ORIGINAL ARTICLE e-ISSN: 2349-0659 p-ISSN; 2350-0964 Malnutrition and Anemia: A Health Burden among Tea Garden Workers in West Tripura District, Tripura, India Suman K. Nath 1 , Asankur S. Das 1 , Sutapa Data 1 , Wankupar Wankhar 2 * A BSTRACT Introduction: The tea garden workers are an underestimated group of our society and are considered to be the most nutritionally vulnerable community. This study was undertaken to study the nutritional status of the male and female tea garden workers of West Tripura district, Tripura, India. Methods: In this cross-sectional study, a total of 409 tea garden workers including both sexes (males: 197; females: 212) of age group 18–60 years were selected. A questionnaire for on-ground data collection was administered along with the assessment of dietary intake and dietary quality, anthropometric data measurements, physiological measurements, hematological and biochemical estimation. Results: Most of the workers were vegetarian, and about two-thirds of the participants consumed two meals per day. None of the subjects was in the habit of taking packed lunch in routine, and maximum respondents (males: 84.26%; female: 83.96%) were in the habit of keeping fast. Skipping meals was also common in a vast number of the participants (males: 83.24%; females: 84.90%). A maximum number of participants complained of anorexia, headache, breathlessness on exertion, lethargic feeling, pale conjunctiva, pale skin, and fat nails. A very high prevalence of anemia (males: 94.91%; females: 99.04%) was observed among the workers. The present study also revealed dietary inadequacies, particularly regarding protein, energy, calcium, and all micronutrients (iron, β-carotene, folic acid) except vitamin C. A positive signifcant (P < 0.05) correlation was observed between hemoglobin and various daily dietary intakes of blood-forming nutrients. Conclusion: The present study reveals the prevalence of anemia among tea garden workers, especially female workers. Nutritional insufciency might be one of the important factors in this process. This study suggests that a comprehensive public health policy should be developed so that the tea garden workers’ health and nutritional needs can be addressed. Keywords: Anemia, Diet quality, Nutrient adequacy ratio, Nutrient intake, Tea garden workers Asian Pac. J. Health Sci., (2022); DOI: 10.21276/apjhs.2022.9.1.40 ©2022 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. I NTRODUCTION India is the second-largest producer of tea plantations in the world and the biggest consumer of tea. In India, the tea industry occupies a prime position. It holds considerable potential for economic development, as it earns substantial foreign exchange and provides employment to a large number of unskilled laborers in India. [1] The tea sector of India provides a massive scale of employment with production concentrated primarily in West Bengal, north-eastern states, and to a lesser extent in the southern states such as Tamil Nadu and Kerala. Assam, West Bengal, Kerala, and Tamil Nadu produce the most signifcant production of tea in India. [2] Tripura has a history of tea plantations since back to 1916. Tripura is one of the famous tea-growing states. About 54 tea estates, 21 tea processing factories, and more than 4000 small tea growers are available in Tripura. Approximately, 9 million kg of tea is produced in a year, and Tripura achieved the 5 th  largest among the 16-tea producing states in India. [3] Tea is additionally a crucial agro-industry of Tripura, which contributes immensely to the state’s economy. It is well known that the health and socioeconomic status of the worker of any industry is one of the crucial factors for its productivity, development, and growth. As per the report, the majority of the tea garden workers belong to tribal communities from diferent states of India. The workers were brought to the diferent tea estates as forced labor during the colonial period of India. [2] Due to traditional socio-cultural and low literacy levels, the tribal populations generally have poor nutritional status. Hence, it is expected that the prevalence of malnutrition may be found in the tea garden workers of the North-Eastern states. Several reports support this postulation. [4,5] High magnitude of undernutrition and infectious diseases among the tea garden population of 1 Department of Medical Laboratory Technology, Tripura Institute of Paramedical Sciences, Tripura, India. 2 Department of Dialysis, Faculty of Paramedical Sciences, Assam Down Town University, Assam, India. Corresponding Author: Dr. Wankupar Wankhar, Faculty of Paramedical Sciences, Assam Down Town University, Gandhi Nagar, Panikhaiti, Guwahati, Assam - 781 026, India. E-mail: wankuparwankhar@gmail.com How to cite this article: Nath SK, Das AS, Datta S, Wankhar W. Malnutrition and Anemia: A Health Burden among Tea Garden Workers in West Tripura District, Tripura, India. Asian Pac. J. Health Sci., 2022;9(1):255-262. Source of support: Nil Conficts of interest: None. Received: 28/10/2021 Revised: 19/11/2021 Accepted: 03/12/2021 Assam was reported by Medhi et al. [6] Nutritional problems like being underweight among children, thinness among adults, and micronutrient defciency disorders like anemia were widespread. Another report by Deka [7] revealed that tribal populations working in the tea industry are afected by various social, economic, and developmental constraints that expose them to diferent types of health problems and high rates of malnutrition. Several studies have revealed that tea garden workers are suspected of various diseases such as communicable and non-communicable diseases. [8] Malnutrition in tea garden workers is also common due to unhygienic living conditions, overcrowded residentials, poor socioeconomic conditions, and illiteracy. In a study conducted by Sengupta and Sahoo [9] on male tea garden workers in the year 2014, malnutrition was found in the majority of workers. In 2017,