International Journal of Medical and Health Research 2015; 1(1): 01-04 

ISSN: Applied
IJMHR 2015; 1(1): 1-4 Correlation of Nutritional Anemia and Blood Group
© 2015 IJMHR
www.medicalsjournals.com Prevalence among Adolescent Girls in Pudukkottai
Received: 08-07-2015
Accepted: 07-08-2015 District of India
Prabhusaran N
a) Postgraduate and Research Prabhusaran N, Nithya N, Sundhararajan A, Asirvatham Alwin Robert,
Department of Microbiology,
Chennai Medical College Syed M
Hospital and Research Centre
(SRM Group), Tiruchirapalli, Abstract
India. The main objective of this study is to find out the epidemiological correlates of nutritional anemia and
b) Department of Diagnostic and blood group prevalence among adolescent girls in rural areas of Pudukkottai of Tamilnadu. A cross-
Transfusion Medicine, Team sectional study was carried out in adolescent girls of ten villages of Pudukkottai district. The relevant
Superspeciality Hospital,
information was collected with blood grouping kit and hemoglobin estimation. Among the adolescent
Pudukkottai, India.
girls included, 45.9% and 24.3% supported O and B positive respectively, followed by A positive of
Nithya N 13.6%. Less percentage of negative blood groups identified and no AB negative group registered in this
Department of Occupational study. The number of subjects included verses various age groups denoted to 228, 375 and 359 among
Therapy, Kirubai Rehabs 10-12, 13-15 and 16-19 years respectively. Among them, 121, 191 and 206 cases were found to be severe
Centre, Villivakkam, Chennai, anemia among 10-12, 13-15 and 16-19 years respectively. Children and adolescent group of girls are the
INDIA. future backbone of the growth of our nation, their nutritional observation and earliest intervention in
screening and treatment. Long term policies by government, non-government agencies and the
Sundhararajan A community can be directed to formulate effective plans like eradicating anemia in children and
Postgraduate Department of adolescent girls.
Biochemistry, Chennai Medical
College Hospital and Research Keywords: Nutritional anemia, Blood group, Adolescent girls, Pudukkottai.
Centre (SRM Group),
Tiruchirapalli, INDIA.
1. Introduction
Asirvatham Alwin Robert Haemoglobin is the metalloprotein that is present in the blood. It is this iron containing
Department of Endocrinology substance within the red blood cells that helps in carrying oxygen. It is naturally very
and Diabetes, Diabetes important to the human body as a lot of energy within the body is derived from pure oxygen.
Treatment Center, Prince Sultan Blood tests are generally conducted to figure out how much haemoglobin there is within the
Military Medical City,
Riyadh, Saudi Arabia.
blood [1, 2]. The general standard for measuring haemoglobin levels in the blood is grammes per
hundred millilitres. This is written as g/dl. The normal or healthy level of haemoglobin within
Syed M a human varies between 11.5 to 15.5 g/dl in women and 13.5 to 17.5 g/dl in men. The human
Department of Diagnostic and body is very good at adapting and even if the haemoglobin levels drop to a considerable extent
Transfusion Medicine, Team symptoms may not appear [2, 3].
Superspeciality Hospital,
Pudukkottai, INDIA.
Nutritional anemia has become a global disease and cuts across all the sections of the
population. It is not just a medical problem but has its roots in sectors of education,
demography, occupation etc. Developing countries like India is facing this problem for last 50
years [4]. Adolescents being a formative year in life are more prone to major nutritional
deficiency. Since adolescence has the lowest rate of mortality among different age groups it
Correspondence
has been placed in least priority [5, 6].
Prabhusaran N Anemia not only effects the present health status of girls but also has deleterious effects in
a) Postgraduate and Research future pregnancy, that puts the women at three times greater risk of delivering low birth weight
Department of Microbiology, and nine times higher risk of perinatal mortality, thus contributing significantly for increased
Chennai Medical College infant mortality rate and 30% maternal deaths [5, 7]. Since children and young adults are our
Hospital and Research Centre
future citizens, therefore it is important for us to assess their nutritional health at an early stage
(SRM Group), Tiruchirapalli,
INDIA. so that strategic intervention can be planned. Therefore, this study was planned to assess the
b) Department of Diagnostic and level of anemia and blood group in the adolescent girls in Pudukkottai district of INDIA who
Transfusion Medicine, Team need to access adequate diet.
Superspeciality Hospital,
Pudukkottai, INDIA.

