IJCRR

IJCRR - 9(23), December, 2017

Pages: 04-08

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Prevalence of Anaemia in Child Bearing Women: A Challenge

Author: Shiv Lal Solanki, Bhagraj Coudhary, Bhagwan Ram Vishnoi

Category: Healthcare

Abstract:Background: Anaemia is prevalent among population of all strata; whether rich or poor, educational profile high or low, it is prevalent everywhere. Iron deficiency anaemia is a serious public health problem having a significance impact on life of everybody. It affects the physical, mental and psycho-social development of the victim, causing generalized weakness, lethargy, lassitude, with effect on optimal work performance, amount to certain behavioural problems. Status of anaemia in child bearing age has areasonable impact on whole life span and has a reasonable impact on the outcome of pregnancy.
Objectives: 1. To assess the prevalence and associated factors of anaemia.
Materials and Methods: Across-sectional purposive study was conducted on 436 females of reproductive age group (15 to 49 years), residing in the field practice area of urban health training centre of department of community medicine, Geetanjali medical college and hospital, Udaipur, (Rajasthan). Study period was from May 2015 to April 2016.
Results: The prevalence of anaemia among the age group above 18 years was (73.8%), educated (72.4%), nuclear family (73.3%), married (87.1%), and low socio-economic status group V (79.9 %). Among anaemic subjects,(76%) were vegetarian, mean haemoglobin 10.11\?1.03 gm %, and (3.2%) were severely anaemic. History of worm infestation having anaemia was (89.2%), and symptoms of easy fatigability among the anaemic were (84.8%)
Conclusion: The results of the study simplify the need to concentrate on anaemia prophylaxis measures, already in existence for masses and also for child bearing women. The component of health education including nutrition education also to be strengthened with awareness to the public.

Keywords: Haemoglobin, Vegetarian, Worm infestation, Health

Full Text:

Introduction

Anaemia is an important public health problem which affects masses, particularly child bearing women. It is estimated that (75%) of the anaemia is due to iron deficiency, followed by folate and Vitamin B12¹. The adolescent health was given priority by Government of India in RCH package since 1997.The anaemia is one of the major challenges to health sector for quality of day to day life. The prevalence of anaemia is disproportionally high in developing countries, because of lack of education, poverty, inadequate diet, poor health services, and early marriages. Report of WHO 2002 showed anaemia as one among the top 10 risks for infant mortality, maternal mortality, and preterm birth. The facts show that anaemia is one of the most prevalent diseases to combat, for increasing quality and life expectancy.Iron deficiency affects more people than any other condition. As many as (66-80%) of the world population may be iron deficient, over (30%) of the population are anaemic, mainly due to iron deficiency,  frequently exacerbated by malaria and worm infestations² in developing countries.According to world health organization, the global prevalence of anaemia is 24.8%, which means about 1.62 billion people world-wide are suffering with anaemia. The highest prevalence is in preschool age children (47.4%), while the lowest prevalence in men is (12.7%).Adolescent phase of life is the right path, due to the ever increasing evidence that control of anaemia in pregnancy is easy to achieve satisfactory if the iron status can be earned during adolescence. Anaemia occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. Anaemia is the most prevalent haematological disorder in women of reproductive age with increased rates of maternal, prenatal mortality, premature delivery, low birth weight, and other adverse outcomes. Moreover it has been shown to affect the cell-mediated immunity, mental development, learning capacity, resistance to infection and work performance.

Objective: 1. To assess the prevalence and associated factors of anaemia

Materials and methods

The present cross sectional study was conducted on females of reproductive age group residing in catchment area of urban field practice, ofdepartment ofcommunity medicine, Geetanjali Medical College and Hospital, Udaipur.  In this community based study the population proportion 33% was used to arrive for the required sample size of 436 females. The 1^st house was selected randomly by lottery system and thereafter every alternate house was picked up, till the required sample size was covered.The study instrument used was a preformat, pretested semi structured questionnaire. Haemoglobin estimation was done by electric impedance method. The purpose of the study was explained to the study subjects and the written consent was obtained. The study was conducted during May 2015 to April 2016.

Discussion

Table 1.  The Socio-demographic characteristics:

a) Anaemia and age group: In our study the prevalence of anaemia above 18 years(late) was (73.8%), and below 18 (early) (71.2%), similar results were observed by Kaur S et al³,  in late  (64%) as compared to early (58%), study by Biradar S S et al⁴ in rural area of Belgaum showed higher prevalence in late ( 60%) as compared to early (38.9%)

b) Religion: The prevalence of anaemia in our study, among Hindus was slightly more (82.6%), compared to Muslims (80.8%), whereas Sachan B etal⁵   in their study, observed the prevalence (59.2%) in Hindu against (37.5%)Muslims.Similar results,  Hindu(53.96%) and Muslims(47.92%), were seen by Bilkish N et al⁶  in their study on 416 females in rural area of Maharashtra.

