PREVALENCE OF ANEMIA PREVALENCE OF ANEMIA AMONG ADOLESCENT GIRLS IN A AMONG ADOLESCENT GIRLS IN A

RURAL COMMUNITY OF RURAL COMMUNITY OF COIMBATORE, TAMILNADU.COIMBATORE, TAMILNADU.

ByByT. Nirmala, Professor &HOD andT. Nirmala, Professor &HOD and P. Sathya, Assistant Professor, P. Sathya, Assistant Professor,

Community Health Nursing Community Health Nursing Department,Department,

PSG College of Nursing, PSG College of Nursing, COIMBATORE.COIMBATORE.

IntroductionIntroduction Iron Deficiency is the most common Iron Deficiency is the most common

micronutrient deficiency which affects more micronutrient deficiency which affects more than 2 billion population worldwide, leading than 2 billion population worldwide, leading to anemia in more than 40% of women of to anemia in more than 40% of women of reproductive age in the developing world reproductive age in the developing world and 7-12 % in developed countries (WHO, and 7-12 % in developed countries (WHO, 20042004).).

Prevalence of anemia among adolescents is Prevalence of anemia among adolescents is more than 25% in developing countries and more than 25% in developing countries and

In Tamil Nadu, 1-10 per 100 adolescent girls In Tamil Nadu, 1-10 per 100 adolescent girls are prone for anemia and in Coimbatore, 1-are prone for anemia and in Coimbatore, 1-10 per 19 adolescet girls are 10 per 19 adolescet girls are anemic( Government of Tamilnadu,2004)anemic( Government of Tamilnadu,2004)

ObjectivesObjectives

Assessment of factors affecting the Assessment of factors affecting the haemoglobin level of adolescent haemoglobin level of adolescent girls.girls.

Physical assessment of adolescent Physical assessment of adolescent girls to identify anemia.girls to identify anemia.

Estimation of haemoglobin level to Estimation of haemoglobin level to confirm anemia among adolescent confirm anemia among adolescent with signs of anemia with signs of anemia

Research methodologyResearch methodology Descriptive survey design was utilized. Descriptive survey design was utilized.

Population: The adolescent girls Population: The adolescent girls studying in IX standard at Government studying in IX standard at Government Higher Secondary school, Arasur, Higher Secondary school, Arasur, Coimbatore District. Coimbatore District.

Samples: 93 girls studying in IX Samples: 93 girls studying in IX standard were included in the study.standard were included in the study.

Programme OutlineProgramme Outline

1. Assessment of the socio-demographic 1. Assessment of the socio-demographic data and other factors influencing anemia data and other factors influencing anemia such as menstrual cycle, birth order and such as menstrual cycle, birth order and intake of iron rich diet etc was done using intake of iron rich diet etc was done using a questionnaire. a questionnaire.

2. A check list was used to identify the signs 2. A check list was used to identify the signs of anemia among adolescent girls. of anemia among adolescent girls.

3. The adolescent girls who showed the 3. The adolescent girls who showed the signs of anemia underwent hemoglobin signs of anemia underwent hemoglobin estimation through cyanmethglobin estimation through cyanmethglobin method using Rabkin solution.method using Rabkin solution.

Major findings of the study:Major findings of the study:

Out of 93 adolescent girls examined, Out of 93 adolescent girls examined, 72 girls had the signs of anemia. 72 girls had the signs of anemia.

Among 72 girls showing the Among 72 girls showing the signs of anemia, 44 girls (61%) signs of anemia, 44 girls (61%) were diagnosed to be anemic.were diagnosed to be anemic.

3030 girls were girls were mildly anemic, 14mildly anemic, 14 girls were girls were moderately anemicmoderately anemic and and no oneno one found to be found to be severely severely anemicanemic

On Examination,On Examination,• Sixty three girls had pale Sixty three girls had pale

conjunctiva conjunctiva • 60 girls had pale nail color60 girls had pale nail color• Considering the Considering the BMI, BMI, fifty three fifty three

girls were thinly built, 40 were girls were thinly built, 40 were normally built and no one was normally built and no one was found to be over weight or obesefound to be over weight or obese

Out of 93 students, 35 students Out of 93 students, 35 students suffer from severe blood loss suffer from severe blood loss during menstruation.during menstruation.

Socio Demographic DataSocio Demographic Data

The age of the students ranged from The age of the students ranged from 13-16 years. Majority of girls 49 [52%] 13-16 years. Majority of girls 49 [52%] were at the age 14 years, 40.8% are were at the age 14 years, 40.8% are at the age of 15 years. Mean = 14.06. at the age of 15 years. Mean = 14.06.

