Nutritional anaemia in the urban poor: a community-based study of under fives in an Indian slum.

Abstract

The association between from deficiency anemia and both nutritional status and dietary habits was investigated among 182 children under 5 years of age who lived in a slum settlement on the outskirts of the industrial city of Pune (Western India). Social workers pre-primary teachers and local leaders were enlisted to recruit mothers to bring their children to a hut no more than 200 meters from their home and physicians collected clinical data. 73 (43%) of the children examined were anemic with the highest prevalence (61% of total cases) found in the 12-36-month age group. Microcytosis was present in 47% of the blood specimens. Acute malnourishment (defined as a weight for height percentage under 80%) was found in 9 (5%) children 6 of whom were 12-24 months of age. Feeding patterns in this sample were as follows: breast milk only--6-11 months 71%; 12-23 months 13%; 24-35 months 3%; and 0% at ages 36-60 months; mixed feeding--6-11 months 29%; 12-23 months 52%; 24-35 months 39%; 36-47 months 11%; and 48-60 months 2%; and solids only--6-11 months 0%; 12-23 months 35%; 24-35 months 58%; 36- 47 months 89%; and 48-60 months 98%. An unexpected finding was that children fed both breast milk and solid foods were significantly more likely to be anemic regardless of age group. 18 (75%) of the 24 children 12-23 months of age and 8 (73%) of the 11 children 24-35 months of age in the mixed feeding group were anemic. It appears that these children were largely receiving milk with only minimal supplementation. A more general problem is the low iron content and absorbability of the staple foods (rice wheat sorghum and lentils) that comprised the diet of most children surveyed. The promotion of earlier weaning with provision of energy dense foods with an adequate iron content is a priority goal for health workers especially among children under 3 years of age.