Awareness and Knowledge of the Public in Abha City about Vitamin B 12 Deficiency

Transcription

1 Med. J. Cairo Univ., Vol. 85, No. 3, June: , Awareness and Knowledge of the Public in Abha City about Vitamin B 12 Deficiency AHMED AWWADH, M.B.B.S.*; RANA S. AL-TURKI, M.B.B.S.*; AHMAD A. ALSHBRIQE, M.B.B.S.*; REEM S. ALAMRI, M.B.B.S.*; MAHA M. ALQAHTANY, M.B.B.S.*; MOHAMMED S. ALAHMARI, M.B.B.S.*; FARIS A. NASSER, M.B.B.S.*; OSSAMA A. MOSTAFA, M.D.** and ABDULAZIZ S. ALSHAHRANI, M.B.B.S.*** The Department of Family & Community Medicine, King Khalid College of Medicine, Abha*, ** and The Department of Internal Medicine, Najran College of Medicine, Najran***, Saudi Arabia Abstract Objective: To assess public s knowledge about the importance of in Abha City, Saudi Arabia. Methods: A cross sectional study was carried out during January A total of 1088 adult Saudi participants (727 males and 361 females) were interviewed by the researchers at the main malls in Abha City, Saudi Arabia, using a study questionnaire. Based on participants scores assigned for corrected answers, the overall knowledge was graded. Results: About half of participants (599, 55.5%) heard about. Less than half of participants (46.3%) identified the importance of intake to the body, 30.2% knew symptoms and signs of deficiency, 28% knew food sources for, while 27.5% knew complications of deficiency. Knowledge of more than two thirds of participants (67%) was poor, while that of 22% of participants was intermediate and 11% of participants had good knowledge. Participants knowledge grades differed significantly according to their age groups, their educational status and their occupation (p<0.001 for all). Conclusions: Knowledge of the general public in Abha City about deficiency is insufficient. Increasing public s awareness and knowledge about through health education campaigns is a pressing need. Key Words: Vitamin B 12 Knowledge Saudi Arabia. Introduction VITAMIN B 12 is an essential cofactor that is integral to methylation processes necessary in the reactions related to DNA and cell metabolism. Its deficiency may lead to disruption of DNA and cell metabolism and may also lead to a critical consequence [1]. Correspondence to: Dr. Ahmed Awwadh, The Department of Family & Community Medicine, King Khalid College of Medicine, Abha, Saudi Arabia B 12 cannot be made inside the body. It must be obtained from food or supplements. The average adult should get 2.4 micrograms daily [2]. A study done in USA found that some vegetarians develop B 12 deficiency regardless of demographic characteristics, place of residency, age, or type of vegetarian diet. It was suggested that vegetarians should fulfill adequate intake of this vitamin [3]. Some studies were done to explore prevalence of deficiency and how it is associated with different manifestations. One study proved that pernicious anemia is an important cause of various neurological manifestations as a result of deficiency in the age group over 40 years, regardless of socio-economic or dietary status [4]. Another study found that neuropsychiatric disorders in the absence of hematological abnormalities are commonly seen in the elderly people. These include paresthesia, weakness, gait abnormalities, and cognitive or behavioral changes (depression). Hyperhomocysteinaemia, as a result of deficiency, is considered as an independent risk factor for cardiovascular diseases [5]. Moreover, another study that was done on anemic adolescents found that folate and deficiencies are more common than iron deficiency in anemic adolescents [6]. Early detection of deficiency is important to avoid a serious complication. Vitamin B 12 level was shown to decline with age. Early intervention through nutritional education on vitamin B 12 supplementation is considered as an effective strategy to prevent cognitive decline in a significant segment of the population [7]. 1201

