EFFECTS OF IRON AND ZINC SUPPLEMENTATION ON NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS IN LAFIA LOCAL GOVERNMENT AREA, NASARAWA STATE NIGERIA
By
Author
Presented To
Department of Biochemistry
ABSTRACT
A randomized iron and zinc supplementation trial was carried out in Lafia Local
Government, Nasarawa State, Nigeria with a total of 160 children below the age of five
years. They were divided into 4 groups each containing 40 respondents: the Fe-group
received daily and for a 3-month period 10 mg of iron, the Zn-group 10 mg Zinc, the Fe-Zn
group10mg iron + 10mg Zinc and the control group, received no supplement. Serum iron
(SFe) and serum Zinc (SZn), with anthropometry were determined before and at the end of
the intervention. Socioeconomic characteristics of the respondents showed that the female
participants (52%) were more than male (48%), the highest number of household heads
were age 30-39 (50%) while 65.5% of the mothers were between the age range of 21-30
years. Percentage changes in weight, mid upper arm circumference, MUAC, iron and zinc
status were higher in groups supplemented than those that were not. There was a significant
difference (P˂0.05) in SFe among the 36-47 months age group of Fe group. Horizontal
pairs (baseline versus endline) with different superscripts b and a(P<0.05) while pairs with
similar superscripts a and a are not significantly different (P>0.05). Percentage change in
SZn were higher in Zn-group (highest change: 19.10% in female group and 22.36% in male
groups) than in Fe-Zn group (highest % change: 8.45% in male group). However, there was
no significant difference (P˂0.05) in serum concentration and weight in combined Fe & Zn
supplementation. Almost half of the respondents (49.38%) had no knowledge of
micronutrient supplements yet 57% caregivers who knew the importance of micronutrient
supplements do not give their children. There was significant difference (P˂0.05) in
MUAC- for- age as a result of iron supplementation in females of age group less than
11months while Zn supplementation recorded significant difference (P˂0.05) in males and
females of age group 11 - 23 months. Iron and zinc supplementation recovered 12.5%
severely wasted respondents in Fe- group, and reduce acute wasting by 10% in Zn- group.
In conclusion, this study revealed that iron and zinc supplementation recorded a significant
difference (P˂0.05) in iron and zinc status and that single iron and zinc supplement
increased weight.
TABLE OF CONTENT
TITLE PAGE - - - - - - - - - - - - - - - - - - - ii
DECLARATION - - - - - - - - - - - - - - - - - - iii
CERTIFICATION - - - - - - - - - - - - - - - - - - iv
DEDICATION - - - - - - - - - - - - - - - - - - - vi
ACKNOWLEDGEMENT - - - - - - - - - - - - - - - vii
ABSTRACT - - - - - - - - - - - - - - - - - - - viii
TABLE OF CONTENT - - - - - - - - - - - - - - - - ix
LIST OF TABLES - - - - - - - - - - - - - - - - - xiii
LIST OF PLATES - - - - - - - - - - - - - - - - - xiv
LIST OF FIGURES - - - - - - - - - - - - - - - - - xv
LIST OF APPENDICES - …………………………………………………………xiv
ABBREVIATIONS - - - - - - - - - - - - - - - - - xvii
CHAPTER ONE - - - - - - - - - - - - - - - - - - 1
INTRODUCTION - - - - - - - - - - - - - - - - - - 1
11 Background - - - - - - - - - - - - - - - - - - - 1
12 Statement of Research Problem - - - - - - - - - - - - - - 4
13 Justification - - - - - - - - - - - - - - - - - - - 5
14 Aim and Objectives - - - - - - - - - - - - - - - - - 6
141 Aim - - - - - - - - - - - - - - - - - - - - 6
142 Specific Objectives - - - - - - - - - - - - - - - - 6
CHAPTER TWO - - - - - - - - - - - - - - - - - - 8
20 LITERATURE REVIEW - - - - - - - - - - - - - - - 8
21 Nutrition in Infants and Childhood - - - - - - - - - - - - 8
22 Nutrition Intervention - - - - - - - - - - - - - - - 9
23Nutritional Status - - - - - - - - - - - - - - - - - 10
231 Nutritional Assessment of Children - - - - - - - - - - - 11
24 Micronutrients - - - - - - - - - - - - - - - - - 12
25 Mineral Iron - - - - - - - - - - - - - - - - - 13
2 51 Iron Status - - - - - - - - - - - - - - - - - - 15
252 Assessment of Iron Status - - - - - - - - - - - - - - 15
253Iron Overload - - - - - - - - - - - - - - - - - - 16