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2. Material and Methods diagnostic experts, nutritionist and social workers were
2.1. Sample size and design involved in this investigation and trained before gone to field.
A population based cross sectional study adopting multistage
stratified random sampling procedure was carried out in the 3. Results and Discussion
rural area of Pudukkottai district of Tamilnadu during 2014. World interest in adolescent health issues has grown
The ten villages of Pudukkottai district of Tamilnadu dramatically in the past decade beginning with the
investigated in the study. The participating villages are International Year of Youth in 1985 and the World Health
Arasannagaripattinam, South Pudukudi, North Pudukudi, Assembly in 1989, when discussions were focused on the
Mimisal, Ponnagaram, Muthukuda, P.R. Pattinam, health of youth [1, 13]. Among adolescents, girls constitute a
Ammapattinam, Athipattinam, R. Pudupattinam. The study vulnerable group struggling with anemia, particularly in
was carried out from September 2014 to November 2014. The developing countries where they are traditionally married at an
institutional ethical committee clearance was obtained before early age and exposed to a greater risk of reproductive
starting this prevalence study. Using a simple random sample morbidity and mortality [2, 7]. Adolescence represents a real
technique, 962 children and adolescents were selected for opportunity to make a difference in lifelong patterns. The
blood determining the Hb content (nutritional anemia). prevalence of anemia is disproportionately high in developing
Assuming the prevalence of anemia in school children as 70% countries, due to poverty, inadequate diet, certain diseases,
and considering the 95% confidence interval (CI), 90% power pregnancy/lactation and poor access to health services [2].
and relative precision of 10%, a sample size covered due to The nutritional anemia in this group attributes to high MMR,
some constraints during the survey [8, 9]. high incidence of low birth weight babies, high perinatal
mortality and fetal wastage and consequent high fertility rates
[13]
2.2. Selection of subjects . This phase of life is also important due to the ever-
The sample size to be covered from each of the selected increasing evidence that control of anemia in pregnant women
village was determined on the basis of proportion to may be more easily achieved if satisfactory iron status can be
population size (PPS) method. The study was approved by the ensured during adolescence [5]. To plan effective interventions,
scientific advisory committee and written informed consent it is important to understand the epidemiology. Hence, the
and permission was obtained from the parents and school present study was carried out to study the epidemiological
administrators respectively. The subjects included were correlates of nutritional anemia and prevalent blood grouping
classified into three categories including 10-12 years, 13-15 among adolescent girls in rural Pudukkottai.
years and 16-19 years. Among the subjects included in this study, the maximum
numbers of 375 were determined in the age group of 13-15
2.3. Blood sample collection and Technique followed by 16-19 and 10-12 age groups with 359 and 228
The basic socio demographic informations were collected and subjects respectively. The maximum determinants were
finger prick blood samples were collected for blood groups identified in the area R. Pudupattinam followed by
and hemoglobin level estimation. Finger prick blood sample of Muthukuda, Ponnagaram etc. The maximum of 97 subjects in
20µl was collected using fixed volume Finn pipette. Blood the age group of 16-19 and 73 subjects in the age group of 13-
grouping was analyzed by standard method and hemoglobin 15 were included in R. Pudupattinam. In the age group of 10-
was estimated by cyanmethaemoglobin method using 12 the maximum of 47 subjects included in
colorimeter [7, 10]. The cut-off value of <11, <10 and <7g/dL of Arasanagaripattinam. The detailed description of number of
hemoglobin for mild, moderate and severe anemia in test subjects included agewise verses areas was included in figure1.
subjects was compared [11, 12]. Trained medical officer,

Fig 1: Number of subjects included agewise verses areas

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International Journal of Medical and Health Research
 

Out of 962 subjects enrolled in this study, all were subjected supported. The detailed determination of the various blood
for determining blood groups. Maximum of 45.9% supported groups was screened among the subjects and the results were
O positive followed by B positive with 24.3%. The blood depicted in table 1. Among the Rh negative blood groups, O
group A positive was determined among 131 subjects whereas and B negative groups were identified among 10 (1.1%) and 9
A negative was found only among 11 subjects. Among the A (0.9%) subjects respectively. Further the percentage of the
group, A1 positive was found among 71 (7.4) subjects. The blood groups among various study areas were determined and
AB positive group was determined among 55 (5.7%) subjects interpreted in figure 2.

