (13.5%). The prevalence of anaemia was 9.25%, 1.5% and 1.75% in adolescents whose mothers were educated up to primary school, middle school and high school respectively. So we observed that with increase in mother's education the prevalence of anaemia in adolescents decreased. It was also observed that the relation between mother's education and anaemia was statistically significant. [Table 3]
Table 3: Prevalence of Anaemia According to Mother's Education

Click here to view


The prevalence of anaemia was found to be maximum (20.5%) in adolescents whose fathers worked as labourers, while it was 14.5% in adolescents whose fathers were in private service, followed by 10.75% and 9.25% in business occupations and agriculture. [Table 4]
Table 4: Prevalence of Anaemia According to Father Occupation

Click here to view


A significant inverse association was found between socio economic status and anaemia. [Table 5] The prevalence of anaemia was maximum (21.5%) in socio-economic class III and least (2%) in class I. The prevalence of anaemia was 11.25%, 16% and 4.25% in socio-economic classes II, IV and V respectively.
Table 5: Prevalence of Anaemia According to Socio-economic status

Click here to view



  Discussion Top


In the present study prevalence of anaemia was found to be 24.25%, 7.25% and 3% in adolescents who were educated up to primary school, middle school and high school respectively. The prevalence of anaemia decreased as the education level increased in girls. This may be due to the fact that educated adolescents are more aware of their own health, personal hygiene and nutrition. A significant relation (p<.0001) existed between adolescent's education and anaemia. Kaur S et al. (2006) reported that the prevalence of anaemia was 60%, 65.2%, 56.4%, 64.3% and 66.7% in graduate and above, higher secondary, secondary, primary and middle and illiterate girls respectively.[9]

Kulkarni et al. (2012) observed in a study that as girls education increased the prevalence of anaemia decreased. The prevalence of anaemia was found to be 83.7%, 87%, 92.3% and 93.1% in ≥ graduate, higher Secondary, senior Secondary and primary and middle school educated girls repectively.[10]

In the present study, prevalence of anaemia was found to be 9.25%, 1.5%, 1.75% in adolescents whose mother was educated up to primary school, middle school and high school respectively. A statistically significant relation (p<.0001) was found between mother education and anaemia.

Rajaratnam et al. (2000) observed in a study that 49.3%, 28.3%, 33.3% of anaemia were found in girls whose mothers were educated up to 0-5th std, 6-8th std, and >/=9th std respectively. (p<0.01).[11] Saluja N et al. (2011) also observed that percentage of anaemia was significantly (p<0.001) higher in children (5-11 years) of illiterate mothers and working mothers (p<0.001).[12] Thus, as mother's education increases the prevalence of anaemia in adolescents decreases.

In the present study, prevalence of anaemia was found to be maximum 20.5% in adolescents whose father's worked as labourers, while it was 14.5% in children of fathers in private service, followed by 10.75% and 9.25% in those with business occupations and agriculturers. A significant association was found between father's occupation and anaemia (p<.0001). Similarly, Rawat et al. (2001) observed in a study that prevalence of anaemia was found to be significantly higher (44%) in those adolescent girls whose fathers were working as labourers than those whose fathers were agriculturers (27.1%).[13] Prevalence of anaemia was 32.1% and 33.3% in those adolescent girls whose fathers were in service and business respectively. Shah BK et al.(2002) observed that the prevalence of anaemia was maximum in those adolescent girls whose fathers were unemployed, followed by 72.5% and 66.7% in those adolescent girls whose fathers were unskilled workers and skilled workers respectively.[14]

In the present study prevalence of anaemia was maximum (21.5%) in socio-economic classIII and the least (2%) in class I. The highest number of adolescents 186 (46.5%) were found in socioeconomic class III. It was observed that a significant relation existed between socio-economic status and anaemia.(p<.0001). Biradar et al. (2012) found in a study that, out of the 840 adolescents girls, majority (84.2%) belonged to the socio-economic class IV, whereas 11.5% and 4.3% of them belonged to class III and class V respectively. None of the girls belonged to classes I and II.[15] The prevalence of anaemia among the girls who belonged to class III was 4.1%, whereas it was 43.1% and 100% in girls of class IV and classV respectively. This was found to be statistically significant. Gawarika et al. (2006) observed in a study that the prevalence of anaemia among the adolescent girls of weaker economic group was 96.5% and among girls of middle or higher income group was 65.18%. The prevalence of severe anaemia among the adolescent girls of weaker income group was 11.0% and among girls of middle or higher income group was 2.63%.[16]

In present study among 400 adolescents, 267 (66.75%) and 133 (33.25%) belonged to nuclear type and joint type family respectively. The prevalence of anaemia in joint families and nuclear families was 22.75% and 32.25%respectively. Here also we observed that a significant relation existed between types of family and anaemia.(p<.0001). Kulkarni MV et al(2012) observed that high percentage of anaemia was found in girls belonging to nuclear families 89.6% and girls belonging to joint family 93.7% but it was not significantly associated with anaemia. (p=0.65) (10) Chaudhary et al. (2008) also reported that prevalence of anaemia was not significantly associated with the type of family.[17]


  Conclusion Top


We concluded that among the various socio-demographic factors like educational status of mother and adolescent, father's occupation and socio-economic status of family have significant relation with prevalence of anaemia. Hence, it is the need to strengthen the existing adolescent services at basic level of community by improving female literacy, socio-economic status of the masses through poverty alleviation programme, promotion of family planning measures to reduce the family size, nutritional education in school curriculum like importance of regular and adequate amount of iron rich foods or foods fortified with iron in the household diet, emphasis of regular consumption of Vitamin C rich food along meal, use of traditional practices of cooking in iron vessels. Community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents.


