The Prevalence Of Anemia Health And Social Care Essay

2453 words (10 pages) Essay

1st Jan 1970 Health And Social Care Reference this

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Review of literature is an important step in the development of research project and in broadening the understanding and developing an insight into the problem area. It further help in developing the broad context in which the problem fits, methodology, instruction of tool, development of evaluative approach and analysis of data.

Literature review is a critical summary of research on a topic of interest often prepared to put a research problem in context. (Denise.F.Polit, 2011)

The review of literature in this chapter is presented under the following headings.

Literature related to prevalence of anemia

Literature related to treatment of anemia

Literature related to effectiveness of beetroot pulp on anemia

1. Literature related to prevalence of anemia

A cross sectional study was conducted for a period of one year to determine the prevalence and severity of anemia among adolescent girls in rural areas of Vantamuri PHC, Belgaum. 840 adolescent girls were selected for the study by using convenience sampling technique. Information was obtained by demographic variables and the blood samples were analyzed by automated cell counter. The study result showed that the prevalence of anemia was 41.1%, among them majority of adolescent girls had mild anemic. The prevalence of anemia was considerably high among adolescent girls who belonged to the low socioeconomic status. There was a significant association of anemia with the socioeconomic status at (p<0.05). (Shilpa S, Biradar et al, 2012)

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A cross sectional study was conducted to acquire information on the current status of anemia among adolescent girls. A sample of 1269 were selected by random sampling method. Information was obtained by complete blood count, anthropometry, and socioeconomic characteristics. Anemia was differentiated by the application of Bess man’s and Green and King’s index classification. Result showed that the prevalence of microcytic anemia was 59.1% and 35.8% was iron deficiency anemia. (Htet MK, Dilton D, et. al, 2012)

A cross sectional study was conducted to investigate the prevalence and risk factors of anemia and iron deficiency anemia among adolescent girls. Total of 363 adolescent school girls were selected by using random sampling method. Socioeconomic, demographic and related risk factors were obtained by a questionnaire. Hematological parameters and serum iron indices were measured. There were 21 cases of anemia (5.8%), and 37(10.2%) iron deficiency anemia. Most of the adolescent girls were mild anemic (85.7%) MCV, TBC, age and BMI had statistically significant relationship with hemoglobin. Only parasite infestation in the last 3 months had a 6.83 times more risk of anemia than those without this history (95%,CI:1.66-28.11). The result showed that prevalence of anemia was significant (p<0.05) among adolescent school girls. (Ramzi M, Haghpanah S, et al, 2011)

A cross sectional study was conducted in selected Anganwadi centres of rural area of Hassan district to estimate the prevalence of anemia among adolescent girls and to study the socio demographic factors associated with anemia. 14 adolescent girls (10-19years) were selected for this study. Data analysis was done by using the proportions and chi-square test. The study results showed that the prevalence of anemia was found to be 45.2%. Among them 40.1% had mild anemia, 54.92% had moderate anemia and 4.92% had severe anemia. A statistically significant association was found with iron deficiency anemia, weight loss and anemia, pallor and anemia. A high prevalence of anemia among adolescent girls was found, which was higher in low socio economic strata. (Siddha ram SM, et.al, 2011)

A cross sectional study was conducted to estimate the prevalence of anemia among adolescent girls and to study the socio-demographic factors associated with anemia. A total of 296 adolescent girls were selected for this study. Statistical analyses were done by using percentage, standard error of proportion, chi-square test and t test. Result showed that the prevalence of anemia was found to be 35.1% at (p<0.05).A significant association of anemia was found with socioeconomic status and literacy status of parents. Mean weight and height of subjects with anemia was significantly less than subjects without anemia. Study concludes that high prevalence of anemia among adolescent girls was found, which was higher in the low socio economic strata and among those whose parents were less educated. (Sanjeev M Chaudhary et.al, 2008)

