Ghosh Rohini, Bharati Premananda
Anthropology and Human Genetics Unit, Indian Statistical Institute, Kolkata,India.
Asia Pac J Clin Nutr. 2003;12(4):451-9.
A micro level study on the haemoglobin status of 127 Munda (a tribe) and 174 Poundrakshatriya (Pod) (caste) women were conducted in the peri-urban area of Kolkata City, India. The two ethnic groups were selected in order to find out whether populations residing in the same habitat, with similar medical and health care facilities have similar haemoglobin status. Results indicate that there exists very high percentage of anaemia in both the ethnic groups and 100 percent anaemia was observed among the Munda. Mean haemoglobin level was higher among the women of both the ethnic groups, consuming calorie, protein, iron and folic acid, above the recommended value (Indian Council of Medical Research, 2000). Women below the age of 30 years were found to be more anaemic. Education (P <0.001), height (P <0.001) and weight (P<0.005) were significantly associated with the haemoglobin status of the Pod women. Haemoglobin level of both ethnic groups was found to increase with increase in Body Mass Index. Low socioeconomic condition, very low literacy rates, poverty and higher live births may have lowered the haemoglobin level of the women of the Munda population. However, women of both the ethnic groups were found to be anaemic in higher percentage than the state of West Bengal and all India (NFHS, 2000). Linear regression analysis indicated that expenditure on food had positive effect on the haemoglobin level (P<0.05) of the Munda adult women, possibly due to better buying capacity. However, negative effect of food expenditure on the haemoglobin level was noticed among the Pod women (P<0.05), which may be due to disparity in food sharing within the households. Thus populations residing with similar medical and health care facilities revealed differences in the haemoglobin level. Differential expenditure pattern and food sharing practice seems to be the major factors responsible for the differences in haemoglobin status among the adult women in this present study. Very low intake of iron and heavy workload may be the reasons for this high percentage of anaemia. Moreover, hookworm infections need to be analyzed, as its prevalence is very high in India and South Asia. One hundred percent anaemia among Munda women is also very alarming. The results suggest that government policies should be intensified further at problem specific areas for the more vulnerable populations and literacy and antenatal care (especially iron supplementation) at various growing periods among the women should be intensified to eradicate anaemia.
在印度加尔各答市的城郊地区,对127名蒙达族(一个部落)和174名波德拉刹帝利族(种姓)女性的血红蛋白状况进行了微观层面的研究。选择这两个族群是为了弄清楚居住在同一栖息地、拥有相似医疗保健设施的人群是否具有相似的血红蛋白状况。结果表明,两个族群的贫血率都非常高,其中蒙达族的贫血率达100%。在两个族群中,摄入卡路里、蛋白质、铁和叶酸量高于推荐值(印度医学研究理事会,2000年)的女性,其平均血红蛋白水平更高。研究发现,30岁以下的女性贫血情况更为严重。教育程度(P<0.001)、身高(P<0.001)和体重(P<0.005)与波德拉刹帝利族女性的血红蛋白状况显著相关。两个族群的血红蛋白水平均随体重指数的增加而升高。社会经济状况低下、识字率极低、贫困以及较高的活产率可能导致了蒙达族女性血红蛋白水平降低。然而,两个族群女性的贫血率均高于西孟加拉邦和全印度(国家家庭健康调查,2000年)。线性回归分析表明,食品支出对蒙达族成年女性的血红蛋白水平有积极影响(P<0.05),这可能是由于她们有更强的购买能力。然而,在波德拉刹帝利族女性中,食品支出对血红蛋白水平有负面影响(P<0.05),这可能是由于家庭内部食物分配不均所致。因此,居住在拥有相似医疗保健设施地区的人群,其血红蛋白水平存在差异。不同的支出模式和食物分配方式似乎是导致本研究中成年女性血红蛋白状况存在差异的主要因素。铁摄入量极低和繁重的工作量可能是贫血率高的原因。此外,由于印度和南亚地区钩虫感染率很高,需要对其进行分析。蒙达族女性100%的贫血率也非常令人担忧。研究结果表明,政府应针对更弱势群体的特定问题领域进一步加强政策力度,应加强女性在不同成长阶段的识字教育和产前护理(尤其是铁补充剂),以消除贫血现象。