A cross-sectional study of anaemia in children under 15 years of age attending a community health centre in Punjab
DOI:
https://doi.org/10.18203/2349-3291.ijcp20252603Keywords:
Anaemia, Iron deficiency, Serum ferritin, Vitamin B12 deficiencyAbstract
Background: Anaemia is the common nutritional problem in the world having a detrimental effect on the growth and development of the child. The objective of the study was to estimate the prevalence of anaemia in the region and its correlation with iron deficiency, serum ferritin, vitamin B12 and folate deficiency.
Methods: A hospital based observational cross-sectional study was carried out in the outpatient paediatrics department of a Community Health Centre in Punjab. Study subjects included 52 anaemic children aged under 15 years of age. They were evaluated by obtaining a detailed history, physical examination and haemoglobin, serum iron, serum ferritin, serum vitamin B12 and folate levels.
Results: Among 52 anaemic children, iron deficiency was found in 62% cases (32 children) with 48% of cases showing low ferritin levels and 25% having elevated TIBC. Isolated vitamin B12 deficiency was present in 25% cases (13 children) and folic acid deficiency in 8% cases (4 children). Vitamin D deficiency<15 ng/ml was seen in 29% anaemic children (15 children) and vitamin D insufficiency in 31% cases (16 children). Significant associations were found between low hemoglobin and low serum iron (p=0.031) and ferritin (p=0.001).
Conclusions: Iron deficiency anaemia, vitamin B12 and folate deficiency contributes significantly to the prevalence of anaemia. The National Family Health Survey-5 has reported an increase in the prevalence of anaemia in the under-five age group from 59% to 67.1% over the last five years. Hence, there is a need to develop guidelines for the diagnosis, treatment and prevention of anaemia.
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Lokeshwar MR, Shah NK, Agarwal B, Sachdeva A. IAP speciality series on Paediatric Haematology and Oncology. Approach Anaemia. 2006;3:17.
Ministry of Health and Family Welfare. Guidelines for Control of Iron Deficiency Anaemia: National Iron Plus Initiative. 2013. Available at: https://www.nhm.gov.in/images. Accessed 7 February 2022.
Onyeneho NG, Ozumba BC, Subramanian SV. Determinants of childhood anemia in India. Sci Rep. 2019;9:16540. DOI: https://doi.org/10.1038/s41598-019-52793-3
Ministry of Health and Family Welfare. National Family Health Survey (NFHS 5). 2019-2020. Compendium of Fact Sheets: Key indicators India and 14 states/UTs (phase II). Available at: https://main.mohfw.gov.in. Accessed 7 April 2022.
International Institute for Population Sciences, ICF International. National Family Health Survey (NFHS-4), 2015-16. Mumbai: International Institute for Population Sciences. 2017.
Kulkarni B, Peter R, Ghosh S, Pullakhandam R, Thomas T, Reddy GB, et al. Prevalence of iron deficiency and its sociodemographic patterning in Indian children and adolescents: findings from the Comprehensive National Nutrition Survey 2016–18. The J Nutrition. 2021s;151(8):2422-34. DOI: https://doi.org/10.1093/jn/nxab145
Gratham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutrition. 2001;131:649-68. DOI: https://doi.org/10.1093/jn/131.2.649S
Plessow R, Arora NK, Brunner B. Social costs of iron deficiency anemia in 6-59 month-old children in India. PloS One. 2015;10:136581. DOI: https://doi.org/10.1371/journal.pone.0136581
WHO, UNICEF, UNU. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. Geneva, WHO. 2001.
