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Assessment of awareness, knowledge, and usage of folic acid among females in Jazan Region, Saudi Arabia

Gasim Dobie(1), Nouf Al-Hazazi(2), Maram Nahari(3), Areej M. Sabyani(4), Khaled Essawi(5), Abdullah A. Mobarki(6), Waleed Hakami(7), Naema A. Alqahtani(8), Bandar M. Almalki(9), Asma M. Farah(10), Adel M. Hakami(11), Shaqraa Musawi(12), Fatemah A. Alhakami(13), Mohamed Y. Alfoud(14), Yara Alyahyawi(15), Aymen M Madkhali(16), Ali Hakamy(17), Rama Chandika(18), Muhammad Saboor(19), Amnah Hanin(20), Mohammad S. Akhter(21), Hassan A. Hamali(22),


(1) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(2) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(3) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(4) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(5) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(6) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(7) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(8) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(9) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(10) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(11) Jazan University Hospital, Jazan University, Jazan, Saudi Arabia
(12) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(13) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(14) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(15) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(16) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(17) Nursing Department, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(18) Department of Clinical Nutrition, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(19) Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates. Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirate
(20) Pediatric ward, Baish General Hospital, Jazan Health Affairs, Jazan, Saudi Arabia
(21) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
(22) Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
Corresponding Author

Abstract


Folic acid (FA) plays a crucial role in various biological processes. Insufficient intake of FA during pregnancy can lead to serious clinical complications, including neural tube defect. The current study sought to assess the awareness, knowledge, and usage of FA among young females in Jazan region of Saudi Arabia. This cross-sectional descriptive study involved 472 adult females from October 1 to 9, 2023, in Jazan region, Saudi Arabia. The questionnaire of the study was randomly distributed among females. The data showed that awareness and usage of FA supplementation were poor to fair among females. Furthermore, socio-demographic variables, including age, marital status, monthly income, education levels, number of pregnancies, and current pregnancy status, were found to be associated with awareness and utilization of FA supplementation. The study highlights the need to enhance awareness and knowledge of FA supplementation among females in the Jazan region. Introducing educational programs is essential in Saudi Arabia, particularly in the Jazan region, to enhance the knowledge and awareness of FA within the community.

References


Shulpekova Y, Nechaev V, Kardasheva S, Sedova A,

Kurbatova A, Bueverova E, Kopylov A, Malsagova K,

Dlamini JC and Ivashkin V. The Concept of Folic

Acid in Health and Disease. Molecules. 2021;26(12).

doi:10.3390/molecules26123731

Botto LD, Moore CA, Khoury MJ and Erickson JD. Neuraltube defects. N Engl J Med. 1999;341(20):1509-1519.

doi:10.1056/NEJM199911113412006

Botto LD, Lisi A, Robert-Gnansia E, Erickson JD, Vollset SE,

Mastroiacovo P, Botting B, Cocchi G, de Vigan C, de

Walle H, Feijoo M, Irgens LM, McDonnell B, Merlob

P, Ritvanen A, Scarano G, Siffel C, Metneki J, Stoll

C, Smithells R and Goujard J. International

retrospective cohort study of neural tube defects in

relation to folic acid recommendations: are the

recommendations working? BMJ.

;330(7491):571.

doi:10.1136/bmj.38336.664352.82

World Health Organization (WHO). Periconceptional Folic

Acid Supplementation to Prevent Neural Tube

Defects.; 2023.

Saudi Standard of Fortification. 1421H (2001)

MKS/219/1981.

Safdar OY, Al-Dabbagh AA, Abuelieneen WA and Kari JA.

Decline in the incidence of neural tube defects after

the national fortification of flour (1997-2005). Saudi

Med J. 2007;28(8):1227-1229.

Hakami WS, and Majeed-Saidan MA. The incidence and

spectrum of central nervous system malformations in

newborns over a decade (2001-2010) in the Central

Region of Saudi Arabia. Saudi Med J.

;32(11):1137-1142.

Al Rakaf MS, Kurdi AM, Ammari AN, Al Hashem AM,

Shoukri MM, Garne E and Majeed-Saidan

MA. Patterns of folic acid use in pregnant Saudi

women and prevalence of neural tube defects- Results

from a nested case-control study. Prev Med reports.

;2:572-576. doi:10.1016/j.pmedr.2015.06.016

Saudi Arabia Ministry of Health. Planning for pregnancy.

https://

www.moh.gov.sa/en/HealthAwareness/EducationalC

ontent/ wh/Pages/008.aspx.

