- Visibility 68 Views
- Downloads 22 Downloads
- DOI 10.18231/j.ijpns.2022.023
-
CrossMark
Effect of moringa oleifera leaves juice to increase the haemoglobin level among anemic females
Introduction
According to United Nations - World Population Prospects (2022) the current population of India in 2022 is 1,406,631,776, a 0.95% increase from 2021, population 1,393,409,038. According to UNICEF India has the largest adolescent population in the world, 253 million. India stands to benefit, socially, politically and economically if this large number of adolescents are safe, healthy, educated for the nation of 1.39 billion. WHO defines 'Adolescents' as individuals in the 10-19 years age group and 'Youth' as the 15-24 years age group. [1]
Adolescent period is signalized by marked physical activity and rapid growth spurt; therefore, they need additional nutritional supplements and are at utmost risk of developing nutritional anaemia. Nutritional anemia is a worldwide problem, with the highest prevalence in developing countries. Anemia occurs when the number of healthy red blood cells is insufficient to meet the body’s physiological needs for oxygen delivery to the brain, heart, muscles and other vital tissues. Hemoglobin is the primary oxygen-carrying molecule within red blood cells, so anemia is most typically measured in terms of hemoglobin content of the blood rather than red blood cell volume. Anemia is considered as the most common cause of malnutrition and it has great significance in public health affecting children, adolescents and reproductive age group women in worldwide. Anaemia play a major role in affecting the adolescents especially girls. The World Health Organization global estimates of anemia prevalence averaged 56%, with a range of 35%–75% depending on geographic location. In India, the prevalence of anemia is 52%.[2]
A major problem of a girl is a menstrual period. During this period a girl used to lose approximately 45 ml of blood i.e. 22 mg of iron which leads most of the girls to get affect with anemia.[3]
Sunuwar D. R., Singh D. R., Chaudhary N. K., Pradhan P. M. S., Rai P. & Tiwari K. (2020) results from multiple logistic regression suggest that likelihood of anemia is significantly higher among younger women (15–24 years), women with primary or no education, women from the poorest wealth quintile, women without toilet facilities.[4]
One of the major health issues in adolescent Girls is an Iron Deficiency Anemia, which can be reduced by consumption of Drumsticks leaves. Drumstick leaves (DL) with its high beta carotene content (19690 mcg/100g) along with vitamin C from lemon juice may have a positive impact in the mobilization of stored iron and increase hemoglobin levels of anemic subjects. Vitamin C is a well known enhancer of iron bioavailability. Moringa oleifera tree is of sub-Himalayan origin requires very little attention and can survive in arid regions. The transcriptome data indicates multiple stress-responsive genes such as C2H2 and Myb gene families. Together, it provides compelling evidence that this plant is a ‘superfood’ and can provide nutritional sustenance. Studies show that the leaves of Moringa oleifera tree contain 30 times more iron and 100 times more calcium than spinach. “Indeed, iron, zinc and magnesium transporters were found to be highly abundant in the roots and stem parts of this tree.” says Dr. Naseer Pasha.[5]
Statement of the problem
A study to assess the effect of Moringa Oleifera leaves juice to increase the haemoglobin level among anemic females in selected rural areas of Indore, M.P.
Objective of The Study
Assess the pre test hemoglobin level among anemic females in experimental and control group.
Determine the effect of Moringa Oleifera leaves juice to increase the haemoglobin level among anemic females.
Research hypothesis
H1:- There will be significant difference between pre-test and post-test hemoglobin level with the effect of Moringa Oleifera leaves juice among anemic females in experimental and control group at 0.05 level of significance.[6]
Materials and Methods
Research approach
Quantitative research approach was used to assess the effect of Moringa Oleifera leaves juice to increase the haemoglobin level.
Research design
Quasi experimental non randomized control group design (non-equivalent control group design) was adopted to assess the effect of Moringa Oleifera leaves juice.
Variables under study
Independent variable: Moringa oleifera leaves juice
Dependent variable: Hemoglobin level
Research setting
The study is conducted in Bawliya Khurd and Bawliya Bujurg of Indore, M.P.
Population
Anemic females in selected rural areas of Indore, M.P.
Sample and sample size
30 Anemic females (15-24 years of age) in selected rural areas of Indore, M P
Sample techniques
Non probability purposive sampling was used to select the samples.