An analytical study was conducted to assess the anemia among Indian adolescent girls under the project by Health and Family Welfare Bureau. Blood collection was done and serum ferritin, peripheral blood smear and hemoglobin test were done and analysis was carried out. The result showed that in India severe anemia ranges from 1.6% to 11.7% among adolescent girls, moderate anemia seen in rural area were more (38%) than in urban (11.9%) area (P< 0.05). He concluded that the adolescent girls are vulnerable to iron deficiency anemia, which interferes in their physical capacity and work performance. Adolescent period is the preparatory period for the physical development for the future mothers. The young reproductive age group women are more susceptible to anemia, because of their poor dietary intake. (Dreyfuss et al., 2007)

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A cross sectional study was conducted to assess the anemia among adolescent girls in South India. 100 adolescent girls were selected between the age group of 11 to 18 years by purposive sampling method. Blood samples were collected and blood test was done by Hemoglobinometer. The result showed that 29% of adolescent girls were affected with severe anemia, rest of them had mild anemia 71% (p<0.05). Anemia has significant association with low socio economic status, religion and reporting of infrequent and non consumption of meat. He concluded that the hemoglobin status of the adolescent girls needs to be improved through dietary modifications along with the iron supplements and nutritional education. (Choudary et al,2007)

2. Literature related to treatment of anemia

An experimental study was conducted to investigate the effectiveness of low dose once weekly iron supplementation in adolescent girls. The study was community based randomized, supplementation trial. The samples of the study were 193 female high school children aged between 14-16 years. They were randomly selected and assigned into either iron supplemented group (ISG) or iron unsupplemented group (IUG). Iron supplementation group received 150mg ferrous sulfate once weekly for 16weeks, whereas the Iron unsupplemented group did not receive any treatment. Hematological parameters were measured and compared between two groups before and after the intervention. There was no significant difference between the initial measures of the two groups before the intervention. After 16 weeks of intervention mean of hemoglobin and ferritin improved significantly in ISG compared to IUG. At the beginning of the study, percent of anemia and IDA in ISG were 12.5%, 8.3% and whereas IUG percent of anemia and IDA were 14.4%, 10.3% which were not significantly difference between the two groups. After the intervention percent of anemia and IDA in ISG were 2.1% and 0%. The result shows that once a week supplementation of 150mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescent girls and effectively treated Iron deficiency anemia. (Mozaffari-Khosravi.H, 2010)

A quasi experimental study was conducted to evaluate the impact of iron intensive dietary program for the treatment of iron deficiency anemia among adolescent girls at benin. 34 adolescent girls for experimental group and 34 adolescent girls for control group were selected between the age group of 12 to 17 years by random sampling method. Data were obtained from both groups by nutrition knowledge, questionnaire, 24 hours dietary recalls and anthropometric measurement. Nutrition education combined with an increase in content of bioavailability of dietary iron for 22 weeks was implemented only in experimental group not in the control group. The study result showed that mean hemoglobin and serum ferritin values were significantly higher in the experimental group than in the control group and also the prevalence of anemia were significantly lower in the experimental group (85%) than the control group (56%). ( Alaofe. H et al,2009)

A pre experimental study was conducted to determine the effectiveness of diet plan administration on anemia among adolescent girls in selected school at Indore. Pre experimental one group pretest-post test design was adopted for this study. A sample of 47 adolescent girls were selected by using purposive sampling and data was collected by socio demographic proforma and Hemoglobinometer. By following pretest administered antihelminthic agent (Mebendazole 100mg) BD for three days and diet plan for 15 days than posttest was conducted. The mean pretest Hb level was found to be 8.43gm/dl whereas mean post test Hb level was found to be 8.81 gm/dL. The t value computed (t=4.58) showed that significant difference suggesting that the antihelminthic and diet plan was effective in increasing the Hb level. (Ms. Seema Yadav.2008)

