Introduction:

 

Iron deficiency
anemia is a formidable health challenge in developing countries and remains
persistently high despite national programs to control this deficiency. In
the period of later school age and early adolescence, nutrient requirements are
high and reserves are being laid for the subsequent rapid growth and
development. Iron deficiency in this age group has been primarily studied for
its detrimental effect on hematinic status. However, anemia may compromise
pubertal growth spurt. In girls due to initiation of their menstrual period
they are more exposed to iron deficiency. The consequence of this anemia during
puberty has negative effects on fertility of the individual in future and has
the risks of delivery of low birth weight, preterm birth and abortions .It may
also reduce physical work capacity and cognitive function. This in turn may
adversely affect learning and scholastic performance of the schoolgirls
entering adolescence with subsequent academic failure.

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Physical
work capacity may be reduced because in IDA, the decrease in hemoglobin reduces
the availability of oxygen to the tissues, which in turn affects the cardiac
output. Further, in iron deficiency, changes in brain iron content and distribution
and in neurotransmitter function may affect cognition. Anemia may produce
scholastic under-achievement and behavioral disturbances in school children.
However, little is known as regards impact on children entering adolescence and
those undergoing the pubertal growth spurt.

Thus
this project holds an initiative to conduct a general study of iron deficiency
anaemia in 400  girls studying in  public school 
of 11 to 15 years  age . The major
motive being to have an experiment based knowledge to fill the pockets of
information  and to pull attention
towards  this matter for the betterment
of overall development of girls.

 

 

 

 

 

Objectives:-

 

 

·        
To
study complete blood picture of school going girls of pubertal age group (11-15
yrs).

 

·        
To
assess the iron levels in patient presenting with microcytic hypochromic blood
picture.

 

·        
To
establish the correlation between prevalence of iron deficiency anemia and age
at menarche.

 

Methodology:-

 

 

SAMPLE
SIZE AND STUDY AREA:-

 

The
prospective study would be conducted on 400 school going adolescent girls
(10-15 yrs) . –girls would be  selected
through stratified random sampling procedure. Based on the age at menarche the
sample would be  classified as

·        
early
(9.6 – 11.5 years),

·        
normal
(11.5 – 13.6 years) and

·        
late
(13.6 – 15 years) matures .

 

DATA
COLLECTION METHODS:-

Questionnaire-based interview:-

The
study will be carried out using a pre-tested and modified questionnaire. All
the girls would be asked to fill the questionnaire personally in a regular
class room. The questionnaire includes questions regarding the subject’s age at
menarche. Identification data and age of the girls will be ascertained from
school records also. Age at menarche will be noted in completed years and
months.

 

Blood collection and analysis:-

Blood
samples were collected for biochemical assessment of anemia in the presence of
a medical practitioner( 4ml of anticoagulated ethylenediaminetetraacetic
acid& 3ml venous blood sample) ;

The
salient hematological findings in these cases are as under:-

 

 

Blood tests:-

1)     
Complete blood count (CBC)

a)     
Hemoglobin (Hb)

b)    
Hematocrit value

c)     
 Red blood cell
distribution width (RDW)

d)    
Red blood cells (RBCS).

e)     
ABSOLUTE VALUES

i)       
Mean corpuscular volume (MCV)

ii)     
Mean corpuscular hemoglobin (MCH)

iii)   
Mean corpuscular
hemoglobin concentration(MCHC)

f)      
WBC

g)     
Platelet

2)     
BIOCHEMICAL
FINDING

a)     
 Serum ferritin

 

 

 

TECHNIQUES:-

 

·        
To
do complete blood picture using hematology analyzer{5 part}

 

·        
To
study iron levels using KIT Method in patients presenting with microcytic
hypochromic blood picture.

 

Microcytic
Hypochromic Anemia

Change
in lab values in iron deficiency anemia

Change

Parameter

?

ferritin, hemoglobin, MCV

?

TIBC, transferrin, RDW

·        
TIBC = total iron binding capacity.

 

 

Clinical
examination of pallor will be done. The colour of the mucus membrane
particularly those on the underside of the eyelid, in which blood supply is
close to the surface, provides an opportunity to   observe the pigmentation of the blood. A
pale mucous membrane is suggestive of anemia, whereas a more highly coloured
membrane usually occurs in persons with adequate hemoglobin levels.
Presence  of  any 
clinical  signs  of  
nutritional  deficiencies  especially   iron 
deficiency  anemia would be
specifically  looked . Pallor of palms, conjunctiva,
buccal cavity and nails has to be looked for . 
Anemia will be  graded  according 
to  hemoglobin levels and
pallor  as   mild , 
moderate , severe , and  extremely  severe . Each girl will be asked to report
the date of the beginning of her last menses, the length of her usual menstrual
cycle, and the number of days of bleeding. 

Inclusion
criteria:

school
going girls  of age 11 to 15 years.

Exclusion
criteria:

Girls
suffering from other infective chronic disease and other hemoglobinopathies.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Implications:-

 

 

·        
This
study highlights that anemia as a major public health problem in this
population. School-based interventions on identified associated factors are
important to reduce the burden of anemia among school adolescents.

 

·        
To
reduce the burden of iron deficiency anemia in pubertal age group before they
land up into severe iron deficiency. 

 

·        
The prospective study that would be conducted, will hold a
detailed reporting of patient’s findings. Thus will help concerned doctor for better
treatment regimen.

 

·        
This study will also conclude with statistics of disease
epidemiology i.e. Prevalence of disease in corresponding area in particular
span of time.

 

 

References:-