Table 1: Number of Subjects involved in various blood groups

S.No. Village A+ve A1+ve B+ve AB+ve O+ve A-ve B-ve O-ve Total
1 Arasanagaripattinam 34 - 18 8 37 1 1 1 100
2 South Pudukudi 4 10 11 7 13 2 - - 47
3 Mimisal 18 - 15 4 30 1 2 2 72
4 North Pudukudi 2 6 15 4 41 - 1 1 70
5 Ponnagaram 9 - 30 3 59 1 2 3 107
6 Muthukuda 29 - 40 9 62 1 1 2 144
7 P.R.Pattinam 9 14 17 5 55 - - - 100
8 Ammapattinam 10 12 19 5 40 1 - - 87
9 Athipattinam 4 4 12 1 36 - 1 - 58
10 R.Pudupatinam 12 25 57 9 68 4 1 1 177
Total 131 71 234 55 441 11 9 10 962

Table 2: Anemia in Adolescents

Age Anemia [Level of No. of girls observed in
group Hemoglobin (gm/dl)] this category (n=962)
Normal (>11) 52 (22.8)
10-12
Mild (10.0 – 10.9) 12 (5.3)
years
Moderate (7.0 – 10.0) 43 (18.8)
(n=228)
Severe (<7) 121 (53.1)
Normal (>11) 59 (15.7)
13-15
Mild (10.0 – 10.9) 13 (3.5)
years
Moderate (7.0 – 10.0) 112 (29.9)
(n=375)
Severe (<7) 191 (50.9)
Normal (>11) 81 (22.5)
16-19
Mild (10.0 – 10.9) 16 (4.5)
years
Moderate (7.0 – 10.0) 56 (15.6)
(n=359)
Fig 2: Percentage positivity of various blood groups among subjects Severe (<7) 206 (57.4)
included [Figure in parenthesis denoted percentages]

Considering that Anemia development is a consequence The Government of India has made the adolescent health as a
occurred at a later stage of iron deficiency, the problem of iron part of RCH package since 1997 [16, 17]. The anemia in this age
deficiency in these adolescent girls with a prevalence of 59.8% group has been identified as an important health problem10
should be considered serious and calls for an action. In this followed by further reinforcement at the 1994 International
study, the prevalence of normal, mild, moderate and severe Conference on Population and Development held at Cairo. In
anemia were 19.9%, 4.3%, 21.9% and 53.9% respectively the present study, the prevalence of anemia was found to be
among 962 subjects screened (Table 2). High prevalence of 80.1% where other studies showed prevalence rate of 73.7%
mild and moderate anemia demands due to the emphasis so as and 74.7% respectively [18, 19]. These differences in the
to bring down total prevalence of anemia in adolescent girls prevalence of anemia may be due to difference in the study
[10]
. The prophylaxis measures for adolescent girls in India area. WHO/ UNICEF have suggested the problem of anemia is
including nutrition education in schools [14, 15]. The impact of of very high magnitude in a community when prevalence rate
iron deficiency in the upper class adolescents may not be of exceeds to 40% [11].
much consequence since the availability of best health care,
antenatal care and regular consumption of iron folate 4. Conclusion
preparations and also better quality of food during pregnancy Of the 962 persons examined almost all of them belong to
would obviate the iron deficiency acquired during adolescence either any one of the anemia classifications namely, mild,
[15]
. moderate and severe as per the WHO guidelines. It is
Among the age groups, 13-15 and 16-19 groups were showed interesting to note that more severe cases were identified in the
with high severe anemia due to age groups of 13-15 and 16-19 years. The limitations of the
1. Lack of proper nutrition during the adolescent age study were that no intervention was planned, worm infestation
2. Stress due to education in these rural women could not be studied, and in a subsample
3. Non replacement of iron deficiency during menarche both methods hemocue and cyanmethaemoglobin should have
4. Deficiency of Vitamin D, calcium etc. been applied for haemoglobin estimations.
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