|Year : 2013 | Volume
| Issue : 2 | Page : 82-85
A comparative assessment of nutritional and health status between tribal and nontribal under five children of Mysore, India
Sarjapura V Divakar1, Pishey Ashwathnarayan Balaji2, Siddaraju Poornima2, Smitha R Varne3, Syed Sadat Ali2, M Puttaswamy1
1 Department of Community Medicine, Dr. B R Ambedkar Medical College, Affiliated to RGUHS, Karnataka, India
2 Department of Physiology, Dr. B R Ambedkar Medical College, Affiliated to RGUHS, Karnataka, India
3 Consultant, Healing Touch Yoga Centre, Saunders Road, Bangalore. Affiliated to AYUSH, Karnataka, India
|Date of Web Publication||16-Sep-2013|
Syed Sadat Ali
Department of Physiology, Dr. B R Ambedkar Medical College, KG Halli - Bangalore - 45, Karnataka
Source of Support: None, Conflict of Interest: None
Context and Aim: The tribal populations are recognized as socially and economically vulnerable; thereby patterns and trends in tribal areas are required to monitor local epidemics and to assess the effectiveness of public health programs in prevention and control of diseases. This prompted us to assess the health status and morbidity pattern among the tribal and non-tribal population of Mysore. Settings and Design: A cross sectional study was carried in the forest areas of Mysore in the 33 tribal hamlets present. Materials and Methods:Among 33 tribal hamlets, a random selection of 18 hamlets was performed by lottery method. A pre-tested structured interview was used for data collection through house to house visits by individual and family scheduling. Data were statistically analyzed using measures of central tendency, standard normal test (Z), and Chi-square test (χ2 ). P-value of <0.05 was considered statistically significant. All the tests were performed using Smith's Statistical Software version 2.80. Results: The study revealed more of tribal (45.03%) children compared to non-tribal (22.47%) were suffering from protein energy malnutrition with P < 0.001 and 7.35% of tribal children were severely malnourished. Among tribal under five children, morbidity pattern observed was more with skin infections (31.33%), followed by (21.20%) dental caries; (19.20%) intestinal infections; (21.85%) while in non-tribal counterparts, skin infections were (12.98%), (7.78%) dental caries; (17.98%) intestinal infections; (25.84%) respiratory infections; and (20.22%) vitamin deficiencies. Conclusion: Tribals have low socio-economic status, poor nutritional status, increased prevalence of morbid conditions compared to non-tribal population. Further detailed research surveys among tribal population would be invaluable.
Keywords: Morbidity, nutrition, non-tribals, tribals
|How to cite this article:|
Divakar SV, Balaji PA, Poornima S, Varne SR, Ali SS, Puttaswamy M. A comparative assessment of nutritional and health status between tribal and nontribal under five children of Mysore, India. Muller J Med Sci Res 2013;4:82-5
|How to cite this URL:|
Divakar SV, Balaji PA, Poornima S, Varne SR, Ali SS, Puttaswamy M. A comparative assessment of nutritional and health status between tribal and nontribal under five children of Mysore, India. Muller J Med Sci Res [serial online] 2013 [cited 2020 Apr 7];4:82-5. Available from: http://www.mjmsr.net/text.asp?2013/4/2/82/118232
| Introduction|| |
A tribe is an independent political division of a population characterized by a distinctive culture, primitive traits, and socio-economic backwardness. , Tribal people are primitive residents of any country. But, it is a glooming fact that even after six decades of independence the tribes of India are drowned in several problems. In those problems, the poor health status of tribals is now an important issue.  India is home to almost half the tribal population of the world with 84.33 million people classified as tribal, corresponding to 8.2% of the total population. There are 461 groups of tribes who are spread over 26 states and Union Territories with majority of 87% of tribes found in central belt of the country.  Reliable and comprehensive data on patterns and trends of diseases in tribal areas are required to monitor local epidemics and to assess the effectiveness of public health programs for prevention and control of diseases. Religious rites are used mainly to treat diseases and propitiating the deity concerned most of which tribals believe can cure the plagues, which are associated with various diseases. , No comprehensive strategy has been formulated to deal with tribal health problems, as there is not enough knowledge available on their customs, beliefs, and practices, which are intimately connected with the treatment of disease. , Further there is a broad understanding of health problems and morbidity of the general population, particularly of urban areas but studies pertaining to demographic characteristics, health status of under 5 year tribal children among different tribal groups are very few, and there is lack of comparisons due to different criteria studies. Hence, the present study was carried out to evaluate the nutrition and health status of under 5 year tribal children and compare with nontribal counterparts.
