Prevalence of specific micronutrient deficiencies in urban school going children of India aged between 6 and 16 years: study protocol for a multicentric cross-sectional study.
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ABSTRACT: Introduction
Childhood and adolescence are the period of rapid physical and cognitive growth and development, requiring adequate nutrition. Malnutrition in the form of undernutrition or micronutrient deficiency or overweight/obesity affects the health, cognition and educational achievement of this age group. The objective of this study is to assess the prevalence of calcium, iron, zinc, selenium, folate, vitamin A, 25 hydroxy vitamin D and vitamin B12 deficiencies in the serum and haemoglobin, ferritin and lead levels and its association with reported dietary intake and cognitive abilities, in urban school going children aged 6-16 years in 10 cities of India.Methods and analysis
A multicentric cross-sectional study will be conducted to recruit 2400 participants (240 per site) across India. Participants will be selected using random sampling and will be categorised into age groups of 6-11 years and 12-16 years, with equal distribution. Data on socioeconomic status, anthropometric measures and 3-day dietary intake and cognitive performance will be collected. Blood samples will be collected for biochemical analysis of micronutrients. Findings will estimate the prevalence of micronutrient deficiencies and their association with dietary habits and cognitive functioning.Ethics and dissemination
Study protocol has been reviewed and approved by institutional ethics committee of all 10 participating sites. Results will be shared and published in a peer-reviewed journal, so that the findings will be helpful for the stakeholders in planning nutritional interventions for targeted groups.Trial registration number
CTRI/2019/02/017783.
SUBMITTER: Awasthi S
PROVIDER: S-EPMC8671943 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionChildhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6-11 and 12-16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators.MethodsA multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test.ResultsFrom April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females.ConclusionOne or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority.Trial registration numberCTRI/2019/02/017783.
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Project description:BackgroundThe concept of self-rated health (SRH) has widely been studied among the adults and older population in developed as well as developing countries, including India. Also, studies are available in abundance examining the various concepts of SRH among adolescents. However, in India, studies on the SRH of adolescents remain scarce, especially those aiming to understand the correlates of SRH among school-going adolescent girls in an urban setting. Therefore, this study aims to determine the correlates of poor SRH among school-going adolescent girls in the urban setting of Varanasi, India.MethodsThis study is based on the primary data collected in the Varanasi district of Uttar Pradesh, India, from October 2019 to February 2020. Nearly 350 adolescent girls and their mothers were personally interviewed. Self-rated health was the primary outcome variable of this study. The exact wording of the question asked from the adolescent girls was, "In general, how would you say your health is?".ResultsAlmost one-fifth (19.4%) of the adolescent girls reported poor SRH. Adolescent girls from Other Backward Class (OBC) [OR: 0.39; 95% CI: .18-.85] and Others caste [OR: 0.58; 95% CI: .23-0.87] were less likely to report poor SRH than their Scheduled Caste/Scheduled Tribe (SC/ST) counterparts. Girls residing in households where number of daughters were more than sons were more likely to report poor SRH [OR: 7.8; 95% CI: 1.5-39.5] than girls who belonged to the daughters only households.ConclusionComposition of children was one of the important factors as outlined in this study. The role of mothers in improving the overall SRH of the girls is critical as they are involved in caring process of their daughters.
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Project description:BACKGROUND:Mental health problems are leading contributors to the global disease burden in adolescents. This study aims to highlight (1) salient context-specific factors that influence stress and coping among school-going adolescents across two urban sites in India; and (2) potential targets for preventing mental health difficulties. METHODS:Focus group discussions were undertaken with a large sample of 191 school-going adolescent boys and girls aged 11-17 years (mean = 14 years), recruited from low- and middle-income communities in the predominantly urban states of Goa and Delhi. Framework analysis was used to identify themes related to causes of stress, stress reactions, impacts and coping strategies. RESULTS:Proximal social environments (home, school, peers and neighborhood) played a major role in causing stress in adolescents' daily lives. Salient social stressors included academic pressure, difficulties in romantic relationships, negotiating parental and peer influences, and exposure to violence and other threats to personal safety. Additionally, girls highlighted stress from having to conform to normative gender roles and in managing the risk of sexual harassment, especially in Delhi. Anger, rumination and loss of concentration were commonly experienced stress reactions. Adolescents primarily used emotion-focused coping strategies (e.g., distraction, escape-avoidance, emotional support seeking). Problem-focused coping (e.g., instrumental support seeking) was less common. Examples of harmful coping (e.g., substance use) were also reported. CONCLUSIONS:The development of culturally sensitive and age-appropriate psychosocial interventions for distressed adolescents should attend to the challenges posed by home, school, peer and neighborhood environments. Enhancements to problem- and emotion-focused strategies are needed in order to bolster adolescents' repertoire of adaptive coping skills in stressful social environments.
