30DEC

Libyan International Conference for Health Sciences

The First Libyan International Conference for Health Sciences (2024): Open University, Tripoli, Libya
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
https://app.periodikos.com.br/journal/medjpps/article/doi/10.5281/zenodo.7115292

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Original article

Knowledge, attitude, and practice of Libyan medical students about vitamin D deficiency

Mustafa A. Alssageer, Naser M. Alaasswad, Amna I. Jebril, Hajir A. Ahmed, Roqaia S. Almahdi

Downloads: 1
Views: 147

Abstract

The prevalence rate of vitamin D deficiency over the last decades has grown up rapidly worldwide among young adults. Therefore, the aim of this study is to explore the knowledge, attitude, and practice of Libyan medical students of Sebha University regarding vitamin D deficiency. Out of a total of 200 questionnaires, 148 completed questionnaires were returned (74.0% response rate). The majority of respondents did not measure their vitamin D levels (62.1%). Participants who indicated they were exposed to sunlight for less than 15 min were 47.2% while 74.9% were exposed to less than 30 min with a highly significant gender difference (p<0.001). All the males did not use sunscreen creams compared with females (43.5%). Nearly two-thirds of the participants (61.4%) denied drinking milk almost daily with significant differences based on gender (p<0.005) while 56.0 % of the participants reported eating fish, 60.8% of the students denied eating fast food and 74.3% eating eggs daily or weekly. However, 49.3% of the students usually drink tea and coffee after meals, and do not usually practice exercise (53.3%), however, disagreed that their food has a low amount of calcium (30.4%). Most of the students agreed with the benefits of vitamin D (72.0%). Based on the assessment of awareness of the participants about vitamin D information, the average of correct answers percentage of the respondents was 47.1%. The most frequent sources of vitamin D information were the internet which accounted for 49.3%, followed by relatives and friends (31.7%). Some of the respondents (58.7%) reported that unawareness is the main cause of vitamin D deficiency. This study highlights the lack of awareness about the importance of vitamin D among medical students. This finding provides the institutions of medical education in Libya with an evidence base for a deficit of knowledge regarding young health which could be utilized to draw a strategy to correct the health behaviors of students and the community through medical education programs.

