IMPACT OF NUTRITION EDUCATION AND IRON-FOLATE SUPPLEMENTATION ON HEMOGLOBIN, IRON STATUS AND COGNITIVE PERFORMANCE OF ADOLESCENTS IN RURAL KELANTAN

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dc.contributor.authorHAFZAN, YUSOFF
dc.date.accessioned2017-10-31T01:43:07Z
dc.date.available2017-10-31T01:43:07Z
dc.date.issued2012
dc.description.abstractIntroduction: Iron deficiency anemia is a significant public health challenge mostly among resource-poor communities. Realizing that adolescents are among the most vulnerable group to this type of anemia, we have developed a specifically designed nutrition education package for adolescents. Objectives: The aims of this study were to investigate the effectiveness of nutrition education package alone, daily iron-folate supplementation, or combination of both on hemoglobin, iron status (serum ferritin) and cognitive performance of schooling adolescents in Tanah Merah, Kelantan. Methodology: This study falls into two phases; Phase 1: Baseline study, and Phase 2: Community Intervention Trial. Stratified, multistage cluster sampling technique was used for sampling purpose and finally a total of 855 respondents (age 16-17) were recruited and baseline measurements including hemoglobin, body weight and height were taken. Two hundred and eighty eligible respondents were then pursued to Phase 2. They were randomized (by school) into either intervention or control groups namely; Supplement alone (S), Nutrition education alone (NE), Nutrition education plus supplement (NE+S) and Control (C). The stages and the parameters studied in Phase 2 were: i) Pre-intervention - hemoglobin (full blood count), serum ferritin (AxSYM ferritin micro-particle enzyme immunoassay), knowledge and attitude levels (multi-choice questionnaire), nutrients intake (24 hours dietary recall) and cognitive performance (Standard Raven’s Progressive Matrices), followed by ii) Intervention period, iii) Post-intervention 1 (at 3 months) - hemoglobin, knowledge and attitude, and nutrients intake and finally, iv) Post-intervention 2 (at 6 months) - hemoglobin, serum ferritin, cognitive performance. Statistical significant difference between 3 different interventions and control of each parameter were analyzed. Results: About 59.6% (n=855) of anemia prevalence was found in Phase 1 with greatest number of respondents having mild to moderate anemia. In Phase 2, Split-plot ANOVA showed significant main effect of intervention group [INTERVGP] in improving hemoglobin [F (3, 276) = 116.33, p < 0.001] and serum ferritin [F (1, 133) = 1076.29, p < 0.001] levels of respondents. No main effect of intervention group was evidenced in altering cognitive performance, except significant interactions between evaluation stage and intervention group (PHASE*INTERVGP) [F (3, 276) = 5.82, p = 0.001]. The effectiveness of nutrition education package in sustaining iron status was evidenced even after termination of supplementation. Conclusion: The findings demonstrate that the Community Intervention Trial carried out at school setting which incorporating combination of nutrition education and iron-folate supplementation was feasible and effective in improving and sustaining hemoglobin and iron status of adolescents, whereas its true effect on cognitive performance need further confirmation.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/5178
dc.language.isoenen_US
dc.publisherPusat Pengajian Sains Perubatan Universiti Sains Malaysiaen_US
dc.subjectCommunity Medicineen_US
dc.titleIMPACT OF NUTRITION EDUCATION AND IRON-FOLATE SUPPLEMENTATION ON HEMOGLOBIN, IRON STATUS AND COGNITIVE PERFORMANCE OF ADOLESCENTS IN RURAL KELANTANen_US
dc.typeThesisen_US
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