The morbidity pattern in Adolescents is very different from that of younger children and older adults. According to WHO, among the major causes of morbidity in adolescence are depression and road accidents which is a completely different paradigm when compared to the morbidities in other age groups? WHO also states that nearly 35% of the global burden of disease has its roots in Adolescence? Also, the Disability Adjusted Life Years (DALYs) for adolescents in 2012 was 152 per 100 Population [1]. There is a dire need to study the health status of the adolescents because the needs of the adolescents are very different and from the needs of the other age groups [2].

Muslims are the second largest religious group in India. They make up of about 14.23% of the entire population of the country3. The phase of adolescence gets even more confounded and troublesome for Muslim adolescents because of conservative communities and orthodox beliefs. With the current culturally and ideologically expanding and globalising nation like India, it is becoming difficult for Muslim adolescents to cope with the demands of western peer induced pressure.

The problems that Muslim adolescents face are different from their counterparts from other religions. In a developing country like India, in addition to the problems faced by the adolescents in the developed world [4], the Muslim adolescents in our country face other problems such as economic constraints, socio-cultural, political [5], educational and vocational backwardness [6] and educational [7] among many others. In the hindsight of economic hardships, these problems increase multi fold to force the Muslim adolescents to take up jobs at an early age and give up education contrary to their wish [8].

India being a culturally, economically and religiously diverse country, many pockets in the country are predominantly Muslim [9]. The Khaja Bazaar Area under the Urban Health Training centre of Khaja Bandanawaz Institute of Medical Sciences, Kalaburgi, is one such area which is predominantly Muslim and economically backward. Even in the larger picture, not many studies have been conducted on Adolescent Boys and fewer have been conducted in Muslim Adolescent boys. This was the rationale behind taking up such a study. This study aims at bringing out the problems faced by Muslim adolescent boys of Khaja Bazaar area of Kalaburgi in relation to health, disease, social, psychological, economical, sexual and other problems. This study looks to bring out the correlation between the morbidity status among the study population and its socioeconomic status.

This cross-sectional study was carried out in the urban field practice area of Department of Community Medicine, KBNIMS, Kalaburagi, Karnataka. A house-to- house survey was carried out. Households were included in the study by using A Systematic Random Sampling technique [10] where every 5th house was selected (By obtaining the ratio of the total population to the sample size desired). The study was carried out on health status of 260 Muslim adolescent boys who were selected by employing simple random sampling from the entire target population on the basis of the percentage of adolescents in the country i.e., 20.9% [11,12]. A pre designed, pre tested questionnaire was used to collect the information. The subjects were interviewed after obtaining informed consent. The answers were therefore coded and quantified. All ethical boundaries were maintained and clearance for the same has also been obtained in the regard.

The following classification was used to categorize the adolescents under various socioeconomic strata (Table 1).

Table 1: Kuppuswamy’s Modified Socio-Economic Scale12 Adjusted for 2014 Consumer Price Index

The Phases in Adolescence were classified as follows:

• Early Adolescence (10-13 Years): Characterised by a spurt of growth and development of sexual maturation. This is the phase in which the Young People start to think in an abstract way

• Middle Adolescence (14-16 Years): The physical changes are completed as the individual develops a sense of identity. The thinking becomes more reflective

• Late Adolescence (17-19 Years): The Body takes its adult form, while the individual has a distinct identity and have more settled and ideas

The data was analysed using Statistical Package for Social Sciences (SPSS) version 23.0. To test the significance of the study, we applied Chi-Square test and ‘T’ test at 5% level of significance (p<0.05).

Looking into the Occupational status of the Adolescents, it was found that 170 (65.38%) of the individuals were students while 34.61% of the study subjects were not. Among the ones who were not studying, the maximum prevalence was of the individuals who were Unskilled workers followed by Semi-skilled and Skilled workers. 2.69% of the study subjects were unemployed.

In the study, majority of the individuals were either studying in or had dropped out from Middle School giving us a prevalence of 35.38% followed by High School (29.23%) and primary School (14.10%). Only 6.15% of the study population was pursuing Graduate Education while 4.23 and 7.69% were in Diploma courses and Pre-University College respectively. 3.46% of the individuals were Illiterate (Figure 1). 

Figure 1: Educational Distribution of the Adolescents

Out of 260, 90 had dropped out before time due to the reasons cited above (34.61%). Among the 90 individuals who had dropped out of School prematurely, 10% did so because they were required to be working at home. About 9.23% dropped out because they were not interested in continuing. 9.61% dropped out because of financial constraints while 2.69 and 0.38% dropped out because the Parents did not want to send them and they did not have the concept of schooling in the Family at all (Table 2).