Keywords

Attitude, knowledge, Libya, medical student, vitamin D deficiency

References

  1. Cashman KD (2007) Calcium and vitamin D. Novartis Foundation Symposium. 282:123-138, PMID: 17913228.
  2. Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G, Ragi-Eis S, Chandler J (2006) The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. Journal of Internal Medicine. 260 (3): 245-254. doi: 10.1111/j.1365-2796.2006.01685.x
  3. Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. American Journal of Clinical Nutrition. 87 (4): 1080S-1086S. doi: 10.1093/ajcn/87.4.1080S
  4. Prentice A (2008) Vitamin D deficiency: a global perspective. Nutrition Review. 66 (10, 2S): S153-164. doi: 10.1111/j.1753-4887.2008.00100.x
  5. Adams JS, Hewison M (2010) Update in vitamin D. Journal of Clinical Endocrinology and Metabolism. 95 (2): 471-478. doi: 10.1210/jc.2009-1773
  6. Correale J, Ysrraelit MC, Gaitán MI (2009) Immunomodulatory effects of vitamin D in multiple sclerosis. Brain. 132 (5):1146-1160. doi: 10.1093/brain/awp033
  7. Bener A, Al-Hamaq AO, Saleh NM (2013) Association between vitamin D insufficiency and adverse pregnancy outcome: global  comparisons. International Journal of Womens Health. 5: 523-531. doi: 10.2147/IJWH.S51403
  8. Janssen HCJP, Samson MM, Verhaar HJJ (2002) Vitamin D deficiency, muscle function, and falls in elderly people. American Journal of Clinical Nutrition. 75 (4): 611-615. doi: 10.1093/ajcn/75.4.611
  9. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. American Journal of Clinical Nutrition. 84 (1): 18-28. doi: 10.1093/ajcn/84.1.18
  10. Rajpathak SN, Rimm EB, Rosner B, Willett WC, Hu FB (2006) Calcium and dairy intakes in relation to long-term weight gain in US men. American Journal of Clinical Nutrition. 83 (3): 559-566. doi: 10.1093/ajcn. 83.3.559
  11. Tangpricha V, Pearce EN, Chen TC, Holick MF (2002) Vitamin D insufficiency among free-living healthy young adults. American Journal of Medicine. 112 (8): 659-662. doi: 10.1016/s0002-9343(02)01091-4
  12. Alaasswad NM, Jebril AI, Ahmed HA, Almahdi RS, Alssageer MA (2022) Vitamin D deficiency and anemia among pharmacy students. Mediterreanen Journal of Pharmacy and Pharmaceutical Sciences. 2 (2): 90-96. doi: 10.5281/zenodo.6780515
  13. Nowreen N, Hameed R (2019) Awareness regarding the importance of vitamin D and prevention of its deficiency among female undergraduate medical students. International Journal Basic and Clinical Pharmacology. 8 (5): 865-868. doi: 10.18203/2319-2003.ijbcp20191563
  14. Juanid R, Feroz S, Mugh A (2019) Knowledge, attitude and practice of medical students regarding vitamin D. Journal of Rawalpindi Medical Colloge. 23 (S-2): 98-103. doi: Nil.
  15. Kung AWC, Lee K-K (2006) Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong. BMC Public Health. 6 (1): 226. doi: 10.1186/1471-2458-6-226
  16. MacKeigan LD, Larson LN (1989) Development and validation of an instrument to measure patient satisfaction with  pharmacy services. Medical Care. 27 (5): 522-536. doi: 10.1097/00005650-198905000-00007
  17. Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. American Journal of Clinical Nutrition. 80 (6S): 1678S-88S. doi: 10.1093/ajcn/ 80.6.1678S
  18. Glerup H, Mikkelsen K, Poulsen L, Hass L, Overbeck S, Thomsen J, Charles P, Eriksen EF (2000) Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. Journal of Internal Medicine. 247 (2): 260-268. doi: 10.1046/j.1365-2796.2000.00595.x
  19. Gannagé-Yared M-H, Chemali R, Yaacoub N, Halaby G (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. Journal of Bone and Mineral Research. 15 (9): 1856-1862. doi: 10.1359/ jbmr.2000.15.9.1856
  20. Sedrani SH, Elidrissy AW, El Arabi KM (1983) Sunlight and vitamin D status in normal Saudi subjects. American Journal of Clinical Nutrition. 38 (1): 129-132. doi: 10.1093/ajcn/38.1.129
  21. El-Sonbaty MR, Abdul-Ghaffar NU (1996) Vitamin D deficiency in veiled Kuwaiti women. European Journal of Clinical Nutrition. 50 (5): 315-318. PMID: 8735313.
