Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T08:04:46.078Z Has data issue: false hasContentIssue false
  • English
  • Français

Community-based social and demographic assessment of knowledge, attitudes, practices and medical conditions related to vitamin D deficiency in Gilgit Baltistan, Pakistan

Published online by Cambridge University Press:  02 November 2021

Sajida Maryam ,
Saman Saba ,
Waseem Haider ,
Muhmmad Sohail Afzal ,
Saiqa Mukhtar ,
Anna Durrance-Bagale ,
Raja Zoq ul Arfeen ,
Nazneen Bangash ,
Naseer Ali Shah  and
Haroon Ahmed Open the ORCID record for Haroon Ahmed [Opens in a new window]
Sajida Maryam
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
Saman Saba
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
Waseem Haider
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
Muhmmad Sohail Afzal
Affiliation:
Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore, Pakistan
Saiqa Mukhtar
Affiliation:
Fauji Foundation Hospital, Rawalpindi, Pakistan
Anna Durrance-Bagale
Affiliation:
Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
Raja Zoq ul Arfeen
Affiliation:
School of Food & Agricultural Sciences, University of Management & Technology (UMT), Lahore, Pakistan
Nazneen Bangash
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
Naseer Ali Shah
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
Haroon Ahmed*
Affiliation:
Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
*
*Corresponding author. Email: haroonahmad12@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Vitamin D is an important nutrient for bone health, and vitamin D deficiency increases the risk of various diseases. Gilgit Baltistan, the northern-most area of Pakistan, has a high prevalence of vitamin D deficiency, despite many nutritional and food safety programmes. The present study aimed to find how knowledge, attitudes and practices associated with vitamin D related to the prevalence of vitamin D deficiency among people residing in different areas of Gilgit Baltistan. The cross-sectional study was descriptive and used data from a survey carried out between February 2019 and December 2020 on individuals of both sexes aged 10 years or over in Gilgit Baltistan. Of the 575 survey participants, 306 (53.2%) had experienced signs and symptoms of vitamin D deficiency, i.e. tiredness, fatigue and bone weakness. Approximately 64.8% had some general knowledge of vitamin D and its relation to health. Participants aged 19–25 years had the highest scores on knowledge of vitamin D. Only 22.7% of interviewees had ever taken any supplements and only 25.6% often exposed themselves to sunlight. Females’ mean knowledge score (28.7; SD 7.02) was higher than that of males (24; SD 9.01). A lack of consistency was observed between attitude towards daylight exposure and knowledge of vitamin D. There was a large correlation between knowledge and attitude (p = 0.001), while a non-significant association was demonstrated between knowledge and practices (p = 0.1). Better knowledge, attitude and practices by people living in cities or more-developed regions indicates that education can be an effective way to provide awareness regarding micronutrient deficiencies. More emphasis is needed on enhancing knowledge, awareness and practices associated with vitamin D deficiency in rural areas of Pakistan. It is strongly recommended that an awareness campaign on micronutrients is launched in both rural and urban areas of Pakistan, concentrating on poor socioeconomic settings.

