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Title: Effects of vitamin a supplementation on intestinal parasitic reinfections, growth, iron status and educational achievement among Orang Asli schoolchildren in Pos Betau, Pahang, Malaysia
Authors: Hesham Mahyoub S. Al-Mekhlafi
Keywords: Vitamin
Intestinal parasitic reinfection
Iron status
Orang Asli schoolchildren
Pos Betau
Pahang
Malaysia
IDA
Issue Date: Aug-2008
Publisher: University Malaya
Abstract: Intestinal parasitic infections, malnutrition and iron deficiency anaemia (IDA) are still considered as public health problems in rural Malaysia especially among Orang Asli children. Despite intermittent control programmes, the prevalence of these problems is still high suggesting the need of other control and interventions measures. This randomized double-blind, placebo-controlled trial was carried out among Orang Asli schoolchildren from Sekolah Kebangsaan Betau in Pos Betau, Pahang (200 km northeast Kuala Lumpur) to investigate the effects of vitamin A supplementation on intestinal parasitic reinfections, growth, iron status and educational achievement. Two hundred and ninety two children (145 males and 147 females) aged 7-12 years were screened for intestinal parasitic infections using Kato Katz and Harada Mori techniques and trichrome staining technique. Demographic and socioeconomic data were collected using pre-tested questionnaires. Almost all children (98.6%) were found to be infected with one or more soil-transmitted helminthes (STH). The overall prevalence of ascariasis, trichuriasis and hookworm infections were 67.8%, 95.5% and 13.4% respectively. Almost one third of the children had heavy trichuriasis, 22.3% had heavy ascariasis whereas all hookworm infections were light infections. The prevalence of giardiasis was 17.8%. Nutritional status of these children were assessed and the results showed that the overall prevalence of mild and ignificant underweight was 52.3% and 37.3% respectively and the prevalence of mild stunting and wasting was 43.6% and 43.1% respectively while the prevalence of significant stunting and wasting was 43.6% and 5.6% respectively. Blood samples were collected from 241 children to study the serum iron and vitamin A status. Overall, 48.5% of the children were anaemic (Hb <12 g/dL). The prevalence of IDA (Hb<12 g/dL, SI<10.74 μmol/L, TIBC>73.39 μmol/L and/or %TS<16) was 34%, which accounted for 70.1% of the anaemic cases. Moreover, 66 (27.4%) children had serum retinol <0.70 μmol/L. Cognitive function and educational achievement of these children were assessed and found to be poor. All these assessments for intestinal parasitic infections, nutritional status, serum iron and vitamin A status, cognitive function and educational achievement were considered as the baseline data. Two hundred and fifty children were randomly assigned to receive either vitamin A capsule or its identical placebo. The effects of vitamin A supplementation were investigated over periods of 3 and 6 months after receiving the capsules. All children received anthelmintics treatments for three days and complete deworming was achieved. The vitamin A supplementation showed no significant effect on the STH reinfection among these children. However, prevalence of giardiasis among vitamin A supplemented-children was significantly lower than children in placebo group. Vitamin A supplementation showed significant positive impacts on the growth (weight and height) of the children after 3 and 6 months. Similarly, vitamin A supplementation significantly improved the iron and vitamin A status compared with children who received placebo. The IQ increments in vitamin A supplemented-children were significantly higher than in control children. The positive effects of vitamin A supplementation could be attributed to its effects on the immunity status of the children. In conclusion, although the positive effect of vitamin A supplementation on intestinal parasitic reinfections was limited and parasitespecific, but distribution of vitamin A to Orang Asli children is important to control malnutrition and IDA; as it has significant positive effects on growth and serum iron status. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce these health problems significantly in the Orang Asli communities. Periodic distribution of anthelmintic and vitamin A supplementation appeared to have promising effects on the health status of the children that can help in the efforts to improve the quality of life of Orang Asli children.
Description: Thesis (PhD) -- Faculty of Medicine, University of Malaya, 2008.
URI: http://dspace.fsktm.um.edu.my/handle/1812/475
Appears in Collections:PhD Theses: Medicine

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