Kapil U, Kapil R, Gupta A. National Iron Plus Initiative: Current status and future strategy. Indian J Med Res. 2019;150(3):239-47. DOI: https://doi.org/10.4103/ijmr.IJMR_1782_18
Kanchana, Madhusudan S, Ahuja S, Nagaraj N. Prevalence and risk factors of anemia in under five-year old children in children’s hospital. Int J Contemp Pediatr: 2018;5:499-502. DOI: https://doi.org/10.18203/2349-3291.ijcp20180543
John JJ, Mohan G, Ajitha K, David A. Iron deficiency anemia among preschool children belonging to affluent families in Kerala, India. J Curr Res Sci Med. 2019;5:23-7. DOI: https://doi.org/10.4103/jcrsm.jcrsm_41_18
Jose J, Lukose R, Athira TS. Anaemia in under five children attending a tertiary hospital in central Kerala: a cross sectional study. Int J Contemp Pediatr. 2021;8:904-9. DOI: https://doi.org/10.18203/2349-3291.ijcp20211684
Rahman MH, Chauhan S, Patel R. Anaemia among Indian children: A study of prevalence and associated factors among 5-9 years old. Child Youth Serv Rev. 2020;119:105529. DOI: https://doi.org/10.1016/j.childyouth.2020.105529
Raja P, Rajaselvan R. Prevalence of anemia in school children in the age group of 8 to 14 years in Thiruvarur, Tamilnadu, India. Int J Contemp Pediatr. 2019;6:1428-31. DOI: https://doi.org/10.18203/2349-3291.ijcp20192168
Dutta M, Bhise M, Prashad L, Chaurasia H, Debnath P. Prevalence and risk factors of anemia among children 6-59 months in India: A multilevel analysis. Clin Epidemiol Glob Health. 2020;8:868-78. DOI: https://doi.org/10.1016/j.cegh.2020.02.015
Gedfie S, Getawa S, Melku M. Prevalence and Associated Factors of Iron Deficiency and Iron Deficiency Anemia Among Under-5 Children: A Systematic Review and Meta-Analysis. Glob Pediatr Health. 2022;9:67. DOI: https://doi.org/10.1177/2333794X221110860
Ray S, Chandra J, Bhattacharjee J, Sharma S, Agarwala A. Determinants of nutritional anaemia in children less than five years age. Int J Contemp Pediatr. 2016;3:403-8. DOI: https://doi.org/10.18203/2349-3291.ijcp20161023
Pasricha SR, Black J, Muthayya S, Shet A, Bhat V, Nagaraj S, et al. Determinants of anemia among young children in rural India. Pediatrics. 2010;126(1):140-9. DOI: https://doi.org/10.1542/peds.2009-3108
Santokh I, Gaur BK, Narayan R, Maini B, Bharadwaj AK. Iron deficiency anemia among hospitalized children in a rural teaching hospital: a cross sectional study. Int J Contemp Pediatr. 2018;5:1631-6. DOI: https://doi.org/10.18203/2349-3291.ijcp20182579
Chanpura VR, Shah NT. A study of prevalence of iron deficiency anaemia in infants and toddlers (6-24 months) by measuring serum ferritin levels. Int J Contemp Pediatr. 2019;6:656-9. DOI: https://doi.org/10.18203/2349-3291.ijcp20190706
Kapur D, Agarwal KN, Sharma S, Kela K, Kaur I. Iron status of children aged 9-36 months in an urban slum Integrated Child Development Services project in Delhi. Indian Pediatr. 2002;39(2):136-44.
Chhabra A, Chandar V, Gupta A, Chandra H. Megaloblastic anaemia in hospitalized children. JIACM. 2012;13(3):195-7.
Mahajan SK, Anudhaka SC. A study of the prevalence of serum vitamin B12 and folic acid deficiency in western Maharashtra. J Family Med Prim Care. 2015;4(1):64-8. DOI: https://doi.org/10.4103/2249-4863.152255
Thomas D, Chandra J, Sharma S, Jatin A, Pemde HK. Determinants of nutritional anaemia in adolescents. Indian Pediatr. 2015;52(10):867-9. DOI: https://doi.org/10.1007/s13312-015-0734-7
Arora S, Sheemar PS, Khurana MS, Kaur J, Kumar A. Serum folate, vitamin B12 levels and clinicohematological profile in 200 anaemic children aged 1-5 years. Int J Contemp Pediatr. 2018;5:2167-72. DOI: https://doi.org/10.18203/2349-3291.ijcp20184274
Atkinson MA, Melamed ML, Kumar J, Roy CN, Miller Er 3rd, Furth SL, et al. Vitamin D, race and risk for anemia in children. J Pediatr. 2014;164(1):153-8. DOI: https://doi.org/10.1016/j.jpeds.2013.08.060
Jin HJ, Lee JH, Kim MK. The prevalence of vitamin D deficiency in iron-deficient and normal children under the age of 24 months. Blood Res. 2013;48:40-5. DOI: https://doi.org/10.5045/br.2013.48.1.40
Alfhili MA, Basudan AM, Alfaifi M, Awan ZA, Algethami MR, Alsughayyir J. Patterns of 25-Hydroxyvitamin D3, Calcium Status and Anemia in the Saudi Population: A Cross-Sectional Study. Life(Basel). 2022;12(12):2119. DOI: https://doi.org/10.3390/life12122119
Chandra J, Dewan P, Kumar P. Diagnosis, treatment and prevention of nutritional anemia in children: recommendations of the joint committee of pediatric hematology-oncology chapter and pediatric and adolescent nutrition society of the Indian academy of pediatrics. Indian Pediatr. 2022;59:782-801. DOI: https://doi.org/10.1007/s13312-022-2622-2
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