  22. Hashemipour S, Larijani B, Adibi H, Javadi E, Sedaghat M, Pajouchi M, Soltani A, Shafaei AR, Hamidi Z, Fard ARK, Hossein Nezhad A, Booya F (2004) Vitamin D deficiency and causative factors in the population of Tehran. BMC Public Health. 4: 38. doi: 10.1186/1471-2458-4-38
  23. Holvik K, Brunvand L, Brustad M, Meyer HE (2008) Vitamin D status in the Norwegian population. Solar Radiation and Human Health. Oslo: The Norwegian Academy of Science and Letters, 2008.
  24. Ali SM, Salih LMA, Saeed E (2019) Awareness of medical students about vitamin D deficiency at Ahfad University for  women, Sudan. Sudan Journal of Paediatrics. 19 (2): 117-125. doi: 10.24911/SJP.106-1574764595
  25. Matsuoka LY, Ide L, Wortsman J, MacLaughlin JA, Holick MF (1987) Sunscreens suppress cutaneous vitamin D3 synthesis. Journal of Clinical Endocrinology and Metabolism. 64 (6): 1165-1168. doi: 10.1210/jcem-64-6-1165
  26. Zhou M, Zhuang W, Yuan Y, Li Z, Cai Y (2016) Investigation on vitamin D knowledge, attitude and practice of university students in Nanjing, China. Public Health Nutrition. 19 (1): 78-82. doi: 10.1017/ S1368980015000373
  27. Abroms L, Jorgensen CM, Southwell BG, Geller AC, Emmons KM (2003) Gender differences in young adults’ beliefs about sunscreen use. Public Health Education. 30 (1): 29-43. doi: 10.1177/1090198102239257
  28. Misra M, Tsai P, Anderson EJ, Hubbard JL, Gallagher K, Soyka LA, Miller KK, Herzog DB, Klibanski A (2006) Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents. American Journal of Clinical Nutrition. 84 (4): 698-706. doi: 10.1093/ajcn/84.4.698
  29. Stechschulte SA, Kirsner RS, Federman DG (2009) Vitamin D: bone and beyond, rationale and recommendations for supplementation. American Journal of Medicine. 122 (9): 793-802. doi: 10.1016/ j.amjmed.2009.02.029
  30. Henderson L, Gregory J, Swan G (2003) The national diet and nutrition survey: adults aged 19 to 64 years. Vitamamin Mineral intake. Urine Analysis. 3: 1-8. ISBN: 0116215666.
  31. Guo J, Kliem KE, Lovegrove JA, Givens DI (2017) Effect of production system, supermarket and purchase date on the vitamin D content of eggs at retail. Food Chemistry. 221: 1021-1025. doi: 10.1016/j.foodchem. 2016.11.060
  32. Bjørgen K (2016) Physical activity in light of affordances in outdoor environments: qualitative observation studies of 3-5 years olds in kindergarten. Springerplus. 5 (1): 950. doi:10.1186/s40064-016-2565-y.
  33. Altajori NN, ElshrekYM (2017) Risk factors for non-communicable diseases in Libya. Egyptian Journal of Hospital Medicine. 66 (1): 202-214. doi: 10.12816/0034654
  34. Brock K, Huang W-Y, Fraser DR, Tseng M, Solomon RS, Peters U, Ahn J, Purdue M, Mason RS, McCarty C, Zeigler RG, Graubard B (2010) Low vitamin D status is associated with physical inactivity, obesity and low vitamin D intake in a large US sample of healthy middle-aged men and women. Journal of Steroid Biochemistry and Molecular Biology. 121 (1): 462-466. doi: 10.1016/j.jsbmb.2010.03.091
  35. Ahmadieh H, Azar ST, Lakkis N, Arabi A (2013) Hypovitaminosis D in patients with type 2 diabetes mellitus: a relation to disease  control and complications. ISRN Endocrinology. 2013: 641098. doi:10.1155/2013/641098.
  36. Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, Hu FB (2013) Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of  prospective studies. Diabetes Care. 36 (5): 1422-1428. doi: 10.2337/dc12-0962
  37. Kositsawat J, Freeman VL, Gerber BS, Geraci S (2010) Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey. Diabetes Care. 33 (6): 1236-1238. doi: 10.2337/dc09-2150
  38. Wang TJ, Zhang F, Richards JB, Spector TD (2010) Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet (London, England). 376 (9736): 180-188. doi: 10.1016/S0140-6736(10)60588-0
