Journal of Tropical Pediatrics, 2015, 61, 231–233 doi: 10.1093/tropej/fmv016 Advance Access Publication Date: 30 March 2015 Research Letter
RESEARCH LETTER
Anemia among school children in eastern Nepal
1
Department of Pharmacy, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal, 2Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal, 3Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University, Dharan, Nepal and 4Department of Biochemistry, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal Correspondence: Saroj Khatiwada, Department of Pharmacy, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal. Tel: 977 9803763889. E-mail .
SU M MAR Y Anemia is one of the most common public health problems in developing countries like Nepal. This study was done to find the prevalence of anemia among the children aged 4–13 years in eastern Nepal. A cross-sectional study was conducted in 2012 in four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the prevalence of anemia among the school children of eastern Nepal. Children aged 4–13 years were selected randomly from different schools of above districts and 618 venous blood samples were collected. Hemoglobin level was estimated by using cyanmethemoglobin method. The mean hemoglobin level was 12.2 6 1.82 gm/dl. About 37.9% (n ¼ 234) children were found anemic. Anemia prevalence was 42.4% (n ¼ 78), 31.6% (n ¼ 60), 45.3% (n ¼ 48) and 34.8% (n ¼ 48) among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively. The study finds anemia as a significant health problem among the school children of eastern Nepal. K E Y W O R D S : anemia, hemoglobin, iron deficiency anemia, Nepal, school children
Anemia has been one of the commonest public health problems in most parts of world. Prevalence of anemia is high especially in the developing countries like Nepal [1]. According to Nepal demographic and health survey 2006, 48% of 6–59 month children were anemic [2]. In the study of Baral and Onta [3] in eastern Nepal, 65.6% adolescent (10–19 years) were anemic and anemia rate was very high (60.5%) among school-going adolescent girls
of Kathmandu [4]. The epidemiology of anemia varies substantially between different ecological and sociocultural settings and has not been previously described for school children of Nepal. Therefore, we conducted a cross-sectional study in 2012 in the four districts (Morang, Udayapur, Bhojpur and Ilam), selected randomly from 16 districts of eastern Nepal, to describe the prevalence and severity of anemia in these children.
C The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] V
231
Downloaded from http://tropej.oxfordjournals.org/ at Dalhousie University on June 20, 2015
by Saroj Khatiwada,1 Basanta Gelal,2 Sharad Gautam,2 Man Kumar Tamang,3 Prem Raj Shakya,4 Madhab Lamsal,2 and Nirmal Baral2
232
Anemia among school children in eastern Nepal
13 years, whereas anemia showed decreasing trend from 4 to 13 years as shown in Table 1. This suggests that younger children are more prone to anemia than older children. Similar findings were obtained by the study of Ngesa and Mwambi [8] in children aged 6 months to 14 years in Kenya. Our results suggest that anemia is common among Nepalese school children, 37.9% (n ¼ 234) children being anemic, though less prevalent than in 6 months–5 years children and pregnant women. The most common cause of anemia in Nepalese children is lack of sufficient iron in diet. In Nepal, only 32% of pre-school children and 29% of pregnant women were found to consume an adequate amount of iron to fulfill their daily requirements [9]. Among the gender, higher percentage of females (42.4%) were anemic than males (34.8%), and among the districts, prevalence was highest in hilly district Bhojpur (45.3%) followed by plain (terai) district Morang (42.4%). Previous studies on Nepalese pregnant women have shown the higher prevalence of anemia in plain regions than hilly regions. Dreyfuss et al. [10] reported that hookworms, malaria and vitamin A deficiency are associated with anemia and iron deficiency among pregnant women in the plain regions of Nepal. According to Nepal demographic health survey 2006, children receiving deworming tablets
Table 1. Mean Hemoglobin level and prevalence of anemia according to age sub groups, gender and districts Mean Hb 6 SD (gm/dl)
Age-groups
Gender Districts
Total (n ¼ 618)
4–6 years (n ¼ 26) 7–9 years (n ¼ 160) 10–13 years (n ¼ 432) Male (n ¼ 368) Female (n ¼ 250) Morang (n ¼ 184) Udayapur (n ¼ 190) Bhojpur (n ¼ 106) Ilam (n ¼ 138)
11.44 6 2.8 11.92 6 1.55 12.35 6 1.82 12.43 6 1.7 11.86 6 1.93 11.79 6 1.84 12.60 6 1.85 12.49 6 1.61 11.95 6 1.75 12.2 6 1.82
p
0.004
RESEARCH LETTER
Anemia among school children in eastern Nepal
1
Department of Pharmacy, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal, 2Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal, 3Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University, Dharan, Nepal and 4Department of Biochemistry, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal Correspondence: Saroj Khatiwada, Department of Pharmacy, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal. Tel: 977 9803763889. E-mail .