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Project description:IntroductionThe present study describes the distribution of selected micronutrients and anaemia among school-aged children living in Libo Kemkem and Fogera (Amhara State, Ethiopia), assessing differences by socio-demographic characteristics, health status and dietary habits.MethodsA cross-sectional survey was carried out during May-December 2009. Socio-demographic characteristics, health status and dietary habits were collected. Biomarkers were determined for 764 children. Bivariate and multivariable statistical methods were employed to assess micronutrient deficiencies (MD), anaemia, and their association with different factors.ResultsMore than two thirds of the school-aged children (79.5%) had at least one MD and 40.5% had two or more coexisting micronutrient deficiencies. The most prevalent deficiencies were of zinc (12.5%), folate (13.9%), vit A (29.3%) and vit D (49%). Anaemia occurred in 30.9% of the children. Children living in rural areas were more likely to have vit D insufficiency [OR: 5.9 (3.7-9.5)] but less likely to have folate deficiency [OR: 0.2 (0.1-0.4)] and anaemia [OR: 0.58 (0.35-0.97)]. Splenomegaly was positively associated with folate deficiency and anaemia [OR: 2.77 (1.19-6.48) and 4.91 (2.47-9.75)]. Meat and fish consumption were inversely correlated with zinc and ferritin deficiencies [OR: 0.2 (0.1-0.8) and 0.2 (0.1-0.9)], while oil consumption showed a negative association with anaemia and deficiencies of folate and vitamin A [0.58 (0.3-0.9), OR: 0.5 (0.3-0.9) and 0.6 (0.4-0.9)]. Serum ferritin levels were inversely correlated to the presence of anaemia (p<0.005).ConclusionThere is a high prevalence of vitamin A deficiency and vitamin D insufficiency and a moderate prevalence of zinc and folate deficiencies in school-aged children in this area. The inverse association of anaemia and serum ferritin levels may be due to the presence of infectious diseases in the area. To effectively tackle malnutrition, strategies should target not only isolated micronutrient supplementation but also diet diversification.
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Project description:BackgroundMicronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group.ObjectiveWe explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.MethodsWe applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities.ResultsDaily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels.ConclusionsThis study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries.
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Project description:BACKGROUND:Childhood obesity is a growing public health concern in many low-income urban settings; but its determinants are not clear. The purpose of this study is to assess the prevalence of childhood obesity and associated factors among in-school children aged 5-16 years in a Metropolitan district of Ghana. METHODS:A cross-sectional quantitative survey was conducted among a sample of 285 in-school children aged 5-16 years. Pre-tested questionnaires and anthropometric data collection methods were used to collect data. Descriptive, bivariate, binary and multivariate logistic regression statistical techniques were used to analyse data. RESULTS:Some 46.9% (42.2% for males and 51.7% for females) of the children were overweight. Of this, 21.2% were obese (BMI falls above 95th percentile). Childhood obesity was higher in private school (26.8%) than public school (21.4%), and among girls (27.2%) than boys (19%). Factors that increased obesity risks included being aged 11-16 as against 5-10 years (aOR = 6.07; 95%CI = 1.17-31.45; p = 0.025), having a father whose highest education is 'secondary' (aOR =2.97; 95% CI = 1.09-8.08; p = 0.032), or 'tertiary' (aOR = 3.46; 95% CI = 1.27-9.42; p = 0.015), and consumption of fizzy drinks most days of the week (aOR = 2.84; 95% CI = 1.24-6.52; p = 0.014). Factors that lowered obesity risks included engaging in sport at least 3times per week (aOR = 0.56; 95% CI = 0.33-0.96; p = 0.034), and sleeping for more than 8 h per day (aOR = 0.38; 95% CI = 0.19-0.79; p = 0.009). CONCLUSION:Higher parental (father) educational attainment and frequent consumption of fizzy drinks per week may increase obesity risks among in-school children aged 5-16 years in the Metropolitan district of Ghana. However, regular exercise (playing sport at least 3 times per week) and having 8 or more hours of sleep per day could lower obesity risks in the same population. Age and sex-appropriate community and school-based interventions are needed to promote healthy diet selection and consumption, physical activity and healthy life styles among in-school children.
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Project description:BACKGROUND:Formal education can be a nutrition-sensitive intervention that supports the scale-up and impact of nutrition-specific actions. Maternal education has long been linked to child survival, growth, and development while adult earnings and nutrition are tied to years in school as a child. However, less is known about the relationship between maternal education and the micronutrient status of children, women and the general population. METHODS:Using country-level data and an ecological study design, we explored the global associations between women's educational attainment and: a) anemia and vitamin A deficiency (VAD) in children aged 6-59 months; b) anemia in non-pregnant women; and c) zinc deficiency, urinary iodine excretion (UIE), and the proportion of infants protected against iodine deficiency in the general population Cross-sectional relationships (2005-2013) were assessed using linear regression models. RESULTS:Percentage of women without schooling was negatively associated with all outcomes. Number of years of schooling among women was positively associated with all outcomes except for UIE and the proportion of infants protected against iodine deficiency. Income level was a significant effect modifier of the effect of years of women's schooling on child anemia as well as of the proportion of women without formal education on zinc deficiency in the population. The relationship was strongest in low-income countries for child anemia, and was not significant in upper middle-income countries. For zinc deficiency, the relationship was not significant in low or lower middle income countries, which may suggest that a minimum threshold of resources needs to be reached before education can influence zinc status. CONCLUSIONS:While relationships between maternal schooling and micronutrient outcomes vary around the globe, more schooling is generally linked to lower rates of deficiency. These findings draw policy-relevant connections between formal education and anemia and micronutrient status globally. It is necessary to examine the mechanisms through which this relationship may be working at both household and country level.
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