Seventy eight (83.8%) of girls belong Seventy eight (83.8%) of girls belong to nuclear type of family, 15.1% [14] to nuclear type of family, 15.1% [14] of girls belong to joint family, 1.1% of girls belong to joint family, 1.1% [1] belongs to extended family.[1] belongs to extended family.

Distribution of Samples according to their Parent’s

Occupation

0

10

20

30

40

50

60

No

. o

f G

irls

Coolie Private Business

OccupationFather

Mother

Majority 38.7% [36] fathers’ of Majority 38.7% [36] fathers’ of the students were coolie worker, the students were coolie worker, 21.5% [20] were mill worker and 21.5% [20] were mill worker and businessman. businessman.

It is noticed that the haemoglobin It is noticed that the haemoglobin level of daughters of house wives level of daughters of house wives are better compared to other are better compared to other working mothers. working mothers.

71%(25/35) of the daughters of 71%(25/35) of the daughters of working mothers are anemic working mothers are anemic compared to 51%(19/37) of the compared to 51%(19/37) of the daughters of housewives.daughters of housewives.

Distribution of Samples according to their parents’ Educational status

0

10

20

30

40

50

Illitrate Primary Secondary HigherSecondary

College

Father

Mother

Educational status of the Educational status of the parentsparents

Majority of girls’ father and mother Majority of girls’ father and mother were educated up to secondary school were educated up to secondary school level.level.

The education status of the father The education status of the father and mother is positively co- related and mother is positively co- related with the hemoglobin value of their with the hemoglobin value of their daughters. Especially mother’s daughters. Especially mother’s education has a strong influence on education has a strong influence on the status of anemia in their children. the status of anemia in their children.

Distribution of Samples According to Order of Birth

0

10

20

30

40

50

60

No. of Girls

1 2 3 4 5

Order of Birth

Order of BirthOrder of Birth

41 (44.1%) girls had one sibling, 33 41 (44.1%) girls had one sibling, 33 [35.5%] had two siblings and only [35.5%] had two siblings and only 10.7% had three siblings. One had up 10.7% had three siblings. One had up to 5 siblings. to 5 siblings.

The hemoglobin level of the girls was The hemoglobin level of the girls was negatively co-related with the negatively co-related with the number of siblings.number of siblings.

Distribution of samples According to their Parent’s Monthly Income

0

5

10

15

20

25

30

No. o

f Girl

s

<1000 1000-1500

1501-2000

2001-2500

2501-3000

3001-3500

3501-4000

>4000

Monthly Income

Monthly Income of the FamilyMonthly Income of the Family

Twenty eight (30.1%) student’s family Twenty eight (30.1%) student’s family earns a monthly income of Rs.1000 – earns a monthly income of Rs.1000 – 1500, 21.5% [20] of students’ family 1500, 21.5% [20] of students’ family earn a monthly income of Rs. 1501-earn a monthly income of Rs. 1501-2000 and 2501-3000. 2000 and 2501-3000.

It is found that the income of the family It is found that the income of the family and the hemoglobin level of adolescent and the hemoglobin level of adolescent girls are co- relating positively. girls are co- relating positively.

Menstrual HistoryMenstrual History

Among 72 girls, 12 of them had not Among 72 girls, 12 of them had not attained menarche. attained menarche.

While considering the age at While considering the age at menarche, three girls have attained menarche, three girls have attained early menarche at the age of 11 years early menarche at the age of 11 years and seven at the age of 12. and seven at the age of 12.

Four had late menarche at the age of Four had late menarche at the age of 15 years, majority (25) of the girls 15 years, majority (25) of the girls had menarche at the age of 13 years had menarche at the age of 13 years followed by 20 at the age of 14 years. followed by 20 at the age of 14 years.

Menstrual HistoryMenstrual History

Among the 60 girls, only 10 of them Among the 60 girls, only 10 of them had irregular menstruation. But had irregular menstruation. But around 35 of them claim to have around 35 of them claim to have excess bleeding during menstruation. excess bleeding during menstruation.

The co-relation between the age at The co-relation between the age at menarche and haemoglobin level menarche and haemoglobin level showed a positive relationship, showed a positive relationship, meaning as the age at menarche meaning as the age at menarche delays there improvement in the delays there improvement in the hemoglobin level.hemoglobin level.

