Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives

Objective: Anemia is a serious public health problem in Indian school children. Since 2003, simple health intervention programs such as antihelminthic treatment and vitamin A supplementation have been implemented in primary schools in the Bangalore region, Karnataka, India. This study examines the prevalence of anemia in school children who are beneficiaries of this program. Design: Cross-sectional survey. Setting: Bangalore district, South India. Subjects: A total of 2030 boys and girls, aged 5-15 years, attending schools in the Bangalore district. Interventions: School-based, twice yearly intervention: deworming (albendazole 400 mg, single oral dose) and vitamin A supplementation (200 000 IU, single oral dose). Main outcome measures: Anemia prevalence based on measure of blood hemoglobin (Hb). Results: Mean age and blood Hb concentration of all children were 9.5 +/- 2.6 years and 12.6 +/- 1.1 g/dl (range 5.6-16.7), respectively. The overall anemia prevalence in this group was 13.6%. Anemia prevalence was lower in boys than girls (12.0%; n = 1037 vs 15.3%; n = 993 respectively, P < 0.05). There was no significant difference in anemia prevalence between children in urban and rural locations (14.6 and 12.3%, respectively). Conclusions: The current low anemia prevalence in Bangalore could be due to the impact of school-based intervention programs that have been in place since 2003. The beneficial interactions of deworming and vitamin A supplementation could have widespread implications for current preventive public health initiatives. There is now need for the development of clear policy guidelines based on these simple and integrated interventions. Sponsorship: This research was supported by the Micronutrient Initiative, Ottawa, Canada, and Unilever Food and Health Research Institute, Vlaardingen, The Netherlands.