Prevalence of Folate, Ferritin and Cobalamin Deficiencies amongst Adolescent in India

BACKGROUND: In India, 60-90% of adolescent suffer from anemia. Studies have documented folate, ferritin, and cobalamin deficiencies to be the major causes of nutritional anemia. However, limited data is available on the prevalence of folate, ferritin, and cobalamin deficiencies amongst adolescent from India. OBJECTIVES: The present study was carried out to find out the magnitude of folate, ferritin, and cobalamin deficiencies amongst adolescent of 11-18 years of age in National Capital Territory (NCT) of Delhi, India. MATERIALS AND METHODS: A cross-sectional, school-based study was conducted in NCT of Delhi, India in the year 2010-2011. About 347 adolescent belonging to low- (LIG), middle- (MIG), and high-income groups (HIG) were selected using the probability proportionate to size (PPS) sampling methodology. Serum ferritin, serum folate, and serum cobalamin levels were determined by the enzyme-linked immunosorbent assay (ELISA) method, radioimmunoassay (RIA) method, and radioisotopic method, respectively. Hemoglobin (Hb) estimation was done by cyanmethemoglobin method in all the blood samples collected. RESULTS: The prevalence of deficiency of ferritin in HIG, MIG, and LIG categories of adolescent was found to be 52.9, 67, and 58.8%, respectively. In the HIG, MIG, and LIG categories of adolescent, the prevalence of folate deficiency was 22.5, 40.4, and 52.2%, respectively. The prevalence of deficiency of cobalamin in HIG, MIG, and LIG categories of adolescent was 47.1, 80.7 and 87.5%, respectively. About 48, 66.1, and 68.4% of adolescent in the HIG, MIG, and LIG categories, respectively had Hb levels less than 12 g/dL and were found to be suffering from anemia. CONCLUSIONS: A high prevalence of anemia existed along with deficiency of ferritin, cobalamin, and folate amongst adolescent. The strategies for prevention of anemia amongst adolescent in India should also include cobalamin along with iron and folate supplementation for prevention and control of nutritional anemia. Primary care physicians should suspect all the three causes for anemia.