2 1202 Awareness & Knowledge of the Public in Abha City about Vitamin B 12 Deficiency There is an urgent need to raise public s awareness regarding the importance of intake [8]. A study was done in Riyadh, Saudi Arabia proved that deficiency is common, and suggested that awareness programs are needed for the general population to identify risk factors of deficiency, and to implement guidelines for prevention [9]. Therefore, this study aimed to assess level of awareness about importance of among the Saudi general population. Patients and Methods This study followed a descriptive cross sectional study design. A total of 1088 participants were interviewed at the main malls in Abha City during November - December, A structured self-administered questionnaire was designed by researchers based on relevant review of literature. It comprised personal characteristics (i.e., age, gender and educational level, employment and marital status) and 20 questions about participants awareness and knowledge about the vitamin B12 (i.e., importance, food sources, symptoms, signs and complications due to vitamin B 12 deficiency). A correct response was assigned a score of (1) while an incorrect response was assigned a score of (0). Participants overall knowledge regarding B 12 were assessed by summing up the total scores for each participant. Therefore, total scores ranged from 0 to 20. Those who had total scores <10 were considered to have poor: Knowledge, while those who had were considered to have intermediate knowledge and those who had 16 or more were considered to have good knowledge. Collected data were entered into a computer and analyzed using the Statistical Package for Social Sciences (SPSS Version 21). Descriptive statistics (frequency and percentage) were applied to characterize the study population. Chi-square test was applied to assess participants knowledge grades according to their personal characteristics. p-values less than 0.05 were considered as statistically significant. The study procedures were conducted after obtaining the approval of the Ethical Committee of King Khalid University. All participants were informed about the objectives of the current study and a verbal consent was obtained from each participant prior to start of interview. By the end of the interview, researchers provided participants with a factsheet on. Results Personal characteristics of the study sample is presented in (Table 1). A total of 1088 Saudi subjects participated in this study (727 males, 66.8% and 361 females, 33.2%). Most participants aged years (55.9%), while 34.1% aged years. About one fifth of participants (20.1%) had secondary education while about two thirds of participants (66.9%) had university education. The occupation of more than half of participants (55.1%) was governmental, 23% were students while 28% were unemployed. Almost two thirds of participants (64.8%) were married, while 32.4% were single. Table (1): Personal characteristics of the participants. Personal characteristics No. % Gender: Male Female Age groups: < 20 years years years years Educational Level: Primary Intermediate Secondary University Postgraduate Occupation: Government worker Military Health care provider Student Unemployed Marital status: Single Married Divorced Widowed

3 Ahmed Awwadh, et al Table (2) shows that only 55.4% of participants heard about. Less than half of participants (46.3%) identified the importance of vitamin B 12 intake to the body, 30.2% knew symptoms and signs of deficiency, 28% knew food sources for, while 27.5% knew complications of deficiency. Fig. (1) shows that regarding knowledge of more than two thirds of participants (67%) was poor, while that of 22% of participants was intermediate and 11% of participants had good knowledge. Table (2): Proportions of participants awareness and correct knowledge regarding. Item No. % Having ever heard about vitamin B Importance of vitamin B12 intake to the body Symptoms and signs of vitamin B12 deficiency Food sources for vitamin B Complications of vitamin B12 deficiency Intermediate 239, 22% Good 119, 11% Poor 730, 67% Fig. (1): Distribution of participants knowledge levels regarding. Table (3) shows that participants knowledge grades regarding B 12 differed significantly according to their age groups (p<0.001), with highest proportion of good knowledge among those aged years (14%). Participants knowledge grades regarding B 12 also differed significantly according to their educational status (p<0.001), with highest proportion of good knowledge among those with university or postgraduate levels (11.3% and 32.9%, respectively). Participants knowledge grades regarding B 12 differed significantly according to their occupation (p<0.001), with highest proportion of good knowledge among health care providers (38.7%). However, participants knowledge grades did not differ significantly according to their gender or marital status. Table (3): Distribution of knowledge level by demographic factors. Personal characteristics Poor Intermediate Good p- value No. % No. % No. % Gender: Male Female Age groups: < 20 years years years years <0.001 Educational level: Primary Intermediate Secondary University Postgraduate <0.001 Occupation: Government worker Military Health care provider Student Unemployed <0.001 Marital status: Single Married Divorced Widowed Discussion There are two interesting findings regarding personal characteristics of participants in the present study is that one third of participants were females and that most participants attained either university or postgraduate educational levels. The low participation of females in the present study can be explained by the fact that, the Saudi society is very conservative, with unique mix between religion and culture, which poses some outdoor restrictions on women [10]. Moreover, the high educational level among participants in the present study can be explained by the fact that our study population were interviewed at the main malls in Abha City. This may cause a selection bias since it is well expected that most of the people doing shopping at the malls are of relatively higher socioeconomic status. Moreover, the main campus of King Khalid University is located in Abha, hence, the relatively high educational level of the population. After exhaustive review of literature, it has been realized that there are no published studies assessing public s knowledge about.

