Factors affecting the iron status of 15-49 years lactating and non-lactating mothers in Makongeni Thika distict, Kenya
Gitau, Gladys Njura
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Iron deficiency is one of the most prevalent nutrient deficiencies in the world, affecting an estimated two billion people. Iron deficiency anaemia causes maternal deaths, decreased physical work and earning capacity, low birth weight and serious cognitive and psychomotor development in infants and children. In general, the 1999 national micro-nutrient survey found out that the prevalence of anaemia among the non- pregnant mothers was quite high in Kenya and in some clusters nearly half (41-50%) of the mothers were anaemic due to iron deficiency. Unfortunately,Thika was not included in this study. This study aimed to investigate the factors affecting the iron status of lactating and non-lactating mothers in Makongeni, Thika District.The objectives of the study were: -to establish haemoglobin levels of lactating and non-lactating mothers, to establish dietary iron intake of lactating and nonlactating mothers, to determine the factors that affect intake of dietary iron among lactating and non-lactating mothers, and to determine the relationship between the haemoglobin level and dietary iron intake of lactating and nonlactating mothers. The study was carried out in Thika district at Uzima Care Medical centre,a peri-urban area in Makongem estate of Thika Town. The study targeted one hundred lactating and one hundred non-lactating mothers. Socio-demographic, food security, food preparation and consumption patterns, health and sanitation and biochemical data were collected. This was a descriptive cross-sectional survey and an interview schedule was used to collect data including biochemical data on haemoglobin. Data were analysed using SPSS version 11.5, MS Excel and dietary analysis software (Food metres UK 7) for nutrient composition. The 24hr dietary recall and food frequency was used to determine the dietary iron intake. A cut-off of <7g/dl as severe anaemia, 7-10.9g/dl as moderate anaemia, 10.8-11.9g/dl as mild anaemia and 12-16g/dl as normal was used to categorise the haemoglobin levels.The diets of the respondents consisted of plant foods and less intake of animal protein. Iron was significantly related to all vitamins, with the strongest correlation being thiamine(r=0.833, p<0.01). The weakest correlation for iron was carotene (r= 034, p<0.01). Iron indicated a positive significant correlation with most minerals, including calcium (r-0.341, p<0.01, zinc (r= 0.785, p<0.01), and selenium (r=0.503, P<0.05). Copper relationships were not significant. The study revealed that lactating mothers had haemoglobin levels ranging from 7-14 g/dl, while the non-lactating mothers had 9-15 g/dl. On average, lactating mothers had a lower mean (12.1 +l.lg /dl) than nonlactating mothers (12.4 +l.lg/dl. From the findings 25% had mild anaemia (10.9-11.9g/dl) and 8.5% had moderate anaemia (7-10.8g/dl). Mild anaemia (33%), moderate anaemia (17 %), and severe anaemia (1%) was prevalent in the lactating mothers, as compared to 29% mild anaemia and 15% moderate anaemia in non-lactating mothers after altitude adjustment at a calculated factor 0.5 for Thika altitude (1700m ASL). In the past, nutritional studies have placed emphasis on rural population only. An increasing proportion of the population now lives in per'-urban and urban areas and it is important to recognise the critical health care requirements of people living in these settings. The present study, therefore emphasizes the need for a comprehensive intervention strategy, which should include both the nutritional and health strategies to improve the iron status of the population.