Improvement of Reproductive Health by Detecting Iron-Deficiency-Anemia in Adolescent Girls of Rural Area

Universal Journal of Environmental Research and Technology
Available Online at: www.environmentaljournal.org
(c) All Rights Reserved
2011 Vol 1 86-90


Open Access








Short Communication

Improvement of Reproductive Health by Detecting Iron-Deficiency-Anemia in
Adolescent Girls of Rural Area


Shampa Chakraborti


Department of Biotechnology, Fergusson College, Pune 411 004 (India)
Corresponding author: shampachakraborti@yahoo.co.in

Abstract
Anemia is a public health problem and the primary cause of it is dietary deficiency though sometimes genetic
abnormalities of hemoglobin synthesis and parasitic infections are the added reasons. In the present
investigation a total of twenty five blood samples of teen-aged girls (14-18 yrs) were collected from the hospital
of health science department situated at Ambegaon, Pune for the detection of iron-deficiency anemia for the
purpose of improvement of reproductive health of adolescence girls in rural area. The objective of the studies is
to bring awareness of iron status among rural adolescent girls to promote their maternal as well as child health.
Iron deficiency anemia was detected in 43% (38% moderate, 5% severe and no mild anemia) of the tested
population by the indicators (Hemoglobin, Serum iron, TIBC and Transferrin) generally used for assessment of
anemia. Complete blood count (CBC) revealed significant reduction (P>.01) in RBC count, no changes in WBC
count and significant increase in Platelets count (P> 0.01-Thrombocytosis noticed). Result indicates some
relationship of iron deficiency anemia to thrombopoiesis. Improved diet and iron supplement along with
vitamin A and C (needed for absorption of iron) should be implemented to control iron deficiency anemia in
rural area. The results revealed were as: Haemoglobin (), MCV (), MCH (), MCHC (), serum iron ((), TIBC
(), transferrin saturation (), Platelet count ().

Keywords: Anemia, Hemoglobin, Public health, Vitamins

1. Introduction
because of increased Iron requirement and
Anemia is one of the most common nutritional
decreased Iron intake.
problems in the world today. Indicator used to

assess anemia is hemoglobin concentration showing
2. Methodology
the value below recommended thresholds. The main
2.1 Blood Parameters (Jain, 2004)
causes of anemia are dietary iron deficiency (Conrad,
a) Estimation
of
Hemoglobin-
using
Sahli's
2009; Ball and Bartnett, 1999; Brady, 2007). Other
Hemoglobinometer
b) Determination of total erythrocyte (RBC) count-
causes include parasitic diseases like malaria,
using Neubauer's Chamber and RBC Diluting Fluid.
hookworm infections etc. (Dreyfuss, et al., 2000).
c) Determination of RBC indices (MCV, MCH, MCHC,
Deficiency of vitamin A and C also plays an important
CI,)-using standard formulas.
role (Bloem, et al., 1990 and WHO, 1996) lastly
d) Haematocrit

values(ESR
and
PCV)-using
inherited conditions for e.g. thalassaemia and sickle
Wintrobe's tubes
shaped anemia (Hemoglobinopathy) also affect the
e) Platelet count-using Neubauer's chamber and
synthesis of hemoglobin in red blood cells (Sagone
platelet diluting fluid (1% ammonium oxalate).
f) Microscopic examination of blood smear
and Balcerzak, 1970). Iron deficiency anemia is

prevalent among adolescence girls, children and

pregnant ladies (Halterman et al., 2004) usually
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Universal Journal of Environmental Research and Technology
2.2 Assessment of ID Anemia

A) Determination of Serum Iron Level-Using
C) Transferrin saturation (%) - It is the ratio of serum
Spectrophotometric Method (Stookey, 1970)
iron and total iron binding capacity multiplied by 100
Principle: In an acidic medium transferrin bound iron
(Haematol, 1978).
dissociates into ferric ions which are reduced to

ferrous ions in the presence of ascorbic acid. The
3. Results and Discussion
ferrous iron reacts with the chromogen Ferozine(R) to
Results of anemia detection revealed that 38 %
form a blue-violet chromophore which absorbs at
are showing moderately anemic (Hb< 10 gm/dL)
595 nm. The absorbance is directly proportional to
and
5%
are
showing
severely
anemic
the serum iron concentration of the blood sample.

(Hb<7gm/dL). History of the people was
B) Total Iron Binding Capacity (TIBC)-using
collected on diet and socio economic condition
Spectrophotometric Method at 560nm (Levinson,
of the patients which revealed that 3-5% of the
1980)
tested populations were suffering from parasitic
Principle: When the serum iron (SI) determination is
infections like malarial and hook worm
performed, for TIBC the serum is treated with excess
infection. No Hemoglobinopathy (sickle shaped
of ferrous ions to saturate the iron binding sites on
anemia and thalassaemia) was reported.
transferrin. The excess ferrous ions get adsorbed and
Socioeconomic condition of the patient was
precipitated and the Iron content in the supernatant
poor. Patients suffering from parasitic infections
is measured by spectrophotometry at 560 nm to give
were not taken into consideration for ID anemia
TIBC value. When the serum iron (SI) determination
is performed concurrently with the TIBC and the
detection. The history of the patient revealed
result subtracted from the TIBC value, the difference
that they visited the hospital because of their
yields the unsaturated iron-binding capacity (UIBC),
general weakness as constant fatigue, dizziness,
or serum transferrin not bound to iron.
headache, irritability, palpitation, pallor etc.







