Public Health Crisis of Anemia in India: A Pediatric Interventional Study

Background: Anemia is a consistent and prevalent public health crisis in India. One of the largest public health surveys of adolescent girls in India reported an overall anemia prevalence of 89%. Of these, 56% of adolescent girls in India are affected by iron deficiency anemia (IDA). The state of Gujarat, India has a population of over 60.4 million people, with strikingly high rates of IDA, a public health crisis that has yet to be addressed. The goal of this study is to assess the efficacy of an IDA intervention to improve hemoglobin levels in the pediatric population of a Kanera boarding school in the state of Gujarat. Results showed a statistically and clinically significant increase in hemoglobin levels after intervention implementation. This provides data necessary to implement large scale interventions to combat IDA for a significant sector of India’s population. There must be further research to identify the feasibility of implementing similar interventions in a statewide response.

Methods: In this study, 10th and 12th grade girls at Kanera Girls High School in Gujarat were given one dose of deworming tablets (Albendazole 200 mg) followed by 1 week rest and then Autrin Ferrous Fumarate combination tablets (Ferrous Fumarate 300mg, Vitamin B12 15μg, and Folic Acid 1.5mg) everyday for 100 days. This combination of medications was given to address the low vitamin and nutrient levels that are found in foods native to this region. Blood samples were taken to measure hemoglobin levels (g/dl) utilizing a hemoglobin analyzer before and after the treatment. Samples include 10th grade girls (n=199) and 12th grade girls (n=75). Researchers calculated the difference in hemoglobin level means using a two-tailed t-test analysis with a p-value threshold for statistical significance of 0.05. Classification for anemia severity is based on World Health Organization (WHO) criteria.

Results: The results show hemoglobin levels for the girls at Kanera Girls High School before and after receiving the treatment of Albendazole and Autrin Ferrous Fumarate combination tablets. Both groups of girls showed a clinically and statistically significant increase in hemoglobin levels post treatment, and a change from moderate anemia to no anemia based on WHO Criteria.

Conclusion: Iron deficiency anemia remains a serious issue amongst adolescents in rural Indian villages. This is evident at Kanera Girls High School, where high prevalence of anemia has been reported in 10th and 12th grade girls. The intervention of Albendazole and Autrin Ferrous Fumarate combination tablets led to a dramatic rise in their hemoglobin levels, which holds promise for combating the issue of IDA amongst children in India. More research needs to be done to assess the feasibility and overall cost of implementing these interventions on a larger scale.