254Stages of Iron Depletion - - - - - - - - - - - - - - - 17
255 Serum Ferritin - - - - - - - - - - - - - - - - - 18
256Soluble Transferrin Receptor - - - - - - - - - - - - - 18
257Transferrin, Serum Iron, and Total Iron-Binding Capacity - - - - - - 19
258Erythrocyte Protoporphyrin - - - - - - - - - - - - - - 19
258Haemoglobin - - - - - - - - - - - - - - - - - - 19
259Haematocrit - - - - - - - - - - - - - - - - - - 20
2510Mean Corpuscular Volume - - - - - - - - - - - - - - 20
26 Mineral Zinc - - - - - - - - - - - - - - - - - 20
261Zinc Status - - - - - - - - - - - - - - - - - - 21
262 Measurement of Zinc Status - - - - - - - - - - - - - - 22
263 The Functions of Zinc in the Body - - - - - - - - - - - - 23
264Zinc Deficiency - - - - - - - - - - - - - - - - - 23
265Sources of Dietary Zinc - - - - - - - - - - - - - - - 24
266Efficacy of Iron and Zinc supplementations - - - - - - - - - - 24
267Methods for Anthropometric Assessment - - - - - - - - - - 26
2671 Advantages - - - - - - - - - - - - - - - - - 26
2672 Disadvantages - - - - - - - - - - - - - - - - - 27
CHAPTER THREE - - - - - - - - - - - - - - - - - 29
30 MATERIALS AND METHODS - - - - - - - - - - - - - 29
31 Study Area - - - - - - - - - - - - - - - - - - 29
32 Sampling Method - - - - - - - - - - - - - - - - 29
33 The sample Size of the Study - - - - - - - - - - - - - 29
34 Inclusion and Exclusion Criteria - - - - - - - - - - - - 30
35 Ethical Clearance - - - - - - - - - - - - - - - - 30
36 Data Collection - - - - - - - - - - - - - - - - - 31
37 Instruments - - - - - - - - - - - - - - - - - - 34
38 Food Habit Attitude and Health Knowledge Survey Procedure - - - - - 36
39 Anthropometric measurements - - - - - - - - - - - - - 37
310 Biochemical Assessment - - - - - - - - - - - - - - 38
391Quantitative Determination of Iron - - - - - - - - - - - - 38
392Quantitative Determination of Zinc - - - - - - - - - - - - 41
315Data Analysis - - - - - - - - - - - - - - - - - - 43
317Statistical Analyses - - - - - - - - - - - - - - - - 43
CHAPTER FOUR - - - - - - - - - - - - - - - - - 44
40 RESULTS - - - - - - - - - - - - - - - - - - - 44
41 Socioeconomic and Demographic Characteristics of the Respondent Caregivers
in Lafia Local Government of Nasarawa State (LLGNS) - - - - - - 44
42 Knowledge, Attitudes and Practices on Micronutrients and Supplementation of
the Caregivers Respondents - - - - - - - - - - - - - 47
43 Effect of Iron Supplementation on Weight, and Mid Upper Arm Circumference
(MUAC) of Children Under Five Years in Lafia Local Government of
Nasarawa State (LLGNS) - - - - - - - - - - - - - - 49
44 Effect of Zinc Supplementation on Weight (Kg), and MUAC of Underfive
Children in LLGNS - - - - - - - - - - - - - - - 52
45 Effect of Combined Iron and Zinc Supplementation on Weight (Kg) and MUAC
(cm) of Underfive Children in Lafia Local Government, Nasarawa State - - - 55
46 Effect of Iron Supplementation on Iron Status and Zinc status of Underfive
Children in LLGNS - - - - - - - - - - - - - - - 58
47 Effect of Zinc Supplementation on Iron Status and Zinc Status of Underfive
Children in Lafia Local Government, Nasarawa State - - - - - - - 61
48 Effects of Combined Iron and Zinc Supplementation on Iron Status and Zinc
Status of Underfive Children in Lafia Local Government, Nasarawa State - 64
49 Nutritional Status Based on Weight-for-Age of Children Underfive in Lafia
Local Government, Nasarawa State - - - - - - - - - - - 67
410 Nutritional Status Based on MUAC-for-Age of Underfive Children in Lafia
Local Government, Nasarawa State - - - - - - - - - - - 69
411 Nutritional Status Based on Weight-for-Height of Underfive Children in Lafia
Local Government, Nasarawa State - - - - - - - - - - - 69
CHAPTER FIVE - - - - - - - - - - - - - - - - - - 72
50 DISCUSSION - - - - - - - - - - - - - - - - - - 72
CHAPTER SIX - - - - - - - - - - - - - - - - - - 83
60 SUMMARY, CONCLUSION AND RECOMMENDATION - - - - - 83
61 Summary - - - - - - - - - - - - - - - - - - 83
62 Conclusion - - - - - - - - - - - - - - - - - - 84
63 Recommendation - - - - - - - - - - - - - - - - - 84
REFERENCES - - - - - - - - - - - - - - - - - - 86
APPENDICES - - - - - - - - - - - - - - - - - - 100
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