Keywords

Vitamin DKnowledgePakistan
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 6 , November 2022 , pp. 1100 - 1124
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Bathi, BA, Al-Zayed, KE, Al-Qenai, M, Makboul, G and El-Shazly, MK (2012) Knowledge, attitude and practice of patients attending primary care centers toward vitamin D in Kuwait. Alexandria Journal of Medicine, 48(3), 277–282.10.1016/j.ajme.2012.02.003CrossRefGoogle Scholar
AlBishi, LA, Prabahar, K, Albalawi, YM, Albalawi, SA, Abosalem, AA, Alqarni, WA et al. (2018) Knowledge, attitude and practice of health care practitioners in Saudi Arabia, with regard to prevention of vitamin D deficiency in infancy. Saudi Medical Journal 39(6), 603–608.10.15537/smj.2018.6.22238CrossRefGoogle ScholarPubMed
Aljefree, N, Lee, P and Ahmed, F (2017) Exploring knowledge and attitudes about vitamin d among adults in Saudi Arabia: a qualitative study. Healthcare (Basel) 5(4), 76.10.3390/healthcare5040076CrossRefGoogle ScholarPubMed
Anwar, M, El-Dahiyat, F, Jairoun, A, Raed, R, Butt, I, Abdel-Majid, W and Abdelgadir, H (2019) The sunshine under our skin: public knowledge and practices about vitamin D deficiency in Al Ain, United Arab Emirates. Archives of Osteoporosis 14(1), 111.10.1007/s11657-019-0671-5CrossRefGoogle ScholarPubMed
Benz, A (2013) Education and development in the Karakorum: educational expansion and its impacts in Gilgit-Baltistan, Pakistan. Erdkunde 67(2), 123–136.CrossRefGoogle Scholar
Bolek-Berquist, J, Elliott, ME, Gangnon, RE, Gemar, D, Engelke, J, Lawrence, SJ and Hansen, KE (2009) Use of a questionnaire to assess vitamin D status in young adults. Public Health Nutrition 12, 236–243.CrossRefGoogle ScholarPubMed
Burchell, K, Rhodes, LE and Webb, AR (2020) Public awareness and behaviour in Great Britain in the context of sunlight exposure and vitamin D: results from the first large-scale and representative survey. International Journal of Environmental Research & Public Health 17(18), 6924.CrossRefGoogle ScholarPubMed
Christie, FT and Mason, L (2011) Knowledge, attitude and practice regarding vitamin D deficiency among female students in Saudi Arabia: a qualitative exploration. International Journal of Rheumatic Diseases 14(3), e22–29.CrossRefGoogle ScholarPubMed
Faghih, S, Abdolahzadeh, M, Mohammadi, M and Hasanzadeh, J (2014) Prevalence of vitamin D deficiency and its related factors among university students in Shiraz, Iran. International Journal of Preventive Medicine 5(6), 796–799.Google ScholarPubMed
Geddawy, A, Al-Burayk, AK, Almhaine, AA, Al-Ayed, YS, Bin-Hotan, AS and Bahakim, NO (2020) Response regarding the importance of vitamin D and calcium among undergraduate health sciences students in Al Kharj, Saudi Arabia. Archives of Osteoporosis 15(1), 114.CrossRefGoogle ScholarPubMed
Haq, F, Khan, R and Mustehsan, Z (2017) Assessment of knowledge, attitude and practices regarding vitamin D among students of Saidu Medical College, Swat. Pakistan Journal of Public Health 7(1), 1–4.CrossRefGoogle Scholar
Haque, I, Salam, T, Hussain, M, Iqbal, W, Zafar, S, Tayyab, GUN and Javed, M (2010) Assessment of the Vitamin D levels in the patients presenting with different medical conditions and its correlation with symptomatology. Annals of King Edward Medical University 15(2), 60.Google Scholar
Harvard Health (2017) 9 Things That Can Undermine your Vitamin D Level. Harvard Health Publishing. URL: https://www.health.harvard.edu/staying-healthy/9-things-that-can-affect-your-vitamin-d-level Google Scholar
Hawkins, RC (2009) 25-OH vitamin D3 concentrations in Chinese, Malays, and Indians. Annals of Laboratory Medicine 33(2), 156–158.CrossRefGoogle Scholar
Ho-Pham, LT, Nguyen, ND, Lai, TQ, Eisman, JA and Nguyen, TV (2011) Vitamin D status and parathyroid hormone in an urban population in Vietnam. Osteoporosis International 22(1), 241–248.CrossRefGoogle Scholar
Holvik, K, Meyer, HE, Haug, E and Brunvand, L. (2005) Prevalence and predictors of vitamin D deficiency in five immigrant groups living in Oslo, Norway: the Oslo immigrant health study. European Journal of Clinical Nutrition 59(1), 57–63.CrossRefGoogle ScholarPubMed
Iqbal, R and Khan, AH (2010) Possible causes of vitamin D deficiency (VDD) in Pakistani population residing in Pakistan. Journal of Pakistan Medical Association 60(1), 1–2.Google ScholarPubMed
Kashi, Z, Saeedian, F, Akha, O, Gorgi, M, Emadi, S and Zakeri, H (2011) Vitamin D deficiency prevalence in summer compared to winter in a city with high humidity and a sultry climate. Endokrynologia Polska 62(3), 249–251.Google Scholar