Table 1: Complete Blood Count




Sr. No.
Blood Parameters
Normal Blood
Patient's Blood
Remark
1)
Blood smear
Normocytic
Mirocytic
RBCs with MCV and MCHC
examination
Normochromic
Hypochromic
values below normal range
under microscope
indicating ID Anemia
2)
Total erythrocyte
5million/ cumm
3.6 million/cumm
(P<0.01)
count
( 10.5)
6.8)
Significant
3)
Estimation of
10 gm/dl
7.1 gm/dl
(P <0.01)
hemoglobin
(0.05)
( 0.03)
Significant
4)
Hematocrit Values

(ESR and PCV)

i) ESR
6 mm
5.35 mm
Non-significant

( 0.06)
( 0 .03)


ii) PCV
43%
25%
Significant

(1.1)
( 0.9)
(P<0 .01)

ii) Platelet count
3 Lacs/microlitre
4.5 Lacs /microlitre
Thrombocytosis noticed

( 4.5)
( 6.0)
(P<0.01) significant






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Universal Journal of Environmental Research and Technology
Table 2: Determination of RBC Indices

Sr. No.
Erythrocyte Parameters
Normal Blood
Patient's Blood
Remark
1)
MCV
85 ( 2.0) cubic
60(- 3.2) cubic
P<0.01
microns (um3)
microns (um3)
(significant)
2)
MCH
30.5(1.5) pg
13.0(-0.8) pg
P < 0.001 (significant)
3)
MCHC
35( 1.0) %
18.5 ( 0.9) %
P<0 .001


(significant)
4)
Colour Index
1(0.01)
0.4 ( 0.01)
P<0.01


(significant)

Table 3: Assessment of Iron Deficiency Anemia

Sr. No.
Parameters Related Normal Blood
Patient's Blood
Remark
to ID Anemia
1)
Serum Iron Level
120 ug/dl
75ug/dl
P < 0.01 significant
( 5.5) (

3 .
0 )

2)
TIBC
350 ug/dl
500ug/dl
P <0.01 significant
(9.8)
(10.0)
3)
Transferrin
32%
15%
P<0 .01 significant
Saturation
(2.5)
(1.0)
4)
Fecal Occult Blood Test
Negative
Negative
No hemorrhage/
tumor in G.I Tract

Results revealed that anemia is prevalent among
bleeding. It can also be due to increased iron
adolescence girls in Ambegaon of Pune city. Blood
requirement (in adolescence, in pregnancy), rapid
smear examination along with the values of blood
growth (in children), poor diet and problem with
indices determine the type of anemia as Microcytic
absorption. Here the reason might be increased loss
(RBC with MCV value below normal range),
of iron due to monthly period in adolescence girls
Hypochromic (MCHC Value below normal range),
along with poor diet which cannot accommodate the
which is the characteristic features of iron deficiency
loss (nutritional deficiency) or poor absorption of
anemia
(Jain,
2005).
Other
anemias
are
iron through gut epithelium. Future studies of serum
Megaloblastic anemia (due to Folic acid deficiency-
transferrin receptors levels will help to detect iron
Macrocytic, Normochromic), Pernicious anemia
deficiency more accurately. It is reported by World
(Macrocytic, Normochromic-due to failure in
Health Organisation (WHO) that serum transferrin
absorption of B12) and Hemolytic anemia (due to
receptor levels increase progressively as the supply
destruction of RBCs e.g. malarial infection,
of iron to the tissues becomes progressively more
Hemoglobinopathies etc). Results also revealed that
deficient (WHO, 2001). To control ID anemia, food
there was a decrease in Mean Corpuscular
based approaches include improvement of dietary
Hemoglobin (MCH) value which indicates depletion
intake along with iron supplement. Moreover, intake
in iron reserves and development of iron deficiency.
of Vitamin A and C plays an important role in
A low iron with a high TIBC value usually indicates
absorption of iron in gut epithelium. Iron deficiency
iron deficiency, whereas in case of chronic diseases,
anemia is reported to be associated with or without
both iron and TIBC go down (WHO, 2001). Iron
Thrombopoiesis (Akan et. al., 2000).
deficiency is usually related to long term or heavy

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Universal Journal of Environmental Research and Technology
MICROSCOPIC OBSERVATIONS
*
IRON DEFICIENCY ANEMIA(40x) NORMAL BLOOD (40x)
Less hemoglobin (Hypochromic)
ID ANEMIA 40x
RBCs with Anisocytosis
(variation
in
size
of
RBCs) & Poikilocytosis
Normal hemoglobin
(Abnormal
shape
of
(Normochromic)

RBCs)


4. Acknowledgement


4) Brady, P. G. (2007): Iron Deficiency Anemia: A
Author would like to express sincere thanks to Dr. G.
Call for South. Med. J. 100 (10): 966-7.
R. Pathade, HOD, Department of Biotechnology,
5) Conrad, M. E. (2009): Iron Deficiency Anemia
Fergusson
College,
Pune
for
constant
(Updated August 4, 2009). MD, (Retired),
encouragement during the present investigation.
Professor of Medicine, University of South
Sincere thanks also go to the staff members of
Alabama.
<Http://Emedicine.Medscape.Com
Health Science Institute, Ambegaon of Pune for
/Article/202333-Overview>.
providing the blood samples for the present work.
6) Dreyfuss, M. L., Stoltzfus, R. J., Shrestha, B. et.

al., (2000): Hookworms, Malaria and Vitamin A
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Universal Journal of Environmental Research and Technology
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