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OJHAS Vol. 9, Issue 2:
(2010 Apr - Jun) |
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| Nutritional Status
and Morbidity among School going Adolescents in Wardha, a Peri-Urban area |
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Dambhare
DG, Associate Professor,
Bharambe MS, Senior
lecturer,
Mehendale AM, Professor,
Garg BS, Professor & Head,
Department of
Community
Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram |
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Address For Correspondence |
Associate Professor,
Department of Community
Medicine,
Mahatma Gandhi Institute of Medical Sciences,
Sevagram – 442 102, Wardha,
Maharashtra, INDIA.
E-mail:
dharampal21@gmail.com |
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Dambhare DG, Bharambe MS, Mehendale AM, Garg BS. Nutritional Status
and Morbidity among School going Adolescents in Wardha, a Peri-Urban area. Online J Health Allied Scs.
2010;9(2):3 |
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Submitted: Mar 9, 2010;
Accepted:
Jul 12, 2010; Published: Jul 30, 2010 |
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| Abstract: |
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Objectives:
To assess the nutritional status and morbidity among the school going
adolescents in peri urban area Wardha. Materials and Methods:
The present study was conducted in the year 2008. 116 children in the
age group of 10 to 19 years studying in high school of peri urban area
Wardha were examined. Nutritional
status of the adolescents was assessed through weight for age (wasting)
and height for age (stunting) according to WHO criteria. Data was entered and analyzed by using
Epi Info 6.04 software package. Chi- square value was used for testing
statistical significance. Results: Mean age of the adolescents
was 13.16+ 1.99. 48.3% of the adolescents were found to be normal
and 51.7% were underweight. Early adolescents were at highest risk of
underweight significantly more 73.3% ( p < 0.05 ) as compared
to late adolescents 26.7%. Overall 34.5% of the adolescents were stunted
with boys suffering more 72.5% as compared to girls 27.5%. 28.45% of
the school going adolescents had anaemia with girls suffering
significantly
more 38.89% (p < 0.05) as compared to boys 23.75%. 35.34% adolescents
had dental caries. 13.79% adolescents were found to be suffering from
refractive error. 7.76% adolescents had worm infestation. 6.9%
adolescents
had skin problems. 2.59% adolescents had tonsillitis and 2.59% had wax
in the ear. Conclusion: The study shows the poor health and
nutritional
status among the adolescents. A periodical and regular health check-up
with concerted efforts towards their nutrition along with focused health
education will improve the health and nutritional status of these school
going adolescents in peri urban area Wardha.
Key Words: Adolescents, Anthropometry, Nutritional status.
Morbidity
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Adolescence
is a significant period of human growth and maturation. In India, adolescents
(10-19 years) constitute 21.4 percent of the population, comprising
one fifth of the total population.1 The
health and nutritional status of the children is an index of the
national
investment in the development of its future manpower.2
Therefore
comprehensive health care of this section will fulfils the health need
of 1/5 population. Achievement of optimum growth during this period
is of utmost importance in maintaining good health thereafter. Poor
nutrition among adolescents resulting in short stature and low lean
body mass is associated with many concurrent and future adverse health
outcomes. School health services provide an ideal platform to detect
the health problems early and treat them. Early detection of the
morbidities
through regular survey helps in prompt treatment and prevention of
serious
complications.3
Therefore this
study was carried out with the objective to assess the nutritional
status
and morbidity pattern among school going adolescents in Peri urban
area Wardha.
The present
study was conducted in the year 2008 in a peri urban school which is
the field practice area of department of community medicine, Mahatma
Gandhi Institute of Medical Sciences, Sewagram.116 children in the age
group of 10 to 19 years4 studying in high school of peri
urban area Wardha was examined by the team comprising of doctor, social
workers and school teachers through a scheduled visit. Informed consent
of the head of the institution was taken before the study. Information
was collected regarding any health complaints in the past or at present. Body
weight was measured (to the nearest 0.5 kg) with the subject standing
motionless on the weighing scale and with the weight distributed equally
on each leg. Height was measured (to the nearest 0.5 cm) with the
subject
standing in an erect position against a vertical scale and with the
head positioned so that the top of external auditory meatus was level
with the inferior margin of the bony orbit. Nutritional
status of the adolescents was assessed through weight for age
(underweight)
and height for age (stunting) according to WHO criteria.5 General examination of all the students
was carried out in good natural light. Anaemia was diagnosed from
clinical
signs such as presence of pallor on the conjunctiva, tongue and palm.
Wherever any health problem was detected, the teachers were met and
explained the problem and guided about the further course of action.
Referral was made for further management. Data thus generated was
entered
and analyzed using Epi Info 6.04 software package. Chi- square value was used
for testing statistical significance.
A total of
116 adolescents participated in the study. Out of them 80 (68.97%) were
boys and 36 (31.03%) were girls between the age of 10 to 19 years. Mean
age of the adolescents was 13.16+ 1.99. 48.3% of the adolescents
were found to be normal and 51.7% were malnourished as per their weight
for age. Early adolescents age group in which the growth spurt
takes place, were observed to be at highest risk of underweight
significantly
more 73.3% ( p < 0.05 ) as compared to late adolescents 26.7%
(Table 1). Overall 34.5% of the adolescents were stunted with boys
suffering
more 72.5% as compared to girls 27.5%. 67.5% early adolescents were
stunted as compared to 32.5% late adolescents (Table 2). Various
disorders observed among the adolescent are given in Table 3. 86.21%
adolescents were suffering from one or more illness at the time of
examination.
28.45% of the school going adolescents had anaemia with girls suffering
significantly more 38.89% (p < 0.05) as compared to boys 23.75%.
35.34% adolescents had dental caries. 13.79% adolescents were found
to be suffering from refractive error. 7.76% adolescents had worm
infestation
(on history). 6.9% adolescents had skin problems. 2.59% adolescents
had tonsillitis and 2.59% had wax in the ear.
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Table 1: Nutritional status
of adolescents (underweight) |
| Variables
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Nutritional
Status |
Total |
Percentage |
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Underweight |
Percentage |
Normal |
Percentage |
| Sex |
| Boys |
45 |
75 |
35 |
62.5 |
80 |
69 |
| Girls |
15 |
25 |
21 |
37.5 |
36 |
31 |
| Adolescents |
| Early
adolescent |
44 |
73.3 |
43 |
76.8 |
87 |
75 |
| Late
adolescent |
16 |
26.7 |
13 |
23.2 |
29 |
25 |
| Total |
60 |
51.7 |
56 |
48.3 |
116 |
100 |
| Significant difference x2
= 0.83, df = 1, p<0.05 |
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Table 2: Nutritional status
of adolescents (stunting)
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| Variables
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Nutritional
Status |
Total |
Percentage |
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Stunting |
Percentage |
Normal |
Percentage |
| Sex |
| Boys |
29 |
72.5 |
51 |
67.1 |
80 |
69 |
| Girls |
11 |
27.5 |
25 |
32.9 |
36 |
31 |
| Adolescents |
| Early
adolescent |
27 |
67.5 |
60 |
78.9 |
87 |
75 |
| Late
adolescent |
13 |
32.5 |
16 |
21.1 |
29 |
25 |
| Total |
40 |
34.5 |
76 |
65.5 |
116 |
100 |
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Table 3:
Morbidity pattern among adolescents |
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Diseases |
Boys (n=80) |
Girls (n=36) |
Total (n=116) |
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No |
% |
No |
% |
No |
% |
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Nutrition |
Anaemia |
19 |
23.75 |
14 |
38.89 |
33 |
28.45 |
| Vit A
deficiency |
0 |
0 |
1 |
2.78 |
1 |
0.86 |
| Vit B complex
deficiency |
10 |
12.5 |
7 |
19.44 |
17 |
14.66 |
|
ENT |
Tonsillitis |
3 |
3.75 |
0 |
0 |
3 |
2.59 |
| Pharyngitis |
4 |
5 |
5 |
13.89 |
5 |
4.31 |
| CSOM |
1 |
1.3 |
0 |
0 |
1 |
0.86 |
| Wax in ear |
2 |
2.5 |
1 |
2.78 |
3 |
2.59 |
|
Eye |
Refractive error |
9 |
11.25 |
7 |
19.44 |
16 |
13.79 |
| Conjunctivitis |
2 |
2.5 |
0 |
0 |
2 |
1.72 |
|
Skin |
Pyoderma |
4 |
5 |
1 |
2.78 |
5 |
4.31 |
| Fungal
infection |
2 |
2.5 |
1 |
2.78 |
3 |
2.59 |
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Dental |
Caries |
32 |
40 |
9 |
25 |
41 |
35.34 |
|
Abdomen |
Worm infestation |
5 |
6.25 |
4 |
11.11 |
9 |
7.76 |
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Respiratory |
Bronchial Asthma |
1 |
1.3 |
0 |
0 |
1 |
0.86 |
Adolescence
is a period of increased nutritional requirements and adolescent
anthropometry
varies significantly worldwide.4,6,7
Undernutrition is documented public health problem contributing
substantially
to children’s survival.8 All
the school going adolescents in the age groups of 10 – 19 years were
examined in this study. There is a significant difference (P < 0.05)
between in the age of boys and girls. The mean age of boys (13.40 years)
was significantly higher than the girls (12.61 years).
The
mean height of the adolescents of the present study
was higher but the mean weight and mean BMI of the adolescents was lower than those
reported by Mukhopadhyay
et al, among
urban adolescents of Kolkata.9 The mean height and mean
body weights in the present study (in different ages and sexes) was
far lower than the median values of NCHS standards.10 Saha
Sudip Kumar et al11 reported 32.3% urban school girls were
in the normal range while 65.3% were overweight or obese. In the present
study 48.3% of the adolescents were normal, nobody was overweight or
obese and 51.7%
were undernourished. The extent of undernutrition was higher than those
among Nepali refugees reported by Woodruff et al,12-14
but lower than those reported by one Indian study (53%)13
and two Kenyan studies (61%)15 and (57%).16
Nutritional
deficiency related health problems were strikingly high in the present
study. Overall 28.45% of the school going adolescents had anaemia with
girls suffering significantly more 38.89% (p < 0.05) as compared
to boys 23.75%. Panda et al3 also observed the similar
results
for anaemia among adolescents. Several studies had reported anaemia
almost similar to the present study.3,17-19
Avitaminosis
manifested by adolescents was also high in the present study but notably
absent in the urban girls.7 35.34% adolescents in the present
study had dental caries as compared to that in Ludhiana city.3,19
These problems can be solved by school based programs, health education,
and food fortification. The problem of anemia needs to be tackled with
education, food fortification, routine antihelminthic, iron therapy
and treatment of other chronic infections. Otherwise these problems
would have long-term ill effects on the nutritional status and morbidity
pattern of school going adolescents in peri -urban area Wardha.
The health
and nutritional status among the adolescents was found to be low, more
so in girls than boys. The prevalence of underweight 51.7% and stunting
34.5% in these adolescent was high. Overall 28.45% adolescents had
anaemia,
more in girls 38.89% as compared to boys 23.75%. Malnutrition and
anaemia
make the children more susceptible to infection.
The study shows
the poor health and nutritional status among the adolescents. A
periodical
and regular health check-up with concerted efforts towards their
nutrition
along with focused health education will improve the health and
nutritional
status of these school going adolescents in peri urban area Wardha.
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- Goyal RC, Chavan UA.
Health status of school children in Ahmednagar city. Indian J of
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- Panda P, Benjamin AI, Singh S, Zachariah P. Health status of school children in Ludhiana
city. Indian J of Community Medicine.
Oct – Dec 2000;Vol. XXV(4):150–155.
- World
Health Organization: Physical Status: The Use and Interpretation of
Anthropometry. Technical Report Series No. 854. World Health
Organization, Geneva (1995).
- World
Health Organization: Measuring nutritional status. World Health
Organization,
Geneva (1983).
- Bhadra
M, Mukhopadhyay A, Bose K. Body mass index, regional adiposity
and central body fat distribution among Bengalee Hindu girls: A
Comparative
Study of Premenarcheal and Menarcheal Subjects. Acta. Med. Auxol. 2001;33:39–45.
- Himes JH, Bouchard C, Validity of anthropometry in classifying youths
as obese. Int. J. Obes. 1989;13:183-193.
- Rahmathullah
L, Underwood BA, Thulasiraj RD, Milton RC, Ramaswamy K, Rahmathullah R, Babu,G. Reduced mortality among children in
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India receiving a small weekly dose of vitamin A. N. Engl. J. Med.,
1990;323:929–935.
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Bhadra M, Bose K. Anthropometric
Assessment of Nutritional Status of Adolescents of Kolkata, West
Bengal.
J. Hum. Ecol., 2005;18(3):213-216.
- Hamill
PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM.
Physical
growth: National Center for Health Statistics percentiles. American
Journal of Clinical Nutrition 1979;32:607-629.
- Saha SK,
Bag T, De AK, Basak S, Biswas SC, Ghosh RSC. Adolescent girls’ health profile in
sub-Himalayan
region of West Bengal. J Obstet Gynecol India.
July/August 2006;56(4):329-332
- Woodruff
BA, Duffield A, Blanck H, Larson MK, Pahari S, Bhatia
R. Prevalence of Low Body Mass Index and Specific Micronutrient
Deficiencies
in Adolescents 10-19 y of Age in Bhutanese Refugee Camps, Nepal,
October
1999. Centers for Disease Control and Prevention, Atlanta. 1999.
- Kurz KM, Adolescent nutritional status in developing countries. Proc.
Nutr. Soc., 1996;55:321-331.
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F, Zareen M, Khan MR, Banu CP, Haq MN, Jackson AA.
Dietary patterns, nutrient intake and growth of adolescent school
girls
in urban Bangladesh. Pub. Health Nutr., 1998;1:83-92.
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ST, Woodruff BA, Slutsker L. Prevalence of anemia and low
body mass index among adolescents 10-19 y of age in refugee camps in Dadaab District, Kenya. Centers for Disease Control and Prevention.
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- Woodruff
BA, Slutsker L, Cook ST. Prevalence of anemia and low body
mass index in adolescents 10-19 y age in Kakuma camp, Kenya.
Centers for Disease Control and Prevention. Atlanta. 1998.
- Gangadharan M.
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Pediatrics, 1977;14(8):603–613.
- Gopalan C,
Kaur H. Towards better nutrition – problems and policies. Nutrition
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- Panda P, Benjamin AI,
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