A double blind placebo controlled study was conducted to evaluate the efficacy of multiple fortified beverages which containing eleven nutrients at physiological levels in prevention of anemia and improving iron and vitamin A status during adolescent period ,259 adolescent girls were selected for the study. The subjects were divided into two groups fortified (n=129), non- fortified (n=130) groups. Fortified and non- fortified orange flavored drinks provided in two self – administered servings per day for eight weeks. After 8 weeks of supplementation the fortified had a significantly higher hemoglobin increase of 0.86g/dl compared to 0.45g/dl in the non-fortified group p<0.0001. The risk of the anemic at the end of the study for those in the fortified group was reduced by 51% (RR=0.49.CI=0.28 to 0.85). Iron stores increased by 3 micro g/l in the fortified group (p=0.02) and a decrease of 2 micro g/l in the non -fortified group. The study result showed that the multiple micro nutrient fortified beverages given for 8 weeks of adolescent girls improved their hemoglobin serum ferritin and retinal status. (Tatala.SR, Ash. D, et.al, 2004)

A quasi experimental study was conducted to assess the nutritional intervention for iron deficiency anemia among adolescent girls in Parbhani. 70 adolescent girls were selected between the age group of 12-18 years by using purposive sampling technique. Anemia was assessed by clinical signs and symptoms and Hemoglobinometer. Supplementations were administered to them for 90 days, after that post test was done. The study result shows that in clinical examination, initially 82.5% of the adolescent girls were anemic. At the end of the study there was a decrease in the prevalence of anemia (48%), among experimental group. There was no significant difference in the control group. There was a significant improvement seen (p<0.001) after intervention. (Vijaya et.al,2001)

3. Literature related to effectiveness of beetroot pulp on anemia

A pre experimental study was conducted to assess the effectiveness of beetroot extract on anemia among adolescent girls at selected school Mysore. 60 samples were selected between the age group of 14 and 16 years by convenience sampling technique. Levels of anemia were assessed by clinical, physiological signs and symptoms before and after administration of intervention. Beetroot juice was administered (100ml) for 20 days. After that post test was assessed there was a significant improvement in the hemoglobin level (82%) p<0.01. (Jagadeesh, 2010)

A pre experimental study was conducted to assess the effectiveness of beetroot extract on anemia among adolescent girls. 60 samples were selected between the age group of 13 and 17 years by using purposive sampling technique. Information was obtained by demographic proforma, clinical variables, checklist for signs and symptoms of anemia, structured questionnaire and satisfactory scale for the administration of beetroot extract. Before the administrations of beetroot extract many of them (43.3%) were moderately anemic and (55%) had mild degree of signs and symptoms of anemia, whereas after the administration of beetroot extract (38.30%) of the girls had mild anemic and majority of them (98.8%) had mild degree of signs and symptoms. The level of hemoglobin before the administration of beetroot extract among adolescent girls were low (M= 9.317, SD=1.25) and after the administration of beetroot extract it got increased (M=1.04, SD=1.40). The difference was significantly proven at p<0.001 level. (Sherin Nithya.S,2009)

A pre experimental study was conducted to assess the effectiveness of Beetroot extract upon anemia in Washington. In which 105 adolescents were selected as samples by random sampling method and Blood samples were collected from them, before and after the intervention by Cyanmethaemoglobin method. Beetroot extract was given once in a day for 25 days. The result showed that 76% of adolescents were anemic before the administration of beet root extract. There was significant improvement in the hemoglobin level after the administration of beetroot extract (82%) of the study population (P=0.05). He concluded that vegetarians are at higher risk of developing iron deficiency anemia than non-vegetarians. Vegetarians have to take higher quality of iron rich foods in higher quantity and beetroot has a significant positive impact on the iron storage in the human body. (Jeminar, 2003)

An experimental study was conducted to assess the effectiveness of beetroot juice in anemia correction in Indonesia. 105 school children with iron deficiency anemia were selected, aged from 11-18 years, experimental and control groups were allocated by random sampling method. Beetroot juice (100 ml) was given by oral up to 20 days to the experimental group. Hemoglobin level was checked at pre and post intervention by using Sahlis Hemoglobinometer. There was significant improvement in the hemoglobin level (79.72%) of the experimental group (p < 0.001) than the control group (p < 0.05). He concluded that the intake of beetroot juice has significant character in reducing the prevalence of iron deficiency in adolescents. (Fritz et al., 2002)

Review of literature is an important step in the development of research project and in broadening the understanding and developing an insight into the problem area. It further help in developing the broad context in which the problem fits, methodology, instruction of tool, development of evaluative approach and analysis of data.