  Acknowledgement Top


I would like to express my profound gratitude to all the participants for their co-operation and for their immense faith they reposed in me.



 
  References Top

1.
UNFPA for UN system in India: Adolescents in India - A profile. Sept. 2000 Lodi Estate, New Delhi, India.  Back to cited text no. 1
    
2.
WHO. Adolescent Nutrition: A Review of the Situation in Selected South-East Asian Countries, 2006.  Back to cited text no. 2
    
3.
Singh R. Socio-demographic factors causing anaemia in adolescent girls in Meerut. Health and Population-perspectives and Issues. 2008;38:198-203.   Back to cited text no. 3
    
4.
Hesketh T, Ding QJ, Tomkins AM. Disparities in economic development in Eastern China: impact on nutritional status of adolescents. Public health nutrition. 2002 Apr 1;5(02):313-8.  Back to cited text no. 4
    
5.
Thankachan P, Muthayya S, Walczyk T, Kurpad AV, Hurrell RF. An analysis of the etiology of anemia and iron deficiency in young women of low socioeconomic status in Bangalore, India. Food and nutrition bulletin. 2007 Sep 15;28(3):328-36.  Back to cited text no. 5
    
6.
Barasel J. Changes in Body Composition during Adolescence– Adolescent Nutrition, John Wiley and sons: New York. 1982.  Back to cited text no. 6
    
7.
Rao VG, Aggrawal MC, Yadav R, Das SK, Sahare LK, Bondley MK, Minocha RK. Intestinal parasitic infections, anaemia and undernutrition among tribal adolescents of Madhya Pradesh. Indian J Community Med. 2003 Jan 26;28(1):26-9.  Back to cited text no. 7
    
8.
Vashist BM, Goel MK. Nutritional status of adolescents in rural and urban Rohtak, Haryana. Health and Population-Perspectives and Issues. 2009;32(4):190-7.  Back to cited text no. 8
    
9.
Kaur S, Deshmukh PR, Garg BS. Epidemiological correlates of nutritional anemia in adolescent girls of rural Wardha. Indian J Community Med. 2006 Oct 1;31(4):255-8.  Back to cited text no. 9
    
10.
Kulkarni MV, Durge PM, Kasturwar NB. Prevalence of anemia among adolescent girls in an urban slum. National Journal of Community Medicine. 2012 Jan 1;3(1):108-11.  Back to cited text no. 10
    
11.
Rajaratnam J, Abel R, Asokan JS, Jonathan P. Prevalence of anemia among adolescent girls of rural Tamilnadu. Indian pediatrics. 2000 May 1;37:532-6.  Back to cited text no. 11
    
12.
Saluja N, Garg S, Chopra H, Bajpai S. Socio-Demographic Factors Affecting Anaemia in School Children in Urban Area of Meerut, India. The Internet Journal of Preventive. Medicine. 2001;1.  Back to cited text no. 12
    
13.
Rawat CMS, Garg SK, Singh JV, Bhatnagar M , Chopra H, Bajpai SK; Socio-Demographic Correlates of Anaemia among adolescent girls in rural area of district Meerut (UP) Indian Journal of Community Medicine. 2001;26(4):173-5.  Back to cited text no. 13
    
14.
Shah BK, Gupta P. Anemia in adolescent girls: a preliminary report from semi-urban Nepal. Indian pediatrics. 2002 Dec;39(12):1126-30.  Back to cited text no. 14
    
15.
Biradar SS, Biradar SP, Alatagi AC, Wantamutte AS, Malur PR. Prevalence of anaemia among adolescent girls: a one year cross-sectional study. J. Clin. Diagn. Res. 2012 May;6:372-7.  Back to cited text no. 15
    
16.
Gawarika R, Gawarika S, Mishra AK. Prevalence of anemia in adolescent girls belonging to different economic group. Indian Journal of Community Medicine. 2006 Oct 1;31(4):10-2006.  Back to cited text no. 16
    
17.
Chaudhary SM, Dhage VR. A study of anemia among adolescent females in the urban area of Nagpur. Indian journal of community medicine. 2008 Oct;33(4):243  Back to cited text no. 17
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Methodology
Results
Discussion
Conclusion
Acknowledgement
References
Article Tables

 Article Access Statistics
    Viewed1815    
    Printed91    
    Emailed0    
    PDF Downloaded159    
    Comments [Add]    

Recommend this journal