Criteria for sample selection
Inclusion criteria: Anemic females who are,
Available at the time of data collection.
Willing to participate in the study.
Exclusion criteria: anemic females who are,
Pregnant.
Having any other blood disorders like sickle cell anemia, hemophilia and thrombocytopenia.
Under any treatment.
Data Analysis and Interpretation
Section-I: Distribution of anemic females according to their demographic variable.
|
Characteristics |
Category |
Respondents |
|
|
Experimental group |
Control group |
||
|
Frequency & % |
Frequency & % |
||
|
Age |
a. 15-18 years |
5 (33.3) |
5 (33.3) |
|
b. 19-21 years |
4 (26.7) |
5 (33.3) |
|
|
c. 22-24 years |
6 (40) |
5 (33.3) |
|
|
Religion |
a.Hindu |
15 (100) |
15 (100) |
|
b.Christian |
0 |
0 |
|
|
c. Muslim |
0 |
0 |
|
|
d. Others |
0 |
0 |
|
|
Education |
a. Primary school |
5 (33.3) |
5 (33.3) |
|
b. High school & higher secondary |
10 (66.7) |
9 (60) |
|
|
a. Graduate and above |
0 |
1 (6.7) |
|
|
Marital status |
a. Single |
10 (66.7) |
9 (60) |
|
b. Married |
5 (33.3) |
6 (40) |
|
|
c. Divorced / separated |
0 |
0 |
|
|
Occupation |
a. Student |
5 (33.3) |
7 (46.7) |
|
b.Labour |
3 (20) |
4 (26.7) |
|
|
c. Home maker |
4 (26.7) |
2 (13.3) |
|
|
d. Employed |
3 (20) |
2 (13.3) |
|
|
Type of family |
a. Nuclear |
6 (40) |
5 (33.3) |
|
b.Joint |
7 (46.7) |
7 (46.7) |
|
|
c. Extended |
2 (13.3) |
3 (20) |
|
|
Monthly income of the family |
a. Less than Rs 8000 |
2 (13.3) |
1 (6.7) |
|
b.Rs.8001- 16000 |
|||
|
c. Rs.16001 and above |
4 (26.7) |
2 (13.3) |
|
|
d. |
9 (60) |
12 (80) |
|
|
Source of information regarding anemia |
a. Mass media |
2 (13.3) |
0 |
|
b. Books and magazine |
2 (13.3) |
2 (13.3) |
|
|
c. Relatives and Peer group |
10 (66.7) |
10 (66.7) |
|
|
d. Health personnel |
1 (6.7) |
3 (20) |
|
|
Family history of anemia |
a. Yes |
3 (20) |
4 (26.7) |
|
b. No |
12 (80) |
11 (73.3) |
|
|
Any medical person in the family |
a. Yes |
2 (13.3) |
2 (13.3) |
|
b. No |
13 (86.7) |
13 (86.7) |
|
|
Age at Menarche |
a.10-12 years |
2 (13) |
2 (13) |
|
b.13-15 years |
13 (87) |
13 (87) |
|
|
c. 16-18 years |
0 |
0 |
|
|
Pattern of menstruation |
a. Regular |
12 (80) |
12 (80) |
|
b.Irregular |
3 (20) |
3 (20) |
|
|
Flow of Menstruation |
a. Normal |
11 (73.3) |
12 (80) |
|
b.Heavy |
3 (20) |
1 (6.7) |
|
|
c. Scanty |
1 (6.7) |
2 (13.3) |
|
|
Days of menstruation |
a. 1-2 days |
1 (6.7) |
1 (6.7) |
|
b.3- 5 days |
14 (93.3) |
14 (93.3) |
|
|
c. 6 & above days |
0 |
0 |
|
|
Type of diet |
a. Vegetarian |
10 (66.7) |
7 (46.7) |
|
b. Mixed vegetarian |
5 (33.3) |
8 (53.3) |
|
|
Intake of beverages Coffee/ Tea/ milk |
a. Yes |
15 (100) |
12 (80) |
|
b. No |
0 |
3 (20) |
|
Table 2 Cont... |
|||
|---|---|---|---|
|
Deworming practices before |
a. Yes |
0 |
0 |
|
b. No |
15 (100) |
15 (100) |
|
|
If Yes, Frequency of deworming practice |
a. Never |
0 |
0 |
|
b. Twice a year |
0 |
0 |
|
|
Walk barefoot outside home & toilet |
a. Yes |
2 (13.3) |
1 (6.7) |
|
b. No |
13 (86.7) |
14 (93.3) |
|
|
Practice of washing hands with soap after each defecation |
a. Yes |
15 (100) |
15 (100) |
|
b. No |
0 |
0 |
|
|
Practice of washing hands with soap and water before each meals |
a. Yes |
12 (80) |
10 (66.7) |
|
b. No |
3 (20) |
5 (33.3) |
|
|
Trimming and keeping nails short regularly. |
a. Yes |
5 (33.3) |
2 (13.3) |
|
b. No |
10 (66.7) |
13 (86.7) |