Literature review is a critical summary of research on a topic of interest often prepared to put a research problem in context. (Denise.F.Polit, 2011)

The review of literature in this chapter is presented under the following headings.

Literature related to prevalence of anemia

Literature related to treatment of anemia

Literature related to effectiveness of beetroot pulp on anemia

1. Literature related to prevalence of anemia

A cross sectional study was conducted for a period of one year to determine the prevalence and severity of anemia among adolescent girls in rural areas of Vantamuri PHC, Belgaum. 840 adolescent girls were selected for the study by using convenience sampling technique. Information was obtained by demographic variables and the blood samples were analyzed by automated cell counter. The study result showed that the prevalence of anemia was 41.1%, among them majority of adolescent girls had mild anemic. The prevalence of anemia was considerably high among adolescent girls who belonged to the low socioeconomic status. There was a significant association of anemia with the socioeconomic status at (p<0.05). (Shilpa S, Biradar et al, 2012)

A cross sectional study was conducted to acquire information on the current status of anemia among adolescent girls. A sample of 1269 were selected by random sampling method. Information was obtained by complete blood count, anthropometry, and socioeconomic characteristics. Anemia was differentiated by the application of Bess man’s and Green and King’s index classification. Result showed that the prevalence of microcytic anemia was 59.1% and 35.8% was iron deficiency anemia. (Htet MK, Dilton D, et. al, 2012)

A cross sectional study was conducted to investigate the prevalence and risk factors of anemia and iron deficiency anemia among adolescent girls. Total of 363 adolescent school girls were selected by using random sampling method. Socioeconomic, demographic and related risk factors were obtained by a questionnaire. Hematological parameters and serum iron indices were measured. There were 21 cases of anemia (5.8%), and 37(10.2%) iron deficiency anemia. Most of the adolescent girls were mild anemic (85.7%) MCV, TBC, age and BMI had statistically significant relationship with hemoglobin. Only parasite infestation in the last 3 months had a 6.83 times more risk of anemia than those without this history (95%,CI:1.66-28.11). The result showed that prevalence of anemia was significant (p<0.05) among adolescent school girls. (Ramzi M, Haghpanah S, et al, 2011)

A cross sectional study was conducted in selected Anganwadi centres of rural area of Hassan district to estimate the prevalence of anemia among adolescent girls and to study the socio demographic factors associated with anemia. 14 adolescent girls (10-19years) were selected for this study. Data analysis was done by using the proportions and chi-square test. The study results showed that the prevalence of anemia was found to be 45.2%. Among them 40.1% had mild anemia, 54.92% had moderate anemia and 4.92% had severe anemia. A statistically significant association was found with iron deficiency anemia, weight loss and anemia, pallor and anemia. A high prevalence of anemia among adolescent girls was found, which was higher in low socio economic strata. (Siddha ram SM, et.al, 2011)

A cross sectional study was conducted to estimate the prevalence of anemia among adolescent girls and to study the socio-demographic factors associated with anemia. A total of 296 adolescent girls were selected for this study. Statistical analyses were done by using percentage, standard error of proportion, chi-square test and t test. Result showed that the prevalence of anemia was found to be 35.1% at (p<0.05).A significant association of anemia was found with socioeconomic status and literacy status of parents. Mean weight and height of subjects with anemia was significantly less than subjects without anemia. Study concludes that high prevalence of anemia among adolescent girls was found, which was higher in the low socio economic strata and among those whose parents were less educated. (Sanjeev M Chaudhary et.al, 2008)

