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Abstract
Introduction The objective of this study was to identify the prevalence of anemia
(Hematocrit < 36% and/or Hemoglobin <120 g/L) among Muslim adolescents and identify
possible factors related to anemia.
Meterials and methode The study population consisted of 276 schoolchildren age
1315 years old attending in Islam private schools, located in the urban district of Songkhla.
Certain hematological indices of anemia status were measured. Dietary intake was estimated
using semiquantitative food frequency questionnaire (SFFQ).
Results The prevalence of anemia among female adolescents in Islam private schools
was 46.4%. The data showed that age, menstruation, nutritional status, costs, frequency of
meal, fruit consumption and beverages were not significantly associated with anemic
status(p>0.05). Nonanemia students consumed higher iron, copper and zinc than anemic
students (p<0.05), however, most of the students (85.5%) consumed food with iron value
lower than 67% RDA.
Conclusions the anemia prevalence was very high among Muslim adolescents from
urban district of Songkhla. The factor associated with anemia is a consumption of low iron
value food source.
General Objective
To identify associations between dietary pattern and other lifestyle factors to anemia
status among female adolescents in Islam private schools.
Specific Objectives
1. To identify the prevalence of anemia among female adolescents in Islam private
schools.
2. To assess the dietary pattern related to anemia among female adolescents in Islam
private schools.
3. To assess factors (general characteristic, lifestyle and health behavior) influencing
anemic status among female adolescents in Islam private schools.
Results
The characteristics of the subjects; the mean age was 14 0.77 years, 93.8% has
menstruation, mean age of menarche was 11 2.9 years with duration of 6.5 2 days and
volume estimated by self was moderate level (83.7%). Most students (92.8%) were classified
as having normal nutrition status, whereas the overweight and underweight were 3.3% and
4%, respectively. Most students (72.5%) lived with parents or guardians and 27.5% lived in
the school dormitory. 71.7% of students received money weekly at a mean cost was 79.9
27.8 baht per day which was accepted as enough for demand.
The prevalence of anemia (Hematocrit < 36% and/or Hemoglobin < 120 g/L) was
46.4% as presented in table 1.
Dietary pattern show most students (62.2%) has 3 meals a day and 37.3% has 2 meals
a day, 35.9% has breakfast, 80.8% has lunch and 51.1% has dinner everyday. The dietary
intake of students was either from parents cooking or from food shops already cooked food.
Only 1.4% of in students did not eat beef and seafood. Most students (90.9%) ate fruits in
some meals. Popular beverage drink with a meal of students was water or sweetened juice,
cola beverage (6.2%), fruit juice (6.5%) and tea or coffee (4.7%), respectively. The
consideration or value of food choices of female adolescent in Islam private school was halal
(73.6%) and cleanness (46.4%), respectively. Stylishness was the last consideration of food
choices.
Frequency of consumption in the top five classified by 5 food groups as follow;
1. Flour, nut, seed products: Rice; Noodles; Bread; Instant noodle; and Glutanous rice
respectively.
2. Vegetable group: Swamp cabbage; Chinese white cabbage; Cabbage; Chinese
Kale; and Chinese cabbage respectively.
Dietary intake of anemia related nutrients comparing with 2/3 or 67% Thai
Recommended Daily Intakes (Thai RDI) or Recommended Daily Allowance (RDA) for
population 13-15 years of age showed that most students had iron intake lower than
67%RDA and protein, copper, zinc, vitamin B 12, vitamin C and folate intake higher than
67%RDA (Table 2).
Table 2 The percentage of nutrients related anemia about consumed < 67% or 67% of Recommended
Daily Allowance (RDA).
Nutrients RDA 67%RDA <67%RDA 67%RDA
N (%) N (%)
The demographic, dietary and lifestyle factors (age, menstruation, nutrition status,
address, cost, frequency of meals, fruits and beverages consumed with meal, health behavior
to prevent parasite infection, etc.) were not found to associate significantly with anemic status
of female adolescents in Islam private school (p > 0.05), the data of which were showed in
Table 3.
Age 0.123
13 years 54(36.5) 34(26.6) 88(31.9)
14 years 59(39.9) 52(40.6) 111(40.2)
15 years 35(23.6) 42(32.8) 77(27.9)
Menstruation 0.148
Yes 136(91.9) 123(96.1) 259(93.9)
No 12(8.1) 5(3.9) 17(6.2)
Nutrition status 0.634
Overweight 6(4.1) 3(2.3) 9(3.3)
Normal 137(92.6) 119(93) 256(92.8)
Underweight 5(3.4) 6(4.7) 11(4)
Address 0.217
Parents 103(69.6) 97(75.8) 200(72.5)
Dormitory 45(30.4) 31(24.2) 76(27.5)
Cost 0.059
< 50 bath/day 13(8.8) 3(2.3) 16(5.8)
50100 bath/day 121(81.8) 115(89.8) 236(85.5)
>100 bath/day 14(148) 10(7.8) 24(8.7)
Meal 0.263
1 meal 2(1.4) 0(0) 2(0.7)
2 meals 59(39.9) 44(34.4) 103(37.3)
3 meals 87(59.2) 84(65.6) 171(62.2)
Breakfast 0.093
Every day 47(31.8) 52(40.6) 99(35.9)
Sometime 95(64.2) 75(58.6) 170(61.6)
Not 6(4.1) 1(0.8) 7(2.5)
Lunch 0.629
Every day 120(81.1) 103(80.5) 223(80.8)
Sometime 27(18.2) 25(19.5) 52(18.8)
Not 1(0.7) 0(0) 1(0.4)
Dinner 0.746
Every day 74(50) 67(52.3) 141(51.1)
Sometime 68(45.9) 54(42.2) 122(44.2)
Not 6(4.1) 7(5.5) 13(4.7)
Table 4 Mean and comparisons of nutrients related anemia between nonanemia and anemia groups.
Total Nonanemia Anemia
Nutrients (n = 276) (n = 148) (n = 128) t
X SD X SD X SD
Protein (g) 66.39 25.7 68.4527.16 64.023.77 1.431
Iron (mg) 13.35 5.08 13.99 5.51 12.6 4.45 2.296*
Copper (mg) 1.3 0.49 1.370.55 1.23 0.42 2.278*
Zinc (mg) 7.78 2.85 8.17 3.08 7.332.5 2.470*
Vitamin B12 (mcg) 5.52 2.89 5.813.19 5.19 2.5 1.792
Vitamin C (mg) 128.58 84.33 133.6687.95 122.72 79.89 1.074
Folate (mcg) 1274.44 495.88 1296.0512.66 1249.51 476.54 0.776
*p<0.05
Discussion
Prevalence of anemia (Hematocrit < 36% and/or Hemoglobin < 120 g/L) among
female adolescent 13-15 years old was 46.4%. However, this prevalence was not exclusive of
thalassemia trait because those with thalassemia trait may or may not show symptom and sign
of anemia. The incidence of carriers or thalassemia and abnormal hemoglobin and diseases in
pregnant women of Songklanagarind Hospital, Songkhla province was 23% (Noparat C. et