None listed
Conditions
Brief summary
Background: Anaemia (low haemoglobin) is highly prevalent in India. A recent national study identified that up to 80% of children and 60% of women were anaemic. Anaemia has been associated with impaired growth and development in children, and increased morbidity and maternal mortality in women. Anaemia can be due to numerous causes, particularly iron deficiency, but other causes that may contribute include folate and B12 deficiency, malaria and hookworm infection, and haemoglobinopathy. Delayed growth (stunting and wasting) are also commonly seen amongst rural Indian children. Karnataka is a large state of Southern India, where the prevalence of anaemia amongst children aged 1-2 years has been estimated at 86%. Key questions: What what are the causes and biological types of anaemia amongst young (1-2 year) children of rural Karnataka and how could this problem best be addressed? How do poverty, food insecurity, diet and parasitic infection interact to produce anaemia? Research design/approach: A sample of children and their mothers living in a typical rural district of Karnataka with evaluation of nutritional aspects, socioeconomic conditions, hookworm infection status and blood haemoglobin and iron status. The participants in the study: All children aged 1-2 years of age living in villages served by the selected primary health care subcentres will be invited to participate. Mothers or carers of children will be informed about the study and invited to participate along with their child. We will conduct a questionnaire, perform anthropometry on the child and mother, and collect blood samples by venipuncture from the child, and finger prick from the mother. We will collect stool from the child. Relevance: We seek to identify the reasons for anaemia and under-nutrition in this population to facilitate implementation of a relevant, effective prevention strategy.
Interventions
To be measured at a single point in time in the home village of the child, during a field survey which was undertaken from August to October 2008:
Laboratory indices: Iron status, Folate status, Vitamin B12 status, Inflammation, Hemoglobinopathy, Hookworm infestation status, Malaria infection status
Nutritional intake: Low iron intake, Continued breastfeeding,
Food insecurity,
Maternal nutrition: Maternal haemoglobin and anaemia, maternal body mass index.
Child growth: Stunting, Underweight, W
To be measured at a single point in time in the home village of the child, during a field survey which was undertaken from August to October 2008: Laboratory indices: Iron status, Folate status, Vitamin B12 status, Inflammation, Hemoglobinopathy, Hookworm infestation status, Malaria infection status Nutritional intake: Low iron intake, Continued breastfeeding, Food insecurity, Maternal nutrition: Maternal haemoglobin and anaemia, maternal body mass index. Child growth: Stunting, Underweight, Wasting status. Demographics: wealth, religion, caste
Sponsors
Haematology Research Unit, St John's Research Institute, St Johns National Academy of Health Sciences, Bangalore, India
Eligibility
Sex/Gender
All
Age
12 Months to 23 Months
Healthy volunteers
Yes
Inclusion criteria
Child born between 12 and 23 months 30/31 days prior to the date of sampling, living in selected villages served by randomly selected subcentres of the study Primary Health Centres. Where birth records are unavailable or carers are unaware of the specific birth date, local calendars will be used to identify important dates (eg festivals), and we will ask whether children were born before/ after these dates. We will accept ages and birth dates to within the month.
Exclusion criteria
Exclusion criteria: Any child without a primary carer (mother, father, relative or responsible adult defined as older than 18 years). Where the mother is the primary carer but is younger than 18 years old, the father will be asked to provide additional consent for the child’s involvement in the study if he is older than 18 years old. Where both parents are younger than 18 years, consent attained from the mother will be confirmed by a responsible senior member of the village. Any child living with a carer whom is unwilling or unable to give informed consent for participation in the study. Any child currently suffering from an acute medical illness, defined as: a. Fever – temperature >38.0 degrees Celsius b. Tachypnoea – respiratory rate >45 resps/ minute c. Diarrhoea > 4 soft/ watery stools per day, or bloody diarrhoea. d. Dehydration – signs of moderate – severe dehydration, including sunken eyes, dry mucous membranes, fewer than 4 wet nappies per day, raised skin turgor, or acidotic breathing. e. Drowsiness, excessive fatigue, lethargy. f. Any previous blood transfusion. g. Any other acute illness requiring immediate medical attention. All children will be screened by a medical officer prior to enrolment. Children meeting the above criteria will be transported to the Primary Health Centre for immediate treatment. Child refusing cooperation with the study team despite 15 minutes comforting by carer and study team – such children may be visited again later if the carer agrees. The total number of children eligible, the number found to be unwell, the number whose carers are not willing to participate, and the total number finally enrolled in the study will be reported.
Outcome results
None listed