AL-Mohaithef M, Alaslani H, Javed NB, and

Chandramohan S. Folic acid awareness and usage

among females at Saudi Electronic University in

Jeddah, Saudi Arabia. SAGE Open Med. 2021;9.

doi:10.1177/20503121211059682

Al Arifi MN, Alqahtani AM, Alotaibi AN, Babelghaith SD,

Alwhaibi A, Alsanea S, Alghadeer SM and Al-Arifi

NM. Knowledge and Practice of Childbearing

Women in Saudi Arabia towards Folic Acid

Supplement—Evidence from a Cross-Sectional

Study. Nutrients. 2022;14(2).

doi:10.3390/nu14020357

Alanazi AM, Alanazi AJ, Alanazi YW, Alanazi MS, Rezk G and Hammad SM. Level of Awareness and

Knowledge of Folic Acid Intake among Women in the

Reproductive Age in ARAR Region, Saudi Arabia. J

Pharm Res Int. 2021;33:287-297.

doi:10.9734/jpri/2021/v33i58a34118

Alamer E, Al-Watban L and Nafisah FI. Understanding

primary health care physicians’ perspective and

approach to pre-conception care in Saudi Arabia. Fam

Pract. 2022;39(1):137-143.

doi:10.1093/fampra/cmab065

AlDuraibi S and Al-Mutawa J. Knowledge and awareness of

folic acid usage in Saudi pregnant women in Riyadh

city from 2019-2020. J Fam Med Prim care.

;9(10):5158-5164.

doi:10.4103/jfmpc.jfmpc_638_20

Alreshidi FF, Almujil AS and Malak AS. Awareness of folic

acid use among Saudi women attending outpatient

clinics at King Fahad Medical City. J Fam Med Prim

care. 2018;7(5):957-962.

doi:10.4103/jfmpc.jfmpc_174_18

Al-Marwani S and Al-Zahrani A. Attitude and Practice of

Folic Acid Consumption Among Saudi Pregnant

Women at Yanbu City, Kingdom of Saudi Arabia.

Cureus. 2022;14(9):e28860.

doi:10.7759/cureus.28860

Al Bahhawi T, Doweri AA, Sawadi RM, Awaji MY, Jarad

MM, Sulays ZY and Madkor KA. Consumption habits

of pregnant women in the Jazan region, Saudi Arabia:

a descriptive study. BMC Res Notes. 2018;11(1):817.

doi:10.1186/s13104-018-3921-5

Nemri A, Aslany S, Abulaban O, Sindi G, Zuhairy S, Farsi

R, Almosallam SA and Safdar OY. Folate deficiency

knowledge and use of folic acid among women of

childbearing age in the Kingdom of Saudi Arabia: A

population-based cross-sectional study. Int J Med Dev

Ctries. 2019;3(December 2018):60-66.

doi:10.24911/ijmdc.51-1542585084

Al-holy M, Eideh A, Epuru S, Abu-jamous D and Ashankyty

I. Awareness of Folic Acid Intake among Women in

the Childbearing Age in Hail Region — Saudi Arabia.

Food Nutr Sci. 2013;4(January):49-55.

Sabi EM, Mujamammi AH, Alturki N, Alzaid T, Almutairi

A, Algarni R, Almaziad D, Alhumaidhi N, Kurdee Z

and Sumaily KM. Level of Knowledge and Awareness

of Female Undergraduate Students and Determinants

of Knowledge of Folic Acid and Supplementation.

Med. 2022;58(8):1-8. doi:10.3390/medicina58080986

Al-Zahrani A and Al-Marwani S. The effectiveness of an

educational session about folic acid on pregnant

women’s knowledge in Yanbu City, Kingdom of

Saudi Arabia. AIMS Med Sci. 2022;9(3):394-413.

doi:10.3934/medsci.2022019

Hakami W, Dobie G, Alneami KA, Shaabi M, Essawi K,

Saboor M, Madkhali AM, Nahari MH, Almasoudi

HH, Akhter MS, Hakami FH, Zarbatan FA, Hakamy

A, Chandika RM, Fageehi AA, Mobarki AA and

Hamali HA. Assessing Nutritional Anemia Among

University Students in Jazan, Saudi Arabia: A Public

Health Perspective. J Blood Med. 2024;15:51-60.

doi:10.2147/JBM.S436673

AbdRabou MA. Awareness of Folic Acid Intake for

Prevention of Neural Tube Defects among Women in

Sakaka, Saudi Arabia. Int J Pharmacol. 2019;15:274-

Al-Akhfash AA, Abdulla AM, Osman AM, Abdulgafar JI

and Almesned AA. Maternal knowledge and use of

folic acid among Saudi females. Saudi Med J.

;34(11):1173-1178.

Bukhari AA, Bajouh OS, Aljehani MA, Alzahrani NJ, Al

Qahtani AM and Almrstani AM. The Awareness of

Folic Acid Supplements among Women of Child

bearing Age in King Abdulaziz University Hospital,

Jeddah-Saudi Arabia. Int J Life-Sciences Sci Res.

;2(5):592-598. doi:10.21276/ijlssr.2016.2.5.14

Alhakeem MM. Impact of education on knowledge and use

of folic acid among Saudi Women. Pakistan J Med

Sci. 2012;28(4):686-690.

Al-Hossani H, Abouzeid H, Salah MM, Farag HM and

Fawzy E. Knowledge and practices of pregnant

women about folic acid in pregnancy in Abu Dhabi,

United Arab Emirates. East Mediterr Heal J.