4 1204 Awareness & Knowledge of the Public in Abha City about Vitamin B12 Deficiency However, few studies assessed public s knowledge about nutritional deficiencies. In spite of the high educational status of most participants in the present study, only 55.4% of participants heard or read about, 46.3% identified the importance of intake to the body, 30.2% knew symptoms and signs of deficiency, 28% knew food sources for, while 27.5% knew complications of deficiency. Moreover, the overall knowledge grade for most participants regarding was poor. This indicates the pressing need to raise public s awareness and improve their knowledge regarding importance of and consequences of its nutritional deficiency. These findings are in accordance with that of Shah et al. [11] who assessed knowledge and awareness regarding among blood donors at a rural based tertiary care hospital in India, who reported that proportion of those with correct knowledge were low regarding several aspects of, e.g., rich food (16.2%), symptoms of deficiency (35.4%) and prevention of deficiency (32%). They concluded that knowledge about deficiency was poor, suggesting the need of providing knowledge regarding various aspects of vitamin B 12 deficiency for the prevention of anemia. Moreover, Clayton [12] noted that public s awareness and knowledge regarding nutrition issues is poor and needs to be improved. Results of the present study showed that participants knowledge grades regarding B 12 were significantly better among those aged years, those with university or postgraduate education and among health care providers. However, their knowledge grades did not differ significantly according to their gender or marital status. It was quite expected to find highly educated participants and health care providers most knowledgeable regarding deficiency. Moreover, those who are years old probably represent participants who are currently university educated or recently graduated. Thus, their general scientific knowledge, including that about vitamin B 12 is still fresh. In conclusion, knowledge of the general public in Abha City, Saudi Arabia about deficiency is insufficient. Increasing public s awareness and knowledge about through health education campaigns is a pressing need. References 1- MAHMOOD L.: The metabolic processes of folic acid and Vitamin B 12 deficiency. Journal of Health Research & Reviews, 1 (1): 5-9, SKERRETT P.J.: Vitamin B 12 deficiency can be sneaky, harmful. Harvard Health Blog; Available at: PAWLAK R., PARROTT S.J., RAJ S., CULLUM- DUGAN D. and LUCUS D.: How prevalent is vitamin B 12 deficiency among vegetarians? Nutrition reviews, 71 (2): 110-7, DIVATE P.G. and PATANWALA R.: Neurological manifestations of B 12 deficiency with emphasis on its aetiology. The Journal of the Association of Physicians of India, 62 (5): 400-5, WONG C.W.: Vitamin B12 deficiency in the elderly: is it worth screening. Hong Kong Med. J., 21 (2): , THOMAS D., CHANDRA J., SHARMA S., JAIN A. and PEMDE H.K.: Determinants of nutritional anemia in adolescents. Indian Pediatrics, 52 (10): 867-9, RALAPANAWA D.M.P.U.K., JAYAWICKREME K.P., EKANAYAKE E.M.M. and JAYALATH W.A.T.A.: B 12 deficiency with neurological manifestations in the absence of anaemia. BMC Research Notes, 8 (1): 458, LÖKK J., NILSSON M., NORBERG B., HULTDIN J., SANDSTRÖM H. and WESTMAN G.: Vitamin B 12 in primary health care and geriatrics-attitudes, knowledge and competence. International Journal of Geriatric Psychiatry, 16 (10): , AL-MOMEN A.M., AL-AQEEL A.A., ASEERI M.A., AL-FAWAZ K.A., AL-MOLHEM A., HASANATO R.M.: Vitamin B12 Deficiency in Patients with Normal Blood Count. Blood, 122 (21): 5594, AL ALHARETH Y., AL ALHARETH Y. and AL DIGH- RIR I.: Review of Women and Society in Saudi Arabia. American Journal of Educational Research, 3 (2): 121-5, SHAH A.R., SHETHWALA N.D. and PARMAR B.H.: Knowledge and awareness about Iron deficiency and megaloblastic anaemia among blood donors: A study at rural based tertiary care hospital. Int. J. Res. Med. Sci., 3: , CLAYTON D.B.: Improving public awareness of nutrition issues. Nutrition, 16 (Issues 7-8): 637-9, 2000.

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