SU M MAR Y Anemia is one of the most common public health problems in developing countries like Nepal. This study was done to find the prevalence of anemia among the children aged 4–13 years in eastern Nepal. A cross-sectional study was conducted in 2012 in four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the prevalence of anemia among the school children of eastern Nepal. Children aged 4–13 years were selected randomly from different schools of above districts and 618 venous blood samples were collected. Hemoglobin level was estimated by using cyanmethemoglobin method. The mean hemoglobin level was 12.2 6 1.82 gm/dl. About 37.9% (n ¼ 234) children were found anemic. Anemia prevalence was 42.4% (n ¼ 78), 31.6% (n ¼ 60), 45.3% (n ¼ 48) and 34.8% (n ¼ 48) among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively. The study finds anemia as a significant health problem among the school children of eastern Nepal. K E Y W O R D S : anemia, hemoglobin, iron deficiency anemia, Nepal, school children
Anemia has been one of the commonest public health problems in most parts of world. Prevalence of anemia is high especially in the developing countries like Nepal [1]. According to Nepal demographic and health survey 2006, 48% of 6–59 month children were anemic [2]. In the study of Baral and Onta [3] in eastern Nepal, 65.6% adolescent (10–19 years) were anemic and anemia rate was very high (60.5%) among school-going adolescent girls
of Kathmandu [4]. The epidemiology of anemia varies substantially between different ecological and sociocultural settings and has not been previously described for school children of Nepal. Therefore, we conducted a cross-sectional study in 2012 in the four districts (Morang, Udayapur, Bhojpur and Ilam), selected randomly from 16 districts of eastern Nepal, to describe the prevalence and severity of anemia in these children.
C The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] V
231
Downloaded from http://tropej.oxfordjournals.org/ at Dalhousie University on June 20, 2015
by Saroj Khatiwada,1 Basanta Gelal,2 Sharad Gautam,2 Man Kumar Tamang,3 Prem Raj Shakya,4 Madhab Lamsal,2 and Nirmal Baral2
232
Anemia among school children in eastern Nepal
13 years, whereas anemia showed decreasing trend from 4 to 13 years as shown in Table 1. This suggests that younger children are more prone to anemia than older children. Similar findings were obtained by the study of Ngesa and Mwambi [8] in children aged 6 months to 14 years in Kenya. Our results suggest that anemia is common among Nepalese school children, 37.9% (n ¼ 234) children being anemic, though less prevalent than in 6 months–5 years children and pregnant women. The most common cause of anemia in Nepalese children is lack of sufficient iron in diet. In Nepal, only 32% of pre-school children and 29% of pregnant women were found to consume an adequate amount of iron to fulfill their daily requirements [9]. Among the gender, higher percentage of females (42.4%) were anemic than males (34.8%), and among the districts, prevalence was highest in hilly district Bhojpur (45.3%) followed by plain (terai) district Morang (42.4%). Previous studies on Nepalese pregnant women have shown the higher prevalence of anemia in plain regions than hilly regions. Dreyfuss et al. [10] reported that hookworms, malaria and vitamin A deficiency are associated with anemia and iron deficiency among pregnant women in the plain regions of Nepal. According to Nepal demographic health survey 2006, children receiving deworming tablets
Table 1. Mean Hemoglobin level and prevalence of anemia according to age sub groups, gender and districts Mean Hb 6 SD (gm/dl)
Age-groups
Gender Districts
Total (n ¼ 618)
4–6 years (n ¼ 26) 7–9 years (n ¼ 160) 10–13 years (n ¼ 432) Male (n ¼ 368) Female (n ¼ 250) Morang (n ¼ 184) Udayapur (n ¼ 190) Bhojpur (n ¼ 106) Ilam (n ¼ 138)
11.44 6 2.8 11.92 6 1.55 12.35 6 1.82 12.43 6 1.7 11.86 6 1.93 11.79 6 1.84 12.60 6 1.85 12.49 6 1.61 11.95 6 1.75 12.2 6 1.82
p
0.004
