Anaemia, its determinants and effect of different interventions amongst tea tribe adolescent girls living in Dibrugarh district of Assam

Abstract

Background: Nutritional anaemia, one of the major public health problems in India is associated with lower productivity, higher sickness rate and absenteeism having inter-generational effect. Morbidity during adolescent has implication on future safe motherhood, optimum growth and development of foetus and children. Aims and Objective: To assess, prevalence and determinants of anaemia and effect of different interventions amongst tea tribe adolescent girls. Materials & Methods: A community based intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination. Interventions given were weekly IFA supplementation, dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers was done. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. Results: Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%.  History of passage of worms (9.1%), night blindness (5.6%), weakness (62.1%), loss of appetite (37.5%), gum bleeding (23.6%), loose motion (13%), loss of weight (9.9%), menstrual problem (19.3%) was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Associated morbidities showed significant reduction following active intervention. Conclusions: High anaemia prevalence requires urgent attention to avoid preventable morbidities. Implementation of different intervention in an integrated manner was found effective in reducing the burden of anaemia and associated factor.