Evaluation and comparison of knowledge, attitude and practice about iron deficiency anemia amongst medical students of rural and urban background

Itika Singh, Harminder Singh, Devindra Kaur


Background: Iron Deficiency Anemia (IDA) is most prevalent anemia worldwide. Women have additional iron requirement from puberty to menopause. This arises from physiological needs of menstruation, pregnancy and lactation. Iron is required for oxygen transport, cellular oxidation, phagocytosis and immune functions. The magnitude of anemia as health problem is huge and can be tackled with increasing awareness, promotion of correct attitudes and practices.

Methods: Cross sectional study consisting of 50 medical students of age group 18-22 years divided in two groups coming from rural (Group I) and urban background (Group II). A structured questionnaire of 26 questions, out of which 18 questions based on knowledge. 4 on attitude and 4 on practice. Response was assessed using Percentage analysis and Chi square test.

Results: All students defined anemia as Hb <11 g/dl, RBC <4.5 million/ with pallor. 80% students having knowledge that anemia is more common in rural area. Most common sources of information were books and teachers (76% in Group I and 56% in Group II). The practice of eating green vegetables and taking tea after meals was more in Group I.

Conclusions: The results of our study showed that though Group II had better knowledge regarding IDA  Group I followed more favourable practices. Our study, though small in size gives a glimpse of the greater picture. The attitude and practice of students and society in general needs to be improved with intensive media campaigns. Greater awareness about causes, prevention and treatment will go a long way in combating IDA.



Iron deficiency anemia, Rural, Urban, Knowledge, Attitude, Practice

Full Text:



WHO. Women’s health. In: Who, eds. A Cross Age and Frontier. Geneva: WHO; 1992: 1-6.

Stoltzfus RJ. Deficiency iron-deficiency anemia in public health terms: time for reflection. J Nutr. 2001;131:565-7.

World Bank. Enriching lives: overcoming vitamin and mineral malnutrition in developing countries. In: World Bank, eds. Development in Practice. Washington, DC: World Bank; 1994.

Bararom BA, Kovitz RH, Meytes D. Iron state in female adolescents. Am J Dis Child. 1992;146(83):3.

Pollitt E. Iron deficiency and cognitive functions. Annu Rev Nutr. 1993;13:521-37.

NIN. Nutritional news. In: NIN, eds. The News. Hyderabad, India: National Institute of Nutrition; 1984.

Barr F, Brabin L, Agbaje S, Buseri F, Ikimalo J, Briggs N. Reducing iron deficiency anemia due to heavy menstrual blood loss in Nigerian rural adolescents. Public Health Nutr. 1998;1:249-57.

Atukorala TMS, Desilva LDR. Iron status of adolescent females in three schools in an urban area of Sri Lanka. J Trop Med. 1990;36:316-21.

Ballot DE, Mac Phail, Bothwall TH, Gillody M, Mayet FG. Fortification of curry powder with Na Fe (III) EDTA in an Iron deficient population: initial survey of Iron status. Am J Clin Nutr. 1989;49:156-61.

Paul LA. Iron deficiency in adolescents. BMJ. 1989;298:499.

Kaur S, Deshmukh PR, Garg BS. Epidemiological correlates of nutritional anemia in adolescent girls of Rural Wardha. Indian Community Med J. 2006;31:255-8.

Appanah TP, Ooogarah PB, Ruggoo A. Awareness and consumption of iron among Mauritian female factory workers. Nutr Food Sci. 2009;39(2):168-75.

Leenstra T, Kariuki SK, Kurtis JD, Oloo AJ, Kager PA, ter Kuile FO. Prevalence of anemia and iron deficiency: cross sectional studies in adolescent girls in Western Kenya. Eur J Clin Nutr. 2004;58:681-91.

Pasricha SS, Flecknoe-Brown SC, Allen KJ, Gibson PR, McMahon LP, Olynyk JK, et al. Diagnosis and management of iron deficiency anemia: a clinical update. Med J Austr. 2010;193(9):525-32.