Distribution of anemic females according to their demographic variables shows that maximum of the sample (40%) were in 22-24 years of age in experimental group whereas in control group there was equal distribution of sample in all the age categories. In both the experimental group and control group (100%) of the sample were Hindu in religion.[7] In education of samples (66.7%) and (60%) in experimental and control group were having high school and higher secondary education. In experimental group majority (66.7%) and (60%) in control group were single in marital status. In both the experimental and control group majority of the samples (33.3%) and (47.7%) were students. In relation to type of family, mostly (47.7%) belongs to joint family in both experimental and control group. Regarding monthly income of the family, maximum (60%) and (80%) family of the samples had an income between Rs. 16001 and above in experimental and control group respectively. in both experimental and control group (66.7%) get information regarding anemia from relatives and peer group.[8] Most of the samples (80%) in experimental and (73.3%) in control group had no family history of anemia. In both the groups mostly (86.7%) of samples had no medical person in the family and maximum (87%) of their menarche age is between 13-15 years. With regards to the pattern of menstruation majority of the samples (80%) had regular menstruation in both the groups. Concerning the flow of menstruation largest number (73.3%) & (80%) of them had normal flow and (93.3%) in 3-5 days of menstruation in experimental and control group. Mostly (66.7%) of them belongs to vegetarian in experimental group whereas (53.3%) belongs to mixed vegetarian type of diet in control group. Almost all (100%) and (80%) of them had intake of beverages in experimental and control group. In both the groups no samples practice deworming. Largest number of samples (86.7%) & (93.3%) had not walk barefoot in experimental & control group respectively.[9] All the samples (100%) has practice of washing hands with soap after each defecation. Regarding hand washing practice maximum (80%) & (66.7%) of them use to wash hands with soap and water in experimental & control group respectively. Majority of the samples (66.7%) and (86.7%) has no habit of trimming and keeping nails short regularly in experimental & control group.[10]
Section-II: Distribution of anemic females according to observational checklist.
|
S.No. |
Clinical Symptoms |
Respondents |
|
|
Experimental group |
Control group |
||
|
Frequency & % |
Frequency & % |
||
|
1. |
Shortness of breath |
10 (66.7) |
6 (40) |
|
2. |
Dizziness |
9 (60) |
10 (66.7) |
|
3. |
Irregular or fast heartbeat |
4 (26.7) |
4 (26.7) |
|
4. |
Cold in hand and feet |
8 (53.3) |
7 (40) |
|
5. |
Fatigue |
10 (66.7) |
13 (86.7) |
|
6. |
Headache |
7 (40) |
9 (60) |
|
7. |
Angular cheilitis(inflammatory lesions at the mouth's corners) |
1 (6.7) |
1 (6.7) |
|
8. |
Pale conjunctiva |
8 (53.3) |
10 (66.7) |
|
9. |
Pale tongue |
4 (26.7) |
3 (20) |
|
10. |
Pale nail |
5 (33.3) |
6 (40) |
|
11. |
Pale skin |
2 (13.3) |
2 (13.3) |
|
12. |
Koilonychia(spoon-shaped nails) |
0 (0) |
0 (0) |
|
13. |
Weak & brittle nail |
7 (40) |
7 (40) |
|
14. |
Inability to concentrate or think |
6 (40) |
7 (40) |
|
15. |
Delayed capillary refilling |
5 (33.3) |
3 (20) |
|
Lvel of Hemoglobin |
Moderate |
Mild |
Normal |
Mean |
S.D. |
|||
|
Frequency |
% |
Frequency |
% |
Frequency |
% |
|||
|
Pre test |
7 |
46.7 |
8 |
53.3 |
0 |
0 |
9.6 |
0.98 |
|
Post test |
1 |
6.7 |
10 |
66.6 |
4 |
26.7 |
10.9 |
1.03 |
|
Lvel of Hemoglobin |
Moderate |
Mild |
Normal |
Mean |
S.D. |
|||
|
Frequency |
% |
Frequency |
% |
Frequency |
% |
|||
|
Pre test |
6 |
40 |
9 |
60 |
0 |
0 |
9.6 |
0.97 |
|
Post test |
6 |
40 |
8 |
53.3 |
1 |
6.7 |
9.9 |
0.96 |
|
Group |
Mean |
Mean difference |
Standard deviation |
‘t’ value |
|
|
Experimental group |
Pre test |
9.6 |
1.33 |
0.98 |
10.6* Df 14 |
|
Post test |
10.9 |
1.03 |
|||
|
Control group |
Pre test |
9.6 |
0.3 |
0.97 |
2.3 Df 14 |
|
Post test |
9.9 |
0.96 |
Section III: Assessment of pre-test and post-test hemoglobin level among anemic females in experimental group.
