Prevalence of micronutrient deficiencies clinically in rural school going children

Hemant Pralhad Bharati, Saiprasad Onkareshwar Kavthekar, Swati Saiprasad Kavthekar, Anil Bapurao Kurane


Background: Micronutrients are those vitamins and minerals required in very small quantities in our bodies which are essential for a number of different functions including growth and development. Micronutrient deficiencies (MD) are the conditions which are prevalent in the society and parents are unaware of the same due to their asymptomatic nature. The aim of this study was to study the prevalence of MD in school children in rural area of Kolhapur district.

Methods: This prospective study was carried out among 960 school children of, 8 randomly selected Government schools (120 from each school and from each class 30 children) between the age group of 5-10 years in rural Kolhapur, between July-September 2017. Clinical Features of MD for vitamin A (corneal dryness, Bitot’s spot, skin lesions), for vitamin B (angular chelosis, glossitis, knuckle pigmentation), for vitamin C (bleeding gums, scorbutic rosary), for vitamin D (bow legs, rachitic rosary, pot belly, frontal bossing) and pallor, goitre, dental caries for iron, iodine and fluoride deficiency respectively were examined. The data was analysed statistically.

Results: The overall prevalence of MD was 35% with 37.45% in girls with highest (40.8%) in the age group of 8-9 years. The features of vitamin deficiency for vitamin B in 30%, for vitamin A in 15%, for vitamin D in 12%, for vitamin C in 2%. The features of mineral deficiency for iron and fluoride in 38.8% and 36.6% respectively were present. Commonest clinical features of vitamin deficiency were glossitis (15.6%), corneal dryness (9.6%), angular chelosis (7.5%) and knuckle pigmentation (6.9%). Multiple MD were seen in 12.7% of children.

Conclusions: Rural school children do suffer from MD significantly. These conditions should be timely evaluated as these are preventable and treatable. 


Deficiency, Micronutrient, School children

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Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145-57.

UNICEF. Micronutrient Initiative and United Nations Children’s Fund (UNICEF). Vitamin and mineral deficiency: A Global damage assessment report, Ottawa. 2004. Available at

Joint statement by the World Health Organization (WHO), World Food Programme (WFP) and United Nations Children’s Fund (UNICEF). Preventing and controlling micronutrient deficiencies in populations affected by an emergency. 2007 Available at http://www.who.intnutrition/publications/micronutrients/WHO_WFP_UNICEFstatement.pdf

World Health Organization (WHO). Global prevalence of vitamin A deficiency in populations at risk 1995-2005. WHO Global Database on vitamin A deficiency. Geneva, World Health Organization. 2009. Available at

World Health Organization (WHO). Assessing the iron status of populations. Including literature reviews. Joint World Health Organization / Centres for Disease Control and Prevention Technical consultation on the Assessment of Iron status at the population level. Geneva, Switzerland. 2007. Available at

Lutter CK. Iron deficiency in young children in low income countries and new approaches for its prevention. J Nutr. 2008;138:2523-8.

Suskind DL. Nutritional deficiencies during normal growth. Pediatr Clin North Am. 2009;56:1035-53 .

Adelekan DA. Multiple micronutrient deficiencies in developing countries. Nutr. 2003;19:473-4 .

Prieto MB, Cid JL. Malnutrition in the critically ill child: the importance of enteral nutrition. Int J Environ Res Public Health. 2011;8:4353-66.

World Health Organization (WHO). Global Health risks. Mortality and burden of disease attributable to selected major risks. Geneva, Switzerland. 2009. Available at

Strimbu K, Tavel JA: What are biomarkers? Curr Opin HIV AIDS. 2010;5:463-65.

Bailey RL, West Jr KP, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metabol. 2015;66(2):22-3.

Catherine RA, tan Libo. Vitamin A deficiencies and excess. In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;1(48):317-320.

Sachdev HPS, Dheeraj S. Vitamin B complex deficiencies and excess. In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;1(49):321-8.

Dheeraj S, Sachdev HPS. Vitamin C (Ascorbic Acid). In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;1(50):329-330.

Larry GA. Rickets and Hypervitaminosis D. Vitamin C (Ascorbic Acid). In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;1(51):331-341

Richard S. Iron deficiency anemia. In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;1(51):331-41.

Larry GA. Micronutrient mineral deficiencies. In: Kliegman RM, eds. Nelsons textbook of paediatrics. First South Asia edition. 2016;154:343-5.

Kamath P, Guruprasad BS, Deepthi R, Munninarayana C. Prevalence of ocular morbidity among school going children (6-15 years) in rural areas of Karnataka, South India. Int J Pharma Biomed Res. 2012;3(4):209-12.

Raman KM, Tandon N, Reddy HK. Vitamin D and bone mineral density of healthy schoolchildren in Northern India. Am J Clin Nutr. 2005;82:477-82

Sunil G, Nishi M, Avtar L, Kusum K. Prevalence and etiology of nutritional anemia among school children of urban slums. Indian J Med Res. 2003;118:167-171.

Benoist DB, Maclean E, Egli I, Cogswell M. Worldwide prevalence of anemia 1993-2005: WHO global database on anemia. Geneva, World Health Organization, 2008.

Verma M, Chhatwal J, Kaur G. Prevalence of anemia among urban school children of Punjab. Indian Pediatr. 1998;35(12):1181-6.

Shivprakash NC, Baby JR. Nutritional status of rural school going children (6-12years) of Mandya district of Karnataka. Int J Sci Study. 2014;2(2):39-43.

Caballero B. Global patterns of child health: the role of nutrition. Ann Nutr Metab. 2002;46(1):3-7.

Tulchinsky TH, Kaluski DN, Berry EM. Food fortification and risk group supplementation are vital parts of a comprehensive nutrition policy for prevention of chronic diseases. Eur J Public Health. 2004;14:226-8.

Motti H, Aaron L. Nutritional deficiencies in the pediatric age group in a multicultural developed country Israel. World J Clin Cases. 2014;2(5):120-5.