;16(4):402-407.

Al-Darzi W, Al-Mudares F, Farah A, Ali A and Marzouk D.

Knowledge of periconceptional folic acid use among

pregnant women at Ain Shams University Hospital,

Cairo, Egypt. East Mediterr Heal J. 2014;20(9):561-

Rasmussen MM, and Clemmensen D. Folic acid

supplementation in pregnant women. Dan Med Bull.

;57(1):A4134.

Al-Mohaithef M, Alaslani H, Javed NB and Chandramohan

S. Folic acid awareness and usage among females at

Saudi Electronic University in Jeddah, Saudi Arabia.

SAGE open Med. 2021;9:20503121211059680.

doi:10.1177/20503121211059682

Shulpekova Y, Nechaev V, Kardasheva S, Sedova A,

Kurbatova A, Bueverova E, Kopylov A, Malsagova K,

Dlamini JC and Ivashkin V. The Concept of Folic

Acid in Health and Disease. Molecules. 2021;26(12).

doi:10.3390/molecules26123731

Botto LD, Moore CA, Khoury MJ and Erickson JD. Neuraltube defects. N Engl J Med. 1999;341(20):1509-1519.

doi:10.1056/NEJM199911113412006

Botto LD, Lisi A, Robert-Gnansia E, Erickson JD, Vollset SE,

Mastroiacovo P, Botting B, Cocchi G, de Vigan C, de

Walle H, Feijoo M, Irgens LM, McDonnell B, Merlob

P, Ritvanen A, Scarano G, Siffel C, Metneki J, Stoll

C, Smithells R and Goujard J. International

retrospective cohort study of neural tube defects in

relation to folic acid recommendations: are the

recommendations working? BMJ.

;330(7491):571.

doi:10.1136/bmj.38336.664352.82

World Health Organization (WHO). Periconceptional Folic

Acid Supplementation to Prevent Neural Tube

Defects.; 2023.

Saudi Standard of Fortification. 1421H (2001)

MKS/219/1981.

Safdar OY, Al-Dabbagh AA, Abuelieneen WA and Kari JA.

Decline in the incidence of neural tube defects after

the national fortification of flour (1997-2005). Saudi

Med J. 2007;28(8):1227-1229.

Hakami WS, and Majeed-Saidan MA. The incidence and

spectrum of central nervous system malformations in newborns over a decade (2001-2010) in the Central

Region of Saudi Arabia. Saudi Med J.

;32(11):1137-1142.

Al Rakaf MS, Kurdi AM, Ammari AN, Al Hashem AM,

Shoukri MM, Garne E and Majeed-Saidan

MA. Patterns of folic acid use in pregnant Saudi

women and prevalence of neural tube defects- Results

from a nested case-control study. Prev Med reports.

;2:572-576. doi:10.1016/j.pmedr.2015.06.016

Saudi Arabia Ministry of Health. Planning for pregnancy.

https://

www.moh.gov.sa/en/HealthAwareness/EducationalC

ontent/ wh/Pages/008.aspx.

AL-Mohaithef M, Alaslani H, Javed NB, and

Chandramohan S. Folic acid awareness and usage

among females at Saudi Electronic University in

Jeddah, Saudi Arabia. SAGE Open Med. 2021;9.

doi:10.1177/20503121211059682

Al Arifi MN, Alqahtani AM, Alotaibi AN, Babelghaith SD,

Alwhaibi A, Alsanea S, Alghadeer SM and Al-Arifi

NM. Knowledge and Practice of Childbearing

Women in Saudi Arabia towards Folic Acid

Supplement—Evidence from a Cross-Sectional

Study. Nutrients. 2022;14(2).

doi:10.3390/nu14020357

Alanazi AM, Alanazi AJ, Alanazi YW, Alanazi MS, Rezk G

and Hammad SM. Level of Awareness and

Knowledge of Folic Acid Intake among Women in the

Reproductive Age in ARAR Region, Saudi Arabia. J

Pharm Res Int. 2021;33:287-297.

doi:10.9734/jpri/2021/v33i58a34118

Alamer E, Al-Watban L and Nafisah FI. Understanding

primary health care physicians’ perspective and

approach to pre-conception care in Saudi Arabia. Fam

Pract. 2022;39(1):137-143.

doi:10.1093/fampra/cmab065

AlDuraibi S and Al-Mutawa J. Knowledge and awareness of

folic acid usage in Saudi pregnant women in Riyadh

city from 2019-2020. J Fam Med Prim care.

;9(10):5158-5164.

doi:10.4103/jfmpc.jfmpc_638_20

Alreshidi FF, Almujil AS and Malak AS. Awareness of folic

acid use among Saudi women attending outpatient

clinics at King Fahad Medical City. J Fam Med Prim

care. 2018;7(5):957-962.

doi:10.4103/jfmpc.jfmpc_174_18

Al-Marwani S and Al-Zahrani A. Attitude and Practice of

Folic Acid Consumption Among Saudi Pregnant

Women at Yanbu City, Kingdom of Saudