Socioeconomic determinants of severe anemia and assessment for iron and vitamin B12 deficiency among anemic adolescents

Abstract

Background: Adolescence is the period of most rapid growth due to which they face serious nutritional challenges and make them more vulnerable to anemia. Anemia in the adolescence has a negative effect on their growth & development. Objectives: To study demographic, socioeconomic factors associated with severe anemia, to evaluate Iron and Vitamin B12 deficiency as cause of anemia and to associate serum levels of ferritin and vitamin B12 with severity of anemia in adolescents. Methods: Across sectional hospital based observational study done among 212 adolescents (10-18 years) with anemia. Complete history was taken. Serum levels of ferritin, vitamin B12 were estimated. Statistical analysis was done by Chi-square test, "t" test and Mann Whitney U test. Results: 40.56% participant had mild, 48.58% had moderate and 10.84% had severe anemia. Statistically significant association was seen between severe anemia and educational status of mother (p = 0.0416); participant (p=0.0002) and vegetarianism (p=0.0084). Severely anemic participants had significantly low BMI (p=0.0097), delayed age of menarche (p=0.020) and high MCV values (p=0.000018) as compared to mild to moderately anemic participants. Among severe anemia 47.82% iron deficiency and 60.86% vitamin B12 deficiency was seen. Severely anemic subjects were more likely to have combined iron and vitamin B12 deficiency (39.12%, p=0.0027). Low vitamin B12 level was significantly associated with severe anemia (p=0.008). Conclusion: Educational status and vegetarianism were significant determinant of severe anemia. Significant association of low vitamin B12 level with severe anemia was seen.