  39. Karohl C, Su S, Kumari M, Tangpricha V, Veledar E, Vaccarino V, Raggi P (2010) Heritability and seasonal variability of vitamin D concentrations in male twins. American Journal of Clinical Nutrition. 92 (6): 1393-1398. doi: 10.3945/ajcn.2010.30176
  40. Fuleihan GE, Bouillon R, Clarke B, Chakhtoura M, Cooper C, McClung M, Singh RJ (2015) Serum 25-Hydroxyvitamin D levels: variability, knowledge gaps, and the concept of a desirable range. Journal of Bone and Mineral Research. 30. doi: 10.1002/jbmr.2536
  41. Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, Tamez H, Zhang D, Bhan I, Karumanchi SA, Powe NR, Thadhani R (2013) Vitamin D-binding protein and vitamin D status of black Americans and white Americans. New England Journal of Medicine. 369 (21): 1991-2000. doi: 10.1056/NEJMoa1306357
  42. Babelghaith SD, Wajid S, Al-Zaaqi MA, Al-Malki AS, Al-Amri FD, Alghadeer SA, Al-Arifi M (2017) Knowledge and practice of vitamin D deficiency among people lives in Riyadh, Saudi Arabia-A cross-sectional study. An International Journal of Medical Sciences. 28 (7): 3114-3118. Corpus ID: 28469126.
  43. Brand CA, Abi HY, Couch D, Vindigni A, Wark JD (2008) Vitamin D deficiency: a study of community beliefs among dark skinned and veiled people. International Journal of Rheumatic Diseases. 11 (1): 15-23. doi: 10.1111/j.1756-185X.2008.00323.x
  44. Khalsa S (2009) Vitamin D revolution: how the power of this amazing vitamin can change your life. (Inc. HH, ed.), pp-192. ISBN: 978-1-4019-2470-6. Publisher: Hay House, USA. doi: Nil.
  45. Tariq A, Khan SR, Basharat A (2020) Assessment of knowledge, attitudes and practice towards vitamin D among university students in Pakistan. BMC Public Health. 20 (1): 355. doi: 10.1186/s12889-020-8453-y
  46. Vu LH, van der Pols JC, Whiteman DC, Kimlin MG, 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 and Prevention. 19 (7): 1784-1789. doi: 10.1158/1055-9965.EPI-10-0127
  47. lemu E, Varnam R (2012) Awareness of vitamin D deficiency among at-risk patients. BMC Research Notes. 5 (1): 17. doi: 10.1186/1756-0500-5-17
  48. Sanad HM, Priya G, Mukhaimer JJ, Asokan GV, Belal S (2020) Knowledge and awareness of vitamin D deficiency among the general adult population in BAHRAIN: a cross-sectional study. European Journal of Molecular and Clinical Medicine. 7 (9): 180-191. doi: Nil.
  49. Uddin R, Huda NH, Jhanker YM, Jesmeen T, Imam MZ, Akter S (2013) Awareness regarding the importance of calcium and vitamin D among the undergraduate pharmacy students in Bangladesh. BMC Research Notes. 6: 134. doi: 10.1186/1756-0500-6-134
  50. O’Connor C, Glatt D, White L, Iniesta RR (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. doi: 10.3390/ijerph15112387
  51. Al-Amri F, Gad A, Al-Habib D, Ibrahim AK (2017) Knowledge, attitude and practice regarding vitamin D among primary health care physicians in Riyadh city, Saudi Arabia, 2015. World Journal of Food and Scientific Technology. 1 (2): 47-55. doi: 10.11648/j.wjfst.20170102.13
  52. Mithal A, Wahl DA, Bonjour J-P, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International. 20 (11): 1807-1820. doi: 10.1007/s00198-009-0954-6
  53. Hagenau T, Vest R, Gissel TN, Poulsen CS, Erlandsen M, Mosekidle L, Vestergraad P (2009) Global vitamin D levels in relation to age, gender, skin pigmentation and latitude: an ecologic meta-regression analysis. Osteoporossis International. 20 (1): 133-140. doi: 10.1007/s00198-008-0626-y
  54. Arora H, Dixit V, Srivastava N (2016) Evaluation of knowledge, practices of vitamin D and attitude toward sunlight among Indian students. Asian Journal of Pharmaceutical and Research. 9 (1): 308-313. doi: Nil.
  55. Nair R, Maseeh A. Vitamin D (2012) The “sunshine” vitamin. Journal of Pharmacology and Pharmacotherapy. 3 (2): 118-126. doi: 10.4103/0976-500X.95506

Submitted date:
09/09/2022

Reviewed date:
09/22/2022

Accepted date:
09/27/2022

Publication date:
11/07/2024

672d3ac1a9539543e52824a2 medjpps Articles
Links & Downloads

Mediterr J Pharm Pharm Sci

Share this page
Page Sections