DIETARY HISTORYDIETARY HISTORY

Majority of girls 87.09% (81) take Majority of girls 87.09% (81) take three meals per day, 11.82% (11) take three meals per day, 11.82% (11) take two meals per day, only 1.1% (1) takes two meals per day, only 1.1% (1) takes more than three meals per day.more than three meals per day.

Type of diet

82

11

Non-vegetarian

Vegetarian

Majority of girls (53) consumes meat Majority of girls (53) consumes meat monthly once, 23 girls consume fish monthly once, 23 girls consume fish monthly one, 37 girls consume chicken monthly one, 37 girls consume chicken monthly once.monthly once.

Majority of girls (69) consumes green Majority of girls (69) consumes green leafy vegetables weekly once, 52 girls leafy vegetables weekly once, 52 girls consume drumstick leaves weekly once, consume drumstick leaves weekly once, 28 girls consume pomegranate weekly 28 girls consume pomegranate weekly once, 13 girls consume ragi weekly once, 7 once, 13 girls consume ragi weekly once, 7 girls consume jaggery weekly once.girls consume jaggery weekly once.

17

38

34

4

0

5

10

15

20

25

30

35

40

Numberof girls

1

Intake of Tea or Coffee

Intake of Tea/Coffee

No

Once

Twice

Thrice

PHYSICAL ASSESSMENTPHYSICAL ASSESSMENT

Height of the Adolescent Girls

2

47

41

3

0

5

10

15

20

25

30

35

40

45

50

131-140 141-150 151-160 More than160

Height in cms

Nu

mb

er

of

gir

ls

Majority of girls height is 141-149 Majority of girls height is 141-149 Centimeters (47), 41 girls are of height Centimeters (47), 41 girls are of height 151-159 centimeters, 3 girls are of 151-159 centimeters, 3 girls are of height > 160 centimeters, 2 girls are height > 160 centimeters, 2 girls are of height 131-140 centimeters.of height 131-140 centimeters.

1

39 40

13

0

5

10

15

20

25

30

35

40

Number of girls

20-29 30-39 40-49 50-59

Weight in kgs

Weight of the adolescent girls

Majority of girls weight ranged Majority of girls weight ranged from 40-49 kilogram (40),from 40-49 kilogram (40),

39 girls were weighing30-39 39 girls were weighing30-39 kilograms,kilograms,

13 girls were of 50-59 kilograms, 13 girls were of 50-59 kilograms, only one girl weighed 20-29 only one girl weighed 20-29

kilograms.kilograms.

Estimation of Hemoglobin levelEstimation of Hemoglobin level

Prevalence of Anemia among Adolescent girls

32

15

53

Mild

Moderate

Normal

Estimation of Hemoglobin level:Estimation of Hemoglobin level:

The hemoglobin level of adolescent The hemoglobin level of adolescent girls was estimated using girls was estimated using cyanmethoglobin method. cyanmethoglobin method.

It was found that out of 72 girls who had It was found that out of 72 girls who had the signs of anemia, 44( 61%) were the signs of anemia, 44( 61%) were diagnosed to have anemia. diagnosed to have anemia.

It makes that 47 %,( 44/93) nearly half of It makes that 47 %,( 44/93) nearly half of the population under the study was the population under the study was suffering from anemia. suffering from anemia.

Among the 44, thirty were mildly anemic, Among the 44, thirty were mildly anemic, 14 were moderately anemic and no one 14 were moderately anemic and no one was severely anemic. was severely anemic.

ImplicationImplication

As 47% of the adolescent girls who had As 47% of the adolescent girls who had the signs of anemia are diagnosed to be the signs of anemia are diagnosed to be anemic. The investigator strongly anemic. The investigator strongly recommends consumption of iron recommends consumption of iron supplements and dietry modification for supplements and dietry modification for moderately anemic and dietary modification moderately anemic and dietary modification for mildly anemic adolescents. for mildly anemic adolescents.

It is advisable to educate the adolescents It is advisable to educate the adolescents and the school teachers on identification of and the school teachers on identification of anemia in early stage and its management. anemia in early stage and its management. This will definitely enhance the adolescent This will definitely enhance the adolescent health to face the pregnancy later.health to face the pregnancy later.

ConclusionConclusion

Adolescence, as a period of growth and Adolescence, as a period of growth and development, is considered the best development, is considered the best time to intervene, to assist in physical time to intervene, to assist in physical and mental development, and to and mental development, and to prevent later maternal anemia.prevent later maternal anemia.

It is known that the adolescent girls are It is known that the adolescent girls are prone for anemia. Lets join together to prone for anemia. Lets join together to help them in eliminating it.help them in eliminating it.

THANK YOUTHANK YOU