The data in the table reveals that among anemic females in experimental group, 8 (53.3 %) had mild level of anemia and 7 (46.7 %) had moderate level of anemia in pre-test and 10 (66.6 %) had mild level of anemia, 1 (6.7 %) had moderate level of anemia and 4(26.7%) had no anemia in post-test.
Section IV: Assessment of pre test and post test hemoglobin level among anemic females in control group
Section V: Comparision of mean and standard deviation of hemoglobin level in experimental and control group.
The data in the table reveals that among anemic females in control group, 9 (60 %) had mild level of anemia and 6 (40 %) had moderate level of anemia in pre-test and 8 (53.3 %) had mild level of anemia, 6 (40 %) had moderate level of anemia and 1 (6.7%) had no anemia in post-test.
Source of Funding
None.
Conflict of Interest
None.
References
- D Priyal, S Roy. A Quasi Experimental Study to Assess the Effectiveness of Drumstick Leaves (Moringa Leaves) Juice on Haemoglobin Level among Adolescent Girls. Indian J Pub Health Res Dev 2020. [Google Scholar]
- WHO. About WHO South-East Asia. 2019. [Google Scholar]
- G S Jayasree, KV Shridhar, M Kaur. Effectiveness of Drumstick Leaves Juice on Hemoglobin Level among Reproductive Age Group Women in A Selected Community Area. Indian J Pub Health Res Develop 2020. [Google Scholar]
- M Priyanka. Evaluate the effectiveness of drumstick leaves juice to increase the haemoglobin level among adolescent girls with anemia in a selected homes at Madurai district.. Commun Health Nurs 2015. [Google Scholar]
- . United Nations - World Population Prospects . 2022. [Google Scholar]
- . The United Nations Population Fund (UNFPA) and the Government of India (2021) DTE Staff. . [Google Scholar]
- P Muttreja, S Singh. The United Nations Population Fund (UNFPA) and the Government of India (2021) DTE Staff:,. 2021. [Google Scholar]
- . National Health Mission (Ministry of Health & Family Welfare) 2022. . [Google Scholar]
- . National Health Mission . . [Google Scholar]
- . World Health Organization, Adolescent health and development. Internet] SEARO. World Health Organization 2020. [Google Scholar]
- B D Kamble. Prevalence of anaemia among school going adolescent girls attending Test, Treat and Talk (T-3) camp under Anaemia Mukt Bharat in Delhi. J Family Med Prim Care 2021. [Google Scholar]
- S Antriksh. Anemia in women survey Madhya Pradesh. 2022. [Google Scholar]
- R E Hodges, HE Sauberlich, JE Canham, D L Wallace, RB Rucker, LA Mejia. Hematopoietic studies in vitamin A deficiency. Am J Nutr 1978. [Google Scholar]
- Introduction
- Objective of The Study
- Materials and Methods
- Research approach
- Research design
- Variables under study
- Research setting
- Population
- Sample and sample size
- Sample techniques
- Criteria for sample selection
- Exclusion criteria: anemic females who are,
- Data Analysis and Interpretation
- Source of Funding
- Conflict of Interest