An analytical study was conducted to assess the anemia among Indian adolescent girls under the project by Health and Family Welfare Bureau. Blood collection was done and serum ferritin, peripheral blood smear and hemoglobin test were done and analysis was carried out. The result showed that in India severe anemia ranges from 1.6% to 11.7% among adolescent girls, moderate anemia seen in rural area were more (38%) than in urban (11.9%) area (P< 0.05). He concluded that the adolescent girls are vulnerable to iron deficiency anemia, which interferes in their physical capacity and work performance. Adolescent period is the preparatory period for the physical development for the future mothers. The young reproductive age group women are more susceptible to anemia, because of their poor dietary intake. (Dreyfuss et al., 2007)

A cross sectional study was conducted to assess the anemia among adolescent girls in South India. 100 adolescent girls were selected between the age group of 11 to 18 years by purposive sampling method. Blood samples were collected and blood test was done by Hemoglobinometer. The result showed that 29% of adolescent girls were affected with severe anemia, rest of them had mild anemia 71% (p<0.05). Anemia has significant association with low socio economic status, religion and reporting of infrequent and non consumption of meat. He concluded that the hemoglobin status of the adolescent girls needs to be improved through dietary modifications along with the iron supplements and nutritional education. (Choudary et al,2007)

2. Literature related to treatment of anemia

An experimental study was conducted to investigate the effectiveness of low dose once weekly iron supplementation in adolescent girls. The study was community based randomized, supplementation trial. The samples of the study were 193 female high school children aged between 14-16 years. They were randomly selected and assigned into either iron supplemented group (ISG) or iron unsupplemented group (IUG). Iron supplementation group received 150mg ferrous sulfate once weekly for 16weeks, whereas the Iron unsupplemented group did not receive any treatment. Hematological parameters were measured and compared between two groups before and after the intervention. There was no significant difference between the initial measures of the two groups before the intervention. After 16 weeks of intervention mean of hemoglobin and ferritin improved significantly in ISG compared to IUG. At the beginning of the study, percent of anemia and IDA in ISG were 12.5%, 8.3% and whereas IUG percent of anemia and IDA were 14.4%, 10.3% which were not significantly difference between the two groups. After the intervention percent of anemia and IDA in ISG were 2.1% and 0%. The result shows that once a week supplementation of 150mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescent girls and effectively treated Iron deficiency anemia. (Mozaffari-Khosravi.H, 2010)

A quasi experimental study was conducted to evaluate the impact of iron intensive dietary program for the treatment of iron deficiency anemia among adolescent girls at benin. 34 adolescent girls for experimental group and 34 adolescent girls for control group were selected between the age group of 12 to 17 years by random sampling method. Data were obtained from both groups by nutrition knowledge, questionnaire, 24 hours dietary recalls and anthropometric measurement. Nutrition education combined with an increase in content of bioavailability of dietary iron for 22 weeks was implemented only in experimental group not in the control group. The study result showed that mean hemoglobin and serum ferritin values were significantly higher in the experimental group than in the control group and also the prevalence of anemia were significantly lower in the experimental group (85%) than the control group (56%). ( Alaofe. H et al,2009)

A pre experimental study was conducted to determine the effectiveness of diet plan administration on anemia among adolescent girls in selected school at Indore. Pre experimental one group pretest-post test design was adopted for this study. A sample of 47 adolescent girls were selected by using purposive sampling and data was collected by socio demographic proforma and Hemoglobinometer. By following pretest administered antihelminthic agent (Mebendazole 100mg) BD for three days and diet plan for 15 days than posttest was conducted. The mean pretest Hb level was found to be 8.43gm/dl whereas mean post test Hb level was found to be 8.81 gm/dL. The t value computed (t=4.58) showed that significant difference suggesting that the antihelminthic and diet plan was effective in increasing the Hb level. (Ms. Seema Yadav.2008)

