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Title: | Iron status and effects of iron supplementation and nutrition education among iron deficient and iron deficient anaemic female adolescents in the Gaza strip-Palestine |
Authors: | Marwan O. A. Jalambo (P75376) |
Supervisor: | Norimah A. Karim, Prof. Dr. |
Keywords: | Iron deficiency Gaza Palestine Nutrition education Female adolescents Dissertations, Academic -- Malaysia |
Issue Date: | 16-Jan-2017 |
Description: | Iron deficiency (ID) is the most common form of nutritional disorder worldwide, affecting more than two billion people globally. Most of the adolescents are suffering from ID with its adverse effects on health. In adolescence as a period of growth and development is considered the best time to intervene, to prevent later maternal anaemia. Interventions during pregnancy to reduce anaemia have failed and unsuccessful to restore the iron status. Therefore, it is necessary to correct the iron status before conception. This study investigated the risk factors of ID and anaemia. This study also evaluated the effectiveness and the sustainability of iron supplementation and nutrition education on improving iron status and reducing malonyl dialdehyde (MDA) among iron deficient and iron deficient anaemic female adolescents. The study has two phases: the first phase was a cross-sectional descriptive study, in which 330 female students aged 15-19 years were enrolled randomly from five governorates in the Gaza strip-Palestine. In the second phase, 131 ID students derived from the cross-sectional phase were recruited in the intervention phase randomised controlled trial (RCT) and were allocated randomly into three groups; iron supplementation; iron supplementation with nutrition education; and control group. Data were collected through questionnaires, anthropometric, and biochemical measurements. The results of the cross-sectional part indicated that the prevalence of anaemia, ID, and IDA were 35.8%, 40.3%, and 26%, respectively. A chi-square test of independence was calculated comparing the frequency of ID with or without IDA comparing to mother education (<secondary school; >secondary school), menstruation period per days (3-5days, 5-7, and more than 7days), and age groups (15-16, 16-17, 17-19 years) of the subjects, significant differences were (χ2 (1) =10.920, p<.001), (χ2 (2) =10.920, p=.001), and (χ2 (2) =7.102, p<.05), respectively. Moreover, decreased vegetables, fruits and meat consumption were the risk factors to be ID (OR, .980, 95% CI, .965, .995; p=.011), (OR, .983, 95% CI, .967, .999; p =.036), and (OR, .913, 95% CI, .887, .941; p<.001) respectively. On the other hand, increased milk and legumes consumption were significantly associated with ID (OR, 1.064, 95% CI, 1.021, 1.108; p<.05) and (OR, 1.092, 95% CI, 1.056, 1.130; p<.001) respectively. In the RCT part, the parallel was achieved between the three groups at the randomization time. One hundred thirty-one (97.0%) students were completed to final analysis. Repeated measure ANOVA was conducted to compare the effect of baseline, 3 months of intervention, and 3 months of follow-up on Hb, ferritin, and MDA levels. The findings revealed that overall knowledge had been improved significantly after nutrition education intervention as the percentage of good knowledge (≥50%) was 22.7% for pre-nutrition education and became 90.9% post intervention, p<0.001. Attitude and practice also improved from 36.4% and 54.5% at pre-test to 75.5% and 75.5% at post-test respectively. In conclusion, at follow-up stage, nutrition education with iron supplementation group was effective in improving iron, Hb, knowledge, attitude and practice among female adolescents. Future research in the same area should build on this study to determine the ability of nutrition education on dietary strategies to reduce ID by changing unhealthy dietary habits. Regular nutritional education sessions should be carried out to increase knowledge among female adolescent regarding IDA.,Ijazah Doktor Falsafah (Pemakanan) |
Pages: | 373 |
Call Number: | WB400.J26i 2017 9 |
Publisher: | UKM, Kuala Lumpur |
Appears in Collections: | Faculty of Health Sciences / Fakulti Sains Kesihatan |
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ukmvital_98514+Source01+Source010.PDF Restricted Access | 536.8 kB | Adobe PDF | View/Open |
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