| Materials and Methods|| |
The present cross sectional study was carried out between March 2010 and January 2012 in the forest areas of Mysore, India. Ethical clearance was obtained from institutional ethics committee of DR. B R Ambedkar Medical College, Bangalore. Of the 33 tribal hamlets present, random selection of 18 hamlets were performed by lottery method of sampling technique, wherein the total of 33 hamlets were serially numbered at random on 33 cards. All the cards were shuffled well. One card was drawn and number noted. The card drawn was replaced, reshuffled and second card was drawn. The entire process was repeated till we obtained 18 number of hamlets. Those hamlet numbers already selected, on being drawn for the second time, were rejected. Correspondingly, the villages adjacent to these hamlets were included in the study as non-tribal population constituting intended homogenous population without mix up. A pre-tested structured interview schedule was used for data collection in the present study through house to house visits by individual scheduling - information regarding age, sex, marital, literacy status, occupation, personal habits and health status of individuals, immunization status of pregnant women and children was elicited and family scheduling: Information regarding the type of family, family organization, the socio-economic, and environmental conditions were elicited. Laboratory parameters performed in our study were hemoglobin estimation by Tallquist's method, peripheral smear was done in suspected cases of fever, for example: Malaria. Detailed general and systemic examinations of all the systems of both tribal and non-tribal children were performed by the same group of competent doctors. The diagnosis of morbid conditions was mainly based on history and clinical findings by competent doctors. The nutritional status of under five children was elicited and anthropometric measures of height (cms) and weight (kg) of all studied individuals was recorded. As it was a cross sectional survey involving forest region, only the above limited laboratory parameters were assessed.
Statistics: Data were statistically analyzed using software Smith's Statistical Software Package version 2.80. Measures of central tendency were used to analyze the descriptive data. The standard normal test (Z) was used to compare the equality of proportions having specific type of diseases among tribal and non-tribal children. P < 0.05 was considered to be statistically significant. Chi-square test (χ2 ) was applied to test the difference in the proportion of nutritional status, morbidity status between males and females among both tribal as well as in non-tribal children.
| Results|| |
[Table 1] depicts demographic characters among parents of under five children from tribal and nontribal population. A higher proportion of population belonged to nuclear family in both tribal (78.78%) and nontribal (58.38%) group and the literacy status was better in nontribal than tribal but number of people who finished more than secondary school was meager in both the groups. A higher proportion of population was working as general laborers and agricultural laborers in both the tribal and nontribal.
|Table 1: Demographic characters among parents of under five years old children among tribal and non-tribal population|
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[Table 2] shows nutritional status of under five years old children. Tribal; Of the total 151 tribal under five children, 83 (54.97%) were normal and 68 (45.03%) suffered from malnutrition (protein energy malnutrition). About 48.44% female children compared to 42.53% male children suffered from protein energy malnutrition. A total of 7.35% of tribal children were severely malnourished (grade III and IV). Non tribal; Of the total 89 non-tribal under five children, 69 (77.53%) were normal and 20 (22.47%) suffered from malnutrition (protein energy malnutrition). About 24.53% male children than 19.44% female children counterparts suffered from protein energy malnutrition. Only 1 (5%) of non-tribal child suffered from grade III malnutrition.
[Table 3] shows the morbidity pattern of under five years old children. Tribal; Among morbidities reported in under five tribal children, skin infections were maximum (31.33%), followed by (21.20%) dental caries; (19.20%) intestinal infections; (21.85%) respiratory infections; and (10.6%) vitamin deficiencies. Non tribal; Among morbidities reported in under five non-tribal children, skin infections were (12.98%); (7.78%) dental caries; (17.98%) intestinal infections; (25.84%) respiratory infections; and (20.22%) vitamin deficiencies. [Figure 1] depicts that the main cause of morbidity among under five years old children in tribal population is due to skin infections, dental and intestinal infections while among nontribal children respiratory infections and Vitamin deficiencies form the major problem.
Based on application of Chi-square test, nutritional disorders were more prevalent among females compared to males in both tribal as well as non-tribal population with (χ2 = 3.841), P < 0.05 of significance. However, there was no statistically significant difference in the proportion of all other morbidity status between males and females among both tribal as well as non-tribal population.
| Discussion|| |
The present cross sectional study was carried among tribals and non-tribals residing at Gundlupet taluk of Mysore district.