Table 2: Distribution of the Adolescents as per Occupation

According to Kuppuswamy’s Socioeconomic classification, a majority of the study subjects were in the Upper Lower Group (76.92%) followed by Lower Middle (11.92%) and Lower (7.69%). Only 0.77 and 2.69% of the population was in the Upper and Upper Middle Category of the Socioeconomic Classification (Table 3).

Table 3: Distribution of Adolescents according to their Socio-Economic Status as per Kuppuswamy’s Socio-Economic Scale105

According to Kuppuswamy’s Socioeconomic classification, a majority of the study subjects were in the Upper Lower Group (76.92%) followed by Lower Middle (11.92%) and Lower (7.69%). Only 0.77% and 2.69% of the population was in the Upper and Upper Middle Category of the Socioeconomic Classification (Table 4).

Table 4: Distribution of Adolescents according to their Socio-Economic Status as per Kuppuswamy’s Socio-Economic Scale

The Morbidity pattern displayed by the study subjects showed that 149 (57.30%) of the individuals were Healthy while 111 (42.69%) were Unhealthy. Among the Unhealthy, highest prevalence was that of Micronutrient deficiencies (35.0%) followed by Wax Impaction (29.61%), stained teeth (23.07%), Malnutrition (16.15%) and Caries (12.69%).

The least prevalence was that of Nasal Polyp (1.92%), Deviated Nasal Septum (4.23%) and Ear infections (6.92%) (Table 5).

Table 5: Distribution of Adolescents according to Morbidities 110

Others include: Obesity (7), Stunting (1), Accidents (3), Jaundice (2), Koilonychias (1), Conjunctivitis (1), Squint (2), Hearing Impairment (8), Trauma (6), Tetany (2), Tongue Tie (1), Gingivitis (5), Tonsillitis (5), Micronutrient deficiencies include: Zinc (25), Vitamin A AND C (21), Iron (39), B12 (5), B6 (1)

Age wise comparison of the Morbidity status in the study subjects revealed that healthier individuals were present in the age group of 10 to 13 Years as compared to the other age groups. Similarly, Early Adolescence (10-13 Years) also had a higher prevalence of Unhealthy individuals as compared to the other age groups (38.74%). The least prevalence of Healthy (28.86%) and Unhealthy Adolescents (25.22%) was noticed in Middle Adolescence (Table 6).

Table 6: Age wise comparison of Morbidity

Comparison between the Morbidity and Educational Status of the individuals showed that a greater number of unhealthy individuals were seen among the ones who were illiterate (77.77%) followed by the ones who had received only Primary Education (72.22%). The healthier individuals came from the group of Adolescents who were pursuing their Pre-University College, Graduation and Diplomas at 95, 75 and 72.72% respectively (Table 7).

Table 7: Distribution of Morbidity among Adolescents according to their Educational Status

The chi-square statistic is 5.7672. The p-value is 0.217219. The result is not significant at p<0.05.

The study revealed that in the Upper Class of Kuppuswamy’s Socioeconomic status, everyone was Healthy. The second highest prevalence of Healthy people was in the Upper Middle Class where 85.71% of the people were Healthy. The Upper Lower Class had the highest number of Unhealthy people (45.50%) followed by Lower Middle (41.93%) and Lower Socioeconomic Class (30.00%) (Table 8).

Table 8: Distribution of Morbidity among Adolescents according to Kuppuswamy’s Socio-Economic Status

It was found that 55.29% of the students were Healthy followed by 77.27% of Skilled Workers, 61.54% of the Semi-Skilled Workers and 51.61% of the unskilled workers. The least healthy people were found in the group of the individuals who were Unemployed. Among the Unhealthy people, highest prevalence was among the Farmers (100%), followed by Unemployed individuals (57.12%) and Unskilled workers (48.38%) (Table 9).

Table 9: Distribution of Morbidity among Adolescents according to their Occupational Status

Insight into the Occupational status of the Adolescents showed that 170 (65.38%) of the individuals were studying while 34.61% of the Adolescents were not. Among the ones who were not studying, the maximum prevalence was of the individuals who were Unskilled workers (11.92%) followed by Semi-skilled (10%) and Skilled workers (8.46%) 2.69% of the Adolescents were unemployed. In our study it was found that 34.62% of the adolescent population was working. This figure is much higher than both the urban and the rural working rate of India i.e., 10.2 and 18.0% respectively, according to National Census 201113. It was found that 55.29% of the students were Healthy followed by 77.27% of Skilled Workers, 61.54% of the Semi-Skilled Workers and 51.61% of the unskilled workers. The least healthy people were found in the group of the individuals who were Unemployed. Among the Unhealthy people, highest prevalence was among the Farmers (100%), followed by Unemployed individuals (57.12%) and Unskilled workers (48.38%). A study conducted among working adolescents by Caglayan C concluded that both the physical and the mental health of working adolescent boys was deteriorating because of working at an early age [14]. This finding was at par with the finding of our study.

