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Letters to the Editor

Indian Pediatrics 2003;40:70-72

Prevalence of Anemia and Worm Infestation in School Going Girls at Gulbarga, Karnataka

Intestinal parasitism is a priority health problem. Since worm infestation is seldom the direct cause of death, they tend to be regarded as relatively unimportant. Worm infestation is probably more significant than specific vitamin and mineral deficiences in developing countries. In India, the problem is likely to be more common because of bad hygiene, poor awareness, illiteracy, misbeliefs, poverty and variety of allied factors(1). Studies carried out in various parts of India have reported a prevalence of intestinal parasitism upto 30-50% and anemia from 40-73% among school going girls(2-4). Our objective was to evaluate the prevalence of anemia and worm infestation in 716 school going girls of age 6-10 at Gulbarga, a semiarid region located in the Deccan plateau of North Karnataka.

Grading of anemia was done according to WHO guidelines(5). Prevalence of anemia and mean hemoglobin values are depicted in Table I. The percent prevalence of worm infestation was 71.73%. The maximum infestation was of Ascaris lumbricoides (23.73%) followed by Hymenolepsis nana (16.36%), Entamoeba histolytica (10.34%), Ankylostoma duodenale (8.46%) and Trichuris trichura (6.34%). In severely anemic children, Ankylostoma duodenale infestation was 4.76%, and multiple infestation was seen in 5.56% girls. Enterobius vermicularis, Giardia lamblia, and Diphylobothrium latum were demonstrated in 2.76%, 2.16% and 1.1% cases respectively. Out of 281 non-anemic girls, 177 (62.98%) had worm infestation, while of the 435 anemic girls, 334 (76.8%) demonstrated evidence of worms in their stool. Prevalence of worm infestation was 86.66%, 68.16% and 82.97% in mild, moderate and severely anemic groups respectively.

Table I__Prevalence of Anemia in School Girls at Gulbarga
Category (Hb g/dL)


Hemoglobin (g/dL) Mean±SD  

281 (39.2)
12.6 ± 1.6
Mild anemia (9 to <11)
165 (23.0)
9.9 ± 0.7
Moderate anemia
223 (31.1)
8.2 ± 0.6
(7 to <9)
Severe anemia(<7)
47 (6.56)
6.5 ± 1.2

The high prevalence of worm infestation is stressed here as worms are so closely correlated with nutrition. The continuous presence of worms in marginally nourished children can cause severe anemia and subsequently affect the growth and development of these children. In the present study, stool parasite positivity was 71.3% among school children age 6-10, which is comparatively high as compared to the study carried in the tribal areas of Madhya Pradesh, which reported 50% prevalence, in school going children(2). Anderson et al.(6) reported 41% of population in a rural village of Guatemala in Central America to be infected with Ascaris lumbricoides and 60% with Trichuris trichura.

The high prevalence of parasitic infestation seems directly related to the unhygienic living conditions associated with lack of knowledge about the communicable disease and variety of allied factors, which need to be studied. Amongst the intervention measures, it is important to take up sustained health education, provision of safe drinking water and improvement in environmental sanitation. It would be also useful to teach them about personal hygiene and conduct health education at schools through ‘School Health Projects’. During the school health checkups, periodic screening for intestinal parasites and blood indices can be evaluated.


We would like to thank the Hon’ble President, Khaja Education Society, Gulbarga and Principals of Bibi Raza Primary School, Khaja Primary School and Akbar Hussaini Primary School for their kind co-operation.

Vinod Kumar CS,
Anand Kumar H.,
Sunita V.,
Indu Kapur

Neonatal of microbiology,
K.B.N. Instititue of Medical Sciences,
Gulbarga 585 104,
Karnataka, India.


1. Hennequin C. Prevention of parasitic infections in immuno-compromised patients Ann Med Int 1997; 148: 240-245.

2. Chakma T, Rao PV, Tiwary RS. Prevalence of anemia and worm infestation in tribal areas of Madhya Pradesh. J Indian Med Assoc 2000; 98: 567-670.

3. Mahajan M, Mathur M, Talwar R, Revathi G. Prevalence of intestinal parasitic infections in East Delhi. Indian J Community Med 1993; 18: 177-180.

4. Chaturvedi S, Kapil U, Gnanasekaran, Sachdev HPS, Pandey RM, Bhanti T. Nutrition intake amongst adolescent girls belonging to poor socio-economic groups of rural area of Rajasthan. Indian Pediatr 1996; 33: 197-201.

5. WHO. Nutritional Anemias. Report of a WHO Scientific Group. World Health Organization. Tech Rep Ser 1968; 405: 9-10.

6. Anderson TJ, Zizza CA. The distribution of intestinal helminth infection in a rural village in Guatemala. Mem Inst Oswaldo Cruz 1993; 88: 53-65.



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