Characterization of anemia amongst school going adolescent girls in rural Haryana, India

Abstract Objective: High burden of anemia exists amongst rural adolescent girls in India. The objective of this study was to characterize anemia in school going adolescent girls in rural Haryana, India. Design: Linear and multiple logistic regression analysis of data collected prior to an intervention trial was conducted. Participants were classified into anemic (hemoglobin <12g/dl) and non-anemic group and were further classified into deficiencies of iron, folate or vitamin B 12 , mixed, anemia of other causes and inflammation. Setting: Three schools in Ballabgarh block of Faridabad District, Haryana, India. Participants: 198 non-anemic and 202 anemic adolescent girls (12-19 years). Results: Anemic girls had 29.6% iron deficiency, 28.1% folate or vitamin B 12 deficiency, 15.8% mixed deficiency and 9.7% acute inflammation. Anemia of other causes was found in 16.8% of the anemic participants. Girls with iron and isolated folate deficiency had 2.5 times and 4 times higher odds of developing anemia; respectively, as compared to non-anemic girls. Iron deficiency with no anemia was found amongst 11% non-anemic girls. Non-anemic girls had a high prevalence of combined deficiency of folate or vitamin B 12 (29.5%) and acute inflammation (14.4%). Conclusions: The current strategy of iron and folic acid supplementation alone will not suffice for achieving the desired reduction in the prevalence of anemia as unknown causes and anemia of inflammation contribute to a substantial proportion of anemia. Integrating other nutrition-specific components like improving water, sanitation and hygiene practices with the ongoing micronutrient supplementation program will comprehensively tackle anemia. Unknown causes of anemia warrants further research.