In the study, majority of the individuals were either studying in or had dropped out from Middle School giving us a prevalence of 35.38% followed by High School (29.23%) and primary School (14.10%). Only 6.15% of the study population was pursuing Graduate Education while 4.23 and 7.69% were in Diploma courses and Pre-University College respectively. 3.46% of the individuals were Illiterate. The prevalence of school dropouts was 34.61%. This finding of 34.61% dropped out children was much higher than the national average of 24.9% (Children who had never attended or had dropped out in some time) [15]. In this study it was found that 20.76% of the Adolescents and 21.53% of the Guardians of the Adolescents did not think Education was important. In a study conducted in Uttarakhand to find out the reasons for dropping out of school, it was found that 28% of the parents of the Adolescents were not interested in sending their wards to the school, while 31% did not want to go themselves [16]. These findings were higher than the findings in our study.

According to Kuppuswamy’s Socioeconomic classification, a majority of the Adolescents were in the Upper Lower Group (76.92%) followed by Lower Middle (11.92%) and Lower (7.69%). Only 0.77% and 2.69% of the population was in the Upper and Upper Middle Category of the Socioeconomic Classification. A study conducted in another part of the same city (Urban field practice area of MR Medical College) had the following figures of socioeconomic strata: Class I – 0.54%, Class II – 22.22%; Class III-45.49%; Class IV – 29.47%; Class V – 2.19% [17]. These numbers make it evident that the study area chosen for this study was comparatively poorer compared to the other areas of the city.

The Morbidity pattern displayed by the Adolescents showed that 149 (57.30%) of the individuals were Healthy while 111 (42.69%) were Unhealthy. Among the Unhealthy, highest prevalence was that of Micronutrient deficiencies (35.0%) followed by Wax Impaction (29.61%), stained teeth (23.07%), Malnutrition (16.15%) and Caries (12.69%). The least prevalence was that of Nasal Polyp (1.92%), Deviated Nasal Septum (4.23%) and Ear infections (6.92%). In a study conducted in the Burdwan district of West Bengal, the morbidity pattern displayed was as follows: 55.18% had pallor, 40.33% had dental caries, 33.49% were suffering from refractive errors etc. [18]. While some of the findings of our study were similar to the findings of the study in Burdwan, some of the diseases like ENT diseases and Refractive errors had more prevalence in the latter study.

Age wise comparison of the Morbidity status in the Adolescents revealed that healthier individuals were present in the age group of 10 to 13 Years as compared to the other age groups. Similarly, Early Adolescence (10-13 Years) also had a higher prevalence of Unhealthy individuals as compared to the other age groups (38.74%). The least prevalence of Healthy (28.86%) and Unhealthy Adolescents (25.22%) was noticed in Middle Adolescence. This finding was similar to the finding of the study conducted in Burdwan, West Bengal where highest morbidity was recorded in Early Adolescence [18]. Another study conducted in Muslim Dominant area of Hararge, Ethiopia showed the prevalence of morbidities to be highest (Around 40%) in Early Adolescence [19] which was contrary to the finding of our study.

Comparison between the Morbidity and Educational Status of the individuals showed that a greater number of unhealthy individuals were seen among the ones who were illiterate (77.77%) followed by the ones who had received only Primary Education (72.22%). The healthier individuals came from the group of Adolescents who were pursuing their Pre-University College, Graduation and Diplomas at 95, 75 and 72.72% respectively. This finding of our study was consistent with the finding of another study which was conducted in Ethiopia where a positive relation between Educational and Health status was established [20].

The study revealed that in the Upper Class of Kuppuswamy’s Socioeconomic status, everyone was Healthy. The second highest prevalence of Healthy people was in the Upper Middle Class where 85.71% of the people were Healthy. The Upper Lower Class had the Highest number of Unhealthy people (45.50%) followed by Lower Middle (41.93%) and Lower Socioeconomic Class (30.00%). Such an association between the socioeconomic status and morbidity in an individual has been established in many studies like a study conducted in Tanzania to assess the health status of children in school enrolled and non-enrolled adolescents [21] and a national study conducted on rural adolescents by the national institute of diet and nutrition where a positive relationship was established between undernutrition and the socioeconomic status of an individual [22].