Mays, S, Prowse, T, George, M and Brickley, M (2018) Latitude, urbanization, age, and sex as risk factors for vitamin D deficiency disease in the Roman Empire. American Journal of Physical Anthropology 167(3), 484–496.CrossRefGoogle ScholarPubMed
Mazahery, H and von Hurst, PR (2015) Factors affecting 25-hydroxyvitamin D concentration in response to vitamin D supplementation. Nutrients 7(7), 5111–5142.CrossRefGoogle ScholarPubMed
Mekonnen, W, Feleke, Y, Desalegn, Y, Tarekegne, G, Lambisso, B and Haidar, J et al. (2020) Knowledge, attitude and practice of health care workers on measuring adult vitamin D level, diagnosis of deficiency, and management of consequent health conditions in three ecologies of Ethiopia: a cross-sectional study. BMC Nutrition 6(1), 77.CrossRefGoogle ScholarPubMed
Nimitphong, H and Holick, MF (2013) Vitamin D status and sun exposure in southeast Asia. Dermato-Endocrinology 5(1), 34–37.CrossRefGoogle Scholar
O’Connor, C, Glatt, D, White, L and Revuelta Iniesta, R (2018) Knowledge, attitudes and perceptions towards vitamin D in a UK adult population: a cross-sectional study. International Journal of Environmental Research and Public Health 15(11), 2387.CrossRefGoogle Scholar
Özel, E, Cantarero-Arevalo, L and Jacobsen, R (2020) Vitamin D knowledge, attitudes, and behaviors in young Danish women with a non-western ethnic minority background – a questionnaire survey. International Journal of Environmental Research and Public Health 17(21), 8053.CrossRefGoogle ScholarPubMed
Pludowski, P, Holick, MF, Grant, WB, Konstantynowicz, J, Mascarenhas, MR, Haq, A et al. (2018) Vitamin D supplementation guidelines. Journal of Steroid Biochemistry and Molecular Biology 175, 125–135. doi: 10.1016/j.jsbmb.2017.01.021 CrossRefGoogle ScholarPubMed
Rab, SM (1976) Occult osteomalacia amongst healthy and pregnant women in Pakistan. The Lancet 2(7997), 1211–1213.CrossRefGoogle ScholarPubMed
Riaz, H, Finlayson, AE, Bashir, S, Hussain, S, Mahmood, S, Malik, F and Godman, B (2016) Prevalence of Vitamin D deficiency in Pakistan and implications for the future. Expert Review of Clinical Pharmacology 9(2), 329–338.CrossRefGoogle ScholarPubMed
Roth, DE, Abrams, SA, Aloia, J, Bergeron, G, Bourassa, MW, Brown, KH and Whiting, SJ (2018) Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Annals of the New York Academy of Sciences 1430(1), 44–79.CrossRefGoogle ScholarPubMed
Shahudin, NN, Sameeha, MJ, Mat Ludin, AF, Manaf, ZA, Chin, K-Y and Jamil, NA (2020). Barriers towards sun exposure and strategies to overcome these barriers in female indoor workers with insufficient vitamin D: a qualitative approach. Nutrients 12(10), 2994.CrossRefGoogle ScholarPubMed
Sheikh, A, Saeed, Z, Jafri, SA, Yazdani, I and Hussain, SA (2012). Vitamin D levels in asymptomatic adults – a population survey in Karachi, Pakistan. PLoS One 7(3), e33452.CrossRefGoogle ScholarPubMed
Tariq, A, Khan, SR and Basharat, A (2020) Assessment of knowledge, attitudes and practice towards Vitamin D among university students in Pakistan. BMC Public Health 20(1), 355.CrossRefGoogle ScholarPubMed
Tsiaras, WG and Weinstock, MA (2011) Factors influencing vitamin D status. Acta Dermato-Venereologica 91(2), 115–124 CrossRefGoogle ScholarPubMed
UNICEF (2018) National Nutrition Survey 2018. UNICEF and United Kingdom’s Department for International Development (DFID).Google Scholar
Vu, LH, van der Pols, JC, Whiteman, DC, Kimlin, GM and Neale, RE (2010) Knowledge and attitudes about Vitamin D and impact on sun protection practices among urban office workers in Brisbane, Australia. Cancer Epidemiology, Biomarkers & Prevention 19(7), 1784–1789.CrossRefGoogle Scholar
Wacker, M and Holick, MF (2013) Vitamin D – effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 5(1), 111–148.CrossRefGoogle ScholarPubMed
Wikipedia (2011) Gilgit-Baltistan. Wikipedia.Google Scholar
Zadka, K, Pałkowska-Goździk, E and Rosołowska-Huszcz, D (2018) The state of knowledge about nutrition sources of vitamin D, its role in the human body, and necessity of supplementation among parents in central Poland. International Journal of Environmental Research and Public Health 15(7), 1489.CrossRefGoogle ScholarPubMed
Zhou, M, Zhuang, W, Yuan, Y, Li, Z and Cai, Y (2016) Investigation on vitamin D knowledge, attitude and practice of university students in Nanjing, China. Public Health Nutrition 19(1), 78–82.CrossRefGoogle ScholarPubMed