title: High incidence of aplastic anemia is linked with lower socioeconomic status of Indian population.
abstract: The incidence of aplastic anemia (AA) is common in Asia than in western countries.
  
  
  
  In a case-control study conducted at a tertiary care hematology center in northern India, 102 patients of AA and 201 controls of other blood disorders (OBD) were included. Sociodemographic data and exposure to drugs, toxins and radiation were collected from the study population using a standard questionnaire. Socioeconomic status (SES) was classified based on a calculated standard of living (SL) score. Univariate and multivariate analyses were carried out to delineate the factors associated with incidence of AA.
  
  
  
  Patients with AA were significantly younger than those in control groups (mean age 27.5 ± 12.3 years, P < 0.01). The mean SL score was significantly lower in AA group (26.76 ± 12.88, P < 0.01) than in the controls. The mean monthly family income was significantly lower in AA group than in the controls (83.3% with monthly income <8000 INR, P < 0.01). On univariate analysis, AA group with lower SL score had >3 times higher odds of having the disease (odds ratio 3.41, 95% confidence interval 1.72-6.79, P < 0.0001) compared with the controls. On multivariate analysis, young age and low SES were found to be significantly associated with AA.
  
  
  
  Lower SES is associated with higher incidence of AA in Indian population.
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Vishwanath
authors.initials: V
authors.lastname: Gella
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Guru Subramanian
authors.initials: GS
authors.lastname: Guru Murthy
authors.affiliation: Department of Haematology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Varma
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012923:Social Class; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: blood and immune disorders; chronic disease; environment