This study, which was conducted in a relatively poor area of Gulbarga city, eventually revealed that the prevalence of Morbidity was considerably high. Education was low and the percentage of School drop-outs was noteworthy. The results obtained through the length of this study reveals that the Education, Occupation and the overall socioeconomic status of a population plays an important role in the overall development of an adolescent. In the view of the High Prevalence and Incidence of Morbidity, it may be suggested that there be regular and periodical check-ups and educational camps to promote positive Health. Free Medical check-ups could be organised to diagnose and treat diseases of public health importance. To reach adolescents who have dropped out of school, their places of work and leisure may be approached. Referral services should be organised and monitored systematically. Special attention must be provided to diseases with high prevalence like anaemia, where iron and folic acid supplementation could be provided for free. ARSH OPD (Adolescent Reproductive and Sexual Health) should be carried out at least once every month. Additionally, target IEC activities may also be launched to educate the ones in need.

1. World Health Organization. Adolescent Health Epidemiology: Maternal, Newborn and Adolescent Health. World Health Organization, 2016, www.who.int/maternal_child_adolescent/epidemiology/adolescence/en/.

2. Shahraj, P. and M. Mathur. “Capacity building of under-privileged rural adolescent girls by intervention of extension education.” International Journal of Agricultural Extension, 2014, pp. 43–47.

3. Government of India, Ministry of Home Affairs. Religion Census 2011: Census of India 2011. Government of India, 2011, www.census2011.co.in/religion.php.

4. Sheikh, M.F. An Exploratory Study of the Challenges of Living in America as a Muslim Adolescent Attending Public School. https://doi.org/10.7282/T32J6C2Z.

5. Mohammad, N. Indian Youth: Problems and Prospects. Illustrated ed., APH Publishing, 1995.

6. Azeem, C.M. “Educational problems of Muslim Adolescents: A study with special reference to malabar Region.” Academic Research International, vol. 2, no. 1, January 2012, pp. 545–556.

7. Ali, M.A. Problems of Muslim Community Education in India and Its Remedies. SSC Publication, 2012, pp. 33–37.

8. Ahmad, N. and B. Razia. “Study habits in relation to socio-economic status and gender among Muslim adolescents.” International Journal for Educational Studies, vol. 8, no. 1, August 2015.

9. Dutt, A.K. and S. Davgun. “Religious pattern of india with a factorial regionalisation.” GeoJournal, vol. 3, no. 2, pp. 201–214.

10. Kothari, C.R. et al. Research Methodology: Methods and Techniques. 3rd ed., New Age International, 2014, pp. 55–59.

11. World Health Organization. Programming for Adolescent Health and Development. WHO Technical Report Series, World Health Organization, 1999.

12. Oberoi, S.S. “Updating income ranges for kuppuswamy’s socio-economic status scale for the year 2014.” Indian Journal of Public Health, vol. 59, 2015, pp. 156–157.

13. Cook, L.J. and G. Cook. “Similarities and differences between boys and girls.” Child Development: Principles and Perspectives, vol. 2, 2009, pp. 362–365.

14. Caglayan, C. et al. “Working conditions and health status of child workers: Cross sectional study of the students at an apprenticeship school in Kocaeli.” Paediatrics International, vol. 52, no. 1, February 2010, pp. 6–12.

15. Gouda, S.M. and T.V. Sekher. “Factors leading to school dropouts in India: An analysis of national family health survey–3 Data.” IOSR Journal of Research and Method in Education, vol. 4, no. 6, December 2014, pp. 75–83.

16. Maithily, B. and V. Saxena. “Adolescents’ educational status and reasons to dropout from school.” Indian Journal of Community Medicine, vol. 33, no. 2, April 2008, pp. 127–128.

17. Hussain, M. et al. “Prevalence of overweight and obesity in school children: Its relationship with socio-demographic characteristics.” Journal of Pharmaceutical and Biomedical Research, vol. 30, no. 30, May 2013, pp. S53–S57.

18. Bhattacharya, A. et al. “Nutritional status and morbidity profile of school-going adolescents in a District of West Bengal.” Muller Journal of Medical Sciences and Research, vol. 6, no. 1, 2015, pp. 10–15, www.mjmsr.net/article.asp?issn=0975-9727&year= 2015&volume=6&issue=1&spage=10&epage=15.

19. Teklehaymanot, A. “Nutritional status and associated factors among school adolescents in Chiro Town, West Hararge, Ethiopia.” International Journal of Scientific and Engineering Research, 2010, www.academia.edu/7828728.

20. Assefa, H. et al. “Socio-demographic factors associated with underweight and stunting among Adolescents in Ethiopia.” The Pan African Medical Journal, vol. 20, 2015, p. 252.

21. Measley, N.M.R. et al. “The health of enrolled and non-enrolled children of school age in Tanga, Tanzania.” Acta Tropica, vol. 76, no. 3, October 2000, pp. 223–229.

22. Venkaiah, K. et al. “Diet and nutritional status of rural adolescents in India.” European Journal of Clinical Nutrition, vol. 56, no. 11, November 2002, pp. 1119–1125.Z