Prevalence & etiology of nutritional anaemia among school children of urban slums.

BACKGROUND & OBJECTIVES: The prevalence of anaemia has been well studied particularly on etiology of nutritional anaemia in children of age group 5-10.9 yr in India. The present study was carried out to find out the prevalence and etiology of nutritional anaemia among 5 to 10.9 yr old corporation school children from urban slums. METHODS: Urban Delhi slums were divided into four areas and one corporation school from each area was randomly selected. A total of 406 children from 4 each school were randomly selected over a period of one yr and prevalence of anaemia was estimated. Another subset of 95 anaemic children admitted to the hospital during the same period were evaluated for the etiology of nutritional anaemia. RESULTS: Prevalence of anaemia as judged by WHO recommended cut-off values of haemoglobin among these children was 41.8 per cent. Pure or mixed iron deficiency anaemia was the commonest type of anaemia noted in 68.42 per cent (65 of 95) children followed by pure or mixed B12 deficiency noticed in 28.42 per cent (27 of 95) anaemic children. Of the pure variety, iron deficiency was the commonest cause occurring in 41.05 per cent (39 of 95) children. INTERPRETATION & CONCLUSION: Childhood anaemia continues to be a significant public health problem in school children aged 5 to 10.9 yr and iron deficiency either alone or in combination is the commonest nutritional cause of anaemia. Pure or mixed vitamin B12 deficiency is an important but yet not commonly recognized cause of anaemia among these children.

Iron status of children aged 9-36 months in an urban slum Integrated Child Development Services project in Delhi.

OBJECTIVE: To assess the magnitude/severity and possible etiology of anemia and iron deficiency among children 9-36 months of age. METHODS: A population-based study on the prevalence, etiology of anemia and iron status in 545 children, 9-36 months of age, was conducted in an urban slum ICDS (Integrated Child Development Services) project in North-East Delhi. Hemoglobin and serum ferritin was estimated and information on socio-economic, demographic, parasitic infection/infestation and dietary intake was collected. RESULTS: Prevalence of anemia (using WHO cut-off values of Hb >11.0 g/dl) among children, 9-36 months of age, was 64%, of these 7.8% had severe anemia (Hb >7.0 g/dl). Using 10.0 g/dl as the Hb cut-off point 44% children less than 18 months of age in the present study population were anemic. On a sub-sample study, 88% children were estimated to be iron deficient, with serum ferritin concentration less than 12 microg/L. The peripheral smear red cell morphology showed 33.9% as microcytic-hypochromic and 37.1% as dimorphic. Dimorphic anemia was 55% in moderate anemia group. The energy and iron intakes were 56% and 45%, respectively of the Recommended Dietary Allowances (RDA). The parasitic infestation/infection was not related to the prevalence or severity of anemia. CONCLUSION: In Delhi, high prevalence of moderate to severe anemia and iron deficiency with vitamins folate and/or B12 among children under 3 years of age in an ICDS block in operation for 20 years is of concern. Dietary origin was the main cause of anemia in this age group.