A double blind placebo controlled study was conducted to evaluate the efficacy of multiple fortified beverages which containing eleven nutrients at physiological levels in prevention of anemia and improving iron and vitamin A status during adolescent period ,259 adolescent girls were selected for the study. The subjects were divided into two groups fortified (n=129), non- fortified (n=130) groups. Fortified and non- fortified orange flavored drinks provided in two self – administered servings per day for eight weeks. After 8 weeks of supplementation the fortified had a significantly higher hemoglobin increase of 0.86g/dl compared to 0.45g/dl in the non-fortified group p<0.0001. The risk of the anemic at the end of the study for those in the fortified group was reduced by 51% (RR=0.49.CI=0.28 to 0.85). Iron stores increased by 3 micro g/l in the fortified group (p=0.02) and a decrease of 2 micro g/l in the non -fortified group. The study result showed that the multiple micro nutrient fortified beverages given for 8 weeks of adolescent girls improved their hemoglobin serum ferritin and retinal status. (Tatala.SR, Ash. D, et.al, 2004)

A quasi experimental study was conducted to assess the nutritional intervention for iron deficiency anemia among adolescent girls in Parbhani. 70 adolescent girls were selected between the age group of 12-18 years by using purposive sampling technique. Anemia was assessed by clinical signs and symptoms and Hemoglobinometer. Supplementations were administered to them for 90 days, after that post test was done. The study result shows that in clinical examination, initially 82.5% of the adolescent girls were anemic. At the end of the study there was a decrease in the prevalence of anemia (48%), among experimental group. There was no significant difference in the control group. There was a significant improvement seen (p<0.001) after intervention. (Vijaya et.al,2001)

3. Literature related to effectiveness of beetroot pulp on anemia

A pre experimental study was conducted to assess the effectiveness of beetroot extract on anemia among adolescent girls at selected school Mysore. 60 samples were selected between the age group of 14 and 16 years by convenience sampling technique. Levels of anemia were assessed by clinical, physiological signs and symptoms before and after administration of intervention. Beetroot juice was administered (100ml) for 20 days. After that post test was assessed there was a significant improvement in the hemoglobin level (82%) p<0.01. (Jagadeesh, 2010)

A pre experimental study was conducted to assess the effectiveness of beetroot extract on anemia among adolescent girls. 60 samples were selected between the age group of 13 and 17 years by using purposive sampling technique. Information was obtained by demographic proforma, clinical variables, checklist for signs and symptoms of anemia, structured questionnaire and satisfactory scale for the administration of beetroot extract. Before the administrations of beetroot extract many of them (43.3%) were moderately anemic and (55%) had mild degree of signs and symptoms of anemia, whereas after the administration of beetroot extract (38.30%) of the girls had mild anemic and majority of them (98.8%) had mild degree of signs and symptoms. The level of hemoglobin before the administration of beetroot extract among adolescent girls were low (M= 9.317, SD=1.25) and after the administration of beetroot extract it got increased (M=1.04, SD=1.40). The difference was significantly proven at p<0.001 level. (Sherin Nithya.S,2009)

A pre experimental study was conducted to assess the effectiveness of Beetroot extract upon anemia in Washington. In which 105 adolescents were selected as samples by random sampling method and Blood samples were collected from them, before and after the intervention by Cyanmethaemoglobin method. Beetroot extract was given once in a day for 25 days. The result showed that 76% of adolescents were anemic before the administration of beet root extract. There was significant improvement in the hemoglobin level after the administration of beetroot extract (82%) of the study population (P=0.05). He concluded that vegetarians are at higher risk of developing iron deficiency anemia than non-vegetarians. Vegetarians have to take higher quality of iron rich foods in higher quantity and beetroot has a significant positive impact on the iron storage in the human body. (Jeminar, 2003)

An experimental study was conducted to assess the effectiveness of beetroot juice in anemia correction in Indonesia. 105 school children with iron deficiency anemia were selected, aged from 11-18 years, experimental and control groups were allocated by random sampling method. Beetroot juice (100 ml) was given by oral up to 20 days to the experimental group. Hemoglobin level was checked at pre and post intervention by using Sahlis Hemoglobinometer. There was significant improvement in the hemoglobin level (79.72%) of the experimental group (p < 0.001) than the control group (p < 0.05). He concluded that the intake of beetroot juice has significant character in reducing the prevalence of iron deficiency in adolescents. (Fritz et al., 2002)

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