Prevalence of anemia and its impact on scholastic performance among school-going children in Sangareddy, Telangana: a cross-sectional study

Deepanvitha Yeturi; Pavan Kumar

doi:10.18203/2349-3291.ijcp20262327

Authors

Deepanvitha Yeturi Department of Paediatrics, MNR Medical College and Hospital, Sangareddy, Telangana, India
Pavan Kumar Department of Paediatrics, MNR Medical College and Hospital, Sangareddy, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20262327

Keywords:

Anemia, School children, Scholastic performance, Hemoglobin, Iron deficiency, India

Abstract

Background: Childhood anemia may impair attention, memory and learning. This study assessed the prevalence of anemia among school-going children in Sangareddy and its association with scholastic performance.

Methods: In this cross-sectional observational study, 382 children aged 4-15 years were enrolled from the pediatric outpatient department and participating schools over 18 months (2024 June to 2025 November). Demographic details, clinical findings, hemoglobin levels and annual school marks were recorded. High scholastic performance was defined as annual marks ≥60%. Associations were analysed using chi-square test, Pearson correlation and multivariable logistic regression.

Results: Anemia was present in 168/382 children (44.0%): 126 (33.0%) had mild anemia and 42 (11.0%) had moderate anemia. Rural children had higher anemia prevalence than urban children (49.1% vs 37.5%; p=0.031). High performance increased from 45.2% in moderate anemia to 72.9% in children with normal hemoglobin (chi-square=16.40, p<0.001). Hemoglobin correlated positively with annual marks (r=0.205, p<0.001). Normal hemoglobin independently predicted high scholastic performance (adjusted OR 2.20; 95% CI 1.43-3.41; p=0.001).

Conclusions: Anemia was common and significantly associated with poorer scholastic performance. School-based screening, nutrition education, iron supplementation and deworming may improve health and educational outcomes.

References

Lozoff B, Beard J, Connor J, Felt B, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006;64(5 Pt 2):S34-43.

Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr. 2001;131(2S-2):649S-68S.

Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics. 2001;107(6):1381-6.

McCann JC, Ames BN. An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function. Am J Clin Nutr. 2007;85(4):931-45.

Stoltzfus RJ. Iron deficiency: global prevalence and consequences. Food Nutr Bull. 2003;24(4):S99-103.

Black MM. Micronutrient deficiencies and cognitive functioning. J Nutr. 2003;133(11-2):3927S-31S.

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(9556):145-57.

Pollitt E. Iron deficiency and cognitive function. Annu Rev Nutr. 1993;13:521-37.

Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr. 2001;131(2S-2):568S-79S.

Falkingham M, Abdelhamid A, Curtis P, Fairweather-Tait S, Dye L, Hooper L. The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis. Nutr J. 2010;9:4.

Jeevan J, Karun KM, Puranik A, Deepa C, Lintu MK, Barvaliya M. Prevalence of anemia in India: a systematic review, meta-analysis and geospatial analysis. BMC Public Health. 2025;25:1270.

Scott S, Lahiri A, Sethi V, de Wagt A, Menon P, Yadav K, et al. Anaemia in Indians aged 10-19 years: prevalence, burden and associated factors at national and regional levels. Matern Child Nutr. 2022;18(4):e13391.

Gutema BT, Sorrie MB, Megersa ND, Yesera GE, Yeshitila YG, Pauwels NS, et al. Effects of iron supplementation on cognitive development in school-age children: systematic review and meta-analysis. PLoS One. 2023;18(6):e0287703.

Chen Z, Yang H, Wang D, Sudfeld CR, Zhao A, Xin Y, et al. Effect of oral iron supplementation on cognitive function among children and adolescents in low- and middle-income countries: a systematic review and meta-analysis. Nutrients. 2022;14(24):5332.

Girum T, Wasie A. The effect of deworming school children on anemia prevalence: a systematic review and meta-analysis. Open Nurs J. 2018;12:155-61.