c) Family composition: Our study shows the prevalence of anaemia was more (73.3%) in nuclear families, compared to joint families (69.9%). In contrast to our results Rawat CMS et al⁷ studied 504 females in rural area of Daurala PHC at Meerut, observed prevalence in joint family was higher (45.2%), than nuclear families (28.3%), Bilkish N et al⁶ also observed that the nuclear families were  slightly less prevalent (51.79%) than joint families (52.08%)d) Education In present study the prevalence of anaemia was more among educated  (72.4%) compared to illiterate (68.2%), this is supported by Bhanushali et al⁸ in their study among 387 females that among 104 anaemic females, the (55.8%) were literate. As education increases the prevalence of anaemia decreases, in contrast to our study Kaur S et al³observed,  high prevalence among illiterate (66.7%), and Bilkish N et al⁶observed (71.32%) in illiterate and only (20.25%) in literate females. e) Marital status: Our study shows more prevalence of anaemia among married females (87.1%) compared to unmarried (70.9%). NFHS-3, Rajasthan⁹ also shows the prevalence of anaemia more in married (54.3%) compared to unmarried (49.9%).

f) Socio-economic status:  It is observed that as socio-economic status increases prevalence of anaemia decreases, as in our study it is highest among class V (79.9%) and lowest among class III (67.9%). No female of class I was observed anaemic. Similar results were also observed by Kaur S et al³class V (73.4%), class II (54.3%), class I (41.7%). Rawat CMS et al⁷,   revealed among class V (50%) and class I (27.3%). Biradar SS et al⁴ reported anaemia among females of class III was (4.1%) where as it was (43.1%) in class IV and (100%) in class V. The study by Bilkish N et al⁶  observed prevalence of anaemia among class IV and V (61.42%) and class I, II,III (56.62%).

Table 2 Mean haemoglobin level:

In our study the mean haemoglobin of those females who had anaemia was 10.11±1.03 gm% and that of non – anaemic females was 13.04±0.77 gm%. Similar results were observed by Biradar SS et al⁴ anaemic girls 10.9±1.04 gm%, and non-anaemic girls were 12.80±0.5gm%. Sen A et al¹⁰ studied the functional impact of anaemia in 350 young adolescent females from different schools in Vadodara and the mean haemoglobin level of total sample of females was 11.32g/dl; 10.67g/dl for anaemicand 12.68g/dl for non- anaemic.

Table 3 Severity of anaemia The present study reveals, (68.5%) females moderately anaemic, (28.3%) mild and (3.2%) severely anaemic. Study conducted by Siddharam S M et al¹¹ had more prevalence of mild (54.9%), moderate (45.2%), and (4.92%) severe.  Sharma et al¹² observed similar results to our study, moderate (72%), mild (16.5%), and severe (11.5%), while the study ofToteja G S et al¹³observed moderate, mild, and severe  (50.9%), (29.2%),  (7.1%) prevalence of anaemia respectively.

Table 4  Anaemia and dietIn present study the prevalence of anaemia was more among vegetarian diet females (76%), compared to (63.3%) mixed diet. Bilkishet al⁶ showed prevalence of anaemia among vegetarian (55.08%) v/s (47.78%) among mixed diet, Kakkar R et al¹⁴ studied factors contributing to anaemia in 317 females in Bhopal, observed prevalence of anaemia was dependent on knowledge, literacy level, food habits, and non-vegetarian diet. Patel S et al¹⁵ in their study on 100 anaemic patients from Shri Krishna Hospital, Karamsad observed prevalence of anaemia among vegetarian was very high (84%), against non-vegetarian (16%).

Table 5 Anaemia and worm infestationIn this study the prevalence of anaemia was higher (89.2%) among females who gave a history of worm infestation as compared to those who did not give  such history of worm infestation (69%). This difference was statistically highly significant. Our study is also supported by study of Goel S et al¹⁶ and Bilkish et al ⁶who observed that the females who had history of worm infestation were anaemic v/s non-anaemic(84.6%) v/s (43.8%) and  (77.78%) v/s (50.75%) respectively. RamziM et al¹⁷ studied 363 school females in Kavar, Southern Iran, observed that only parasite infestation in the last three months had a 6.83 times more risk of anaemia than those without this history.

Table 6  Anaemia and presentation of symptoms In our study the prevalence of anaemia was higher (84.8%) among females who had symptoms of easy fatigability as compared to thosewho did not had such symptoms (60.8%), similarly with symptoms of reduced working capacity (82.4%) v/s (69.3%) with no such symptom, with symptom of palpitation (75.3%) v/s (71.3%) without palpitation. Goel S et al¹⁶ observed the signs and symptoms like headache, fatigue, dyspnoea, paraesthesia and attack ofsyncope, significantlymore prevalent in anaemic subjects.

Conclusion

The study was carried out to understand the current prevalence and associated factors of anaemia among females of child bearing age.  To prevent anaemia, publicshould be made aware through conduction of health and nutrition education campaign, so that the current   comprehensive health services may be utilised properly.  Our study emphasised forvarious measures of social and economic development to be initiated for lowering the prevalence of anaemia to improve the quality of life of the females.

Acknowledgement

Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals, and books from where the literature for this article has been received and discussed.

Funding: No funding sources.

Conflict of interest: None declared

Ethical approval:This study was approved by the Institutional Ethics Committee.

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