WJOA

Vimee Bindra 10.5005/jp-journals-10065-0003

Review Article

Anemia in Adolescence
Vimee Bindra

ABSTRACT RISK GROUPS FOR ADOLESCENT ANEMIA

Adolescent anemia is a global health problem. Prevalence of • Underweight and malnourished adolescents
anemia in girls in India is estimated to be around 56%. Various • Low dietary intake and increased demands due to
risk groups are prone to anemia and it leads to long-term growth spurt. Iron requirement peaks in adolescence
consequences. Government has launched national programs
to fight adolescent anemia by identifying high-risk groups,
due to rapid growth spurt and increase in blood
supplementing with iron and folic acid tablets and raising volume and lean body mass. The iron requirement
awareness about the nutritional anemia. increases form preadolescent levels of 0.7–0.9 to
Keywords: Adolescence, Anemia, Iron deficiency. 1.37–1.88 mg per day for adolescent boys and 1.40 to
3.27 mg per day for adolescent girls.5
How to cite this article: Bindra V. Anemia in Adolescence.
World J Anemia 2017;1(1):18-19. • Adolescents with chronic illness
• Heavy menstrual blood loss (>80 mL)
Source of support: Nil
• Obese and overweight adolescents (iron deficiency
Conflict of interest: None in these individuals may be due to low-quality food
and increased body requirements due to increased
INTRODUCTION weight.6
• Hand hygiene and worm infestation in India is also
The World Health Organization (WHO) defines adoles-
a major contributor of anemia in girls. One study has
cence as the period of life between 11 and 19 years.1 These
reported that one third of girls had worm infestation,7
are most formative years in terms of physical, intellectual,
and prevalence of anemia is almost double in these
emotional, psychological, and behavioral development.
girls as compared with girls who were not having
Also, this is the most vulnerable period for development
worm infestation.
of anemia, especially in adolescent girls. Iron deficiency
• Adolescent pregnancy is also one of the major risk
anemia (IDA) is a major public health concern both
factors for IDA. The culture of early marriage and
nationally and globally.2 Adolescent age group is also the
pregnancy further depletes their already low stores
opportunity for us to correct nutritional deficiencies to
of iron and folic acid. Social pressure does not allow
prevent the long-term consequences. Among adolescents,
them to delay first pregnancy after marriage and
girls are more vulnerable and more neglected as far as
majority of young adolescent girls conceive soon
their nutrition, health, education, and overall growth and
after marriage.
development is concerned.
ADVERSE EFFECTS OF ANEMIA IN
PREVALENCE OF ANEMIA
ADOLESCENCE
It has been estimated that the prevalence of anemia in
adolescent girls in India is around 56%, which means at As adolescent age is the formative years for develop-
any point of time 64 million adolescent girls are suffering ment, anemia at this stage of life has some long-term
from anemia.3 In India, various studies conducted in dif- consequences, such as
ferent regions show the prevalence of anemia as follows: • Stunted growth
Madhya Pradesh 52.5%, Gujarat 37%, Uttar Pradesh 56.3%, • Poor school performance, reduced attention span,
Andhra Pradesh 77.73%, Tamil Nadu 58.4%, Maharashtra memory loss, increased school drop-out rate
85.4%, Shimla 21.5%, Karnataka 41.5%.4 • Reduced immunity and increased infection rate
• Delay in onset of menarche and menstrual irregulari-
ties if already attained
Consultant • If anemic girl becomes pregnant, chances of intrauter-
Department of Gynaecology, Apollo Hospitals, Hyderabad ine growth restriction, low birth weight, increased
Telangana, India perinatal morbidity and mortality, and also increased
Corresponding Author: Vimee Bindra, Consultant, Department maternal morbidity and mortality8
of Gynaecology, Apollo Hospitals, Hyderabad, Telangana, India • Directly or indirectly it affects the national and economic
Phone: +917893996924, e-mail: vimee.bindra@gmail.com
growth as well. It can have economic implications and

18
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Anemia in Adolescence

can be estimated by the costs incurred to prevent this Assessment, prevention and control. A guide for pro-
condition, impact of maternal and infant morbidity and gramme managers; WHO 2001 – WHO/NHD/01.3
mortality, and also due to impaired mental development
and poor capital formation of the country. Prevention of Anemia in Adolescent Girls
(Source: www.cdc.gov)
HOW TO FIGHT ADOLESCENT ANEMIA?
• Encourage them to take iron-rich diets
It requires a multipronged approach to fight this multifac- • Guiding them in optimizing adequate iron-rich
torial disorder. Adolescence is the best time to intervene diets
not only because of growth and development but also • Screening of all nonpregnant women for anemia start-
because we can catch them easily through school health ing in adolescence every 5 to 10 years through routine
program involvement and get good results. health examinations
Strategic focus is very important to prevent IDA from • Screening of women who are at risk of IDA (heavy
the point of view of productivity gains from proper physi- menstrual bleeding, worm infestation, low-iron diets).
cal and mental development and improved pregnancy They should be screened annually.
outcomes, lesser economic burden, and more intergen-
erational benefits. Treatment of Anemia in adolescent Girls
(Source: www.cdc.gov)
ADOLESCENT ANEMIA CONTROL
• Counseling them for correction of anemia through
PROGRAMME (AACP)
iron-rich diets
To overcome the problem of adolescent anemia, the • Prescribing iron supplements 60 to 120 mg per day.
Government of India has launched National Programme • For cases of confirmed anemia, iron treatments should
for Control of Adolescent Anaemia in conjunction with continue for at least 2 to 3 months.
United Nations Children's Fund. • If after 4 weeks also, anemia does not respond in spite
of iron-rich food intake and adhering to treatment,
Objectives of AACP further evaluation is required.
• Providing iron and folic acid supplementation on a
REFERENCES
weekly basis
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Flow Chart 1 shows the strategies for prevention break the inter-generational cycle of malnutrition in India.
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World Journal of Anemia, January-March 2017;1(1):18-19 19