Prevalence of Undernutrition and Anemia among Santal Adivasi Children, Birbhum District, West Bengal, India

Abstract

India’s Adivasi scheduled tribe population is disproportionately affected by undernutrition and anemia, thereby prevailing in the poorest wealth deciles denominated as socially and economically vulnerable. This study was designed to assess the extent of child undernutrition (conventional and composite index of anthropometric failure (CIAF) classification), as well as the burden of anemia in children and its independent nutrition specific and sensitive drivers, moreover to reflect the living conditions of Santal Adivasis. The research survey was conducted in 21 Santal villages, Birbhum District, West Bengal, in 2015. An overall 307 children (aged 6–39 months) and their mothers (n = 288) were assessed for their hemoglobin (Hb) levels (HemoCue Hb201+) and anthropometric indices such as height/length, weight and mid-upper arm circumference (MUAC). Moreover, socio-demographic household characteristics were surveyed. The study confirmed Adivasi children lagging behind national average with a high prevalence of undernutrition (height-for-age z-score (HAZ) 51.9%, weight-for-age z-score (WAZ) 49.2%, weight-for-height z-score WHZ 19.0% and CIAF 61.6%) and of moderate and severe anemia (Hb < 10 g/dL, 73.3% altogether). Child’s age <24 months, low WAZ scores, morbidity (any fever, diarrhea or respiratory infection) on the checkup day or during previous week, low maternal Hb level, and lack of dietary diversification were identified as predictors for anemia, thereby warrant targeted interventions to decrease the high anemia rates assessed in the study site.

Effect of diversified meals only, or either enriched with Amaranthus tricolor and Moringa oleifera leaf powder or commercial micronutrient powder on prevention/treatment of anemia in Adivasi children, West Bengal, India

“…dry eyes -wavy strucutre of eyeball, Bitot´s spot (vitamin A); skin lesions, pigmentation, rough skin, perlèche (vitamin B-complex); the supplementation was performed in a defined way). The incidence of symptomatic micronutrient deficiencies during baseline assessment is outlined in a previous publication [24], chi-square analysis showed comparability (p>0.05) across the study groups (not presented). Enrolled children allocated to the four study arms were assessed in the same manner (i.e.…”

“…Children aged 6-36 months at baseline assessment were the study's primary target group (due to reasons of sample size extended to 39 months). For further information on population data and response rate at baseline please see previous publication [24]. At baseline assessment a total of n=307 children were analyzed with the subsequent inclusion of n=293 children (6-39 months) in the feeding trial.…”

“…Data on socio-demographic characteristics including maternal educational level, cash income, agricultural assets, or infant and young child feeding and caring practices were collected in form of a semi-structured questionnaire conducted by trained field workers. For further details please see previous publication to baseline assessment [24].…”

“…At each checkup children were dewormed (albendazol/mebendazol) in order to reduce the risk of iron deficiency anemia due to worm infestation. For details on the assessment, computing and interpretation of Hb and anthropometric outcome variables (MUAC, weight, height, length) please see previous publication to baseline assessment [24].…”

“…Merely the prevalence of respiratory infections (comparable across groups at baseline) was significantly different between the study groups at 2 nd (p=0.006), and 3 rd (p=0.002) assessment ( Figure 6), respectively. Baseline data ( [24]) revealed the morbidity prevalence (fever, respiratory infections, diarrhea) to be highly agedependent, with children aged 12 to 23 months being most vulnerable to morbidity, with continuous decline thereafter. As the age distribution was comparable across study groups, the observed higher decreases in the prevalence of respiratory infections (from 69.7% to 33.3%) for IG3 may be related to the higher zinc intakes amongst beneficiaries of this intervention arm.…”