Nutritional status of under five years children: The present study revealed more of tribal children compared to non-tribal were suffering from protein energy malnutrition. Observations from our study revealed more of tribal (45.03%) children compared to non-tribal (22.47%) were suffering from protein energy malnutrition with P < 0.001. A total of 7.35% of tribal children were severely malnourished (grade III and IV), seen more in (10.81%) male children than (3.23%) female children. In a study conducted among Warli tribal children, Thane district, Maharastra, India, it was found that normal healthy children were below 1% in this remotely placed inaccessible habitat. A total of 10% babies were grade I malnourished followed by 29, 37, and 18% as grade II, III, and IV, respectively. The grade IV malnourished children were 4% in which maximum mortality was due to diarrhoea. In entire study population it was noticed that 99% were malnourished below 5 year of age group in which female percentage was 51% compared to 49% of males (P > 0.05). Under grade IV, male babies were on higher side than females (P > 0.05).  Rao found that prevalence of protein energy malnutrition such as marasmus was higher (2.2%) in Jenukuruba tribal children than the (0.2%) rural Karnataka.  Rao found only one pre-school child of Onge tribal group was anemic.  Singh observed that two out of three of the under five children of tribals of Chotanagar were malnourished.  Rajalakshmi observed that among Santal tribe of Bihar, 74% of under five children and 66% of non-tribal under five children in same area were malnourished. One-third of both these tribal and non-tribal children suffered from severe malnutrition. 
Morbidity status of under five years children : In the present study more of tribal under five children than non-tribal suffered from various morbid disorders. In a study conducted among Warli tribal children, Thane district, Maharastra, India, it was found that Diarrhoea was observed to be maximum (37%) in grade IV babies followed by skin infections. The intestinal worms were common in all babies suffering from malnutrition. A total of 9% children had skin infections specifically on scalp of grade I babies. The other infectious diseases noticed were around (5%).  In another study diarrhoea was the main problem faced by children under 5 years of age followed by acute respiratory infection (pneumonia) being the second most common problem.  Rao found that 48% of pre-school children of Gond tribal community in Kundam block of Jabalpur district, Madhya Pradesh had intestinal parasitic infestations. 
Paucity of time, funds, and man power forced us to conduct a cross sectional study. Comparatively, a longitudinal study is a better indicator of health problems of a study population.
A comprehensive control strategy with specific interventional measures needs to be evolved and implemented specially in tribals with serious efforts for their overall development.
| Conclusion|| |
Tribal under five children have poor nutritional status, increased prevalence of morbid conditions, such as skin disorders and dental disorders, compared to non-tribal counterparts. Further surveys regarding socio-demographic and health status data among tribal and non-tribal population will be invaluable so that a comprehensive strategy could be formulated to deal with their health problems and tribals need to be made aware of health issues, education, politics, economic opportunities, and how to achieve a higher quality of life.
| References|| |
|1.||Bala SM, Thiruselvakumar D. Overcoming problems in the practice of public health among tribals of India. Indian J Community Med 2009;34:283-7. |
|2.||Dhargupta A, Goswami A, Sen M, Mazumder D. Study on the effect of socio-economic parameters on health status of the Toto, Santal, Sabar and Lodha Tribes of West Bengal, India. Stud Tribes Tribals 2009;7:31-8. |
|3.||Report of the study To Understand the Health Status and Healthcare Systems in Selected Tribal Areas of India. June 2009. Available from: http://whoindia.org/LinkFiles/Health_Systems_Development_Report_of_the_study_to_understand_the_Heal). [Last accessed on 2012 May 21]. |
|4.||Rao HD, Brahmam GN, Rao PN. Primitive tribal groups of Andaman and Nicobar Islands-Health and Nutrition Survey. Hyderabad: National Institute of Nutrition, Indian Council of Medical Research; 1989. |
|5.||Basu SK. A health profile of tribal India. Health Millions 1994;2:12-4. |
|6.||Bhasin V. Health Status of Tribals of Rajasthan. Ethno-Med 2007;1:91-125. |
|7.||Tekale NS. Health and Nutrition Status of Warli Tribal Children in Thane District of Maharastra. Available from: http://www.rmrct.org/files_rmrc_web/.../NSTH06_28.NS.Tekale.pdf. [Last accessed on 2012 Oct 06]. |
|8.||Singh AK, Sinha SK, Singh SN, Jayaswal M, Jabbi MK. The myth of the healthy tribals. Soc Change 1987;17:3-23. |
|9.||Rajalakshmi C. Santal women; Areas of health ignorance. No.17. Soc Change 1992;2:12-23. |
|10.||Singh LP, Gupta SD. Health Seeking Behaviour and Healthcare Services in Rajasthan, India: A Tribal Community′s Perspective. Available from: http://www.jaipur.iihmr.org/Research/publication%20files/Workingp/1.pdf. [Last accessed on 2012 Oct 06]. |
|11.||Rao VG, Yadav R, Bhondeley MK, Das S, Agrawal MC, Tiwary RS. Worm infestation and anaemia: A Public health problem among tribal pre-school children of Madhya Pradesh. J Commun Dis 2002;34:100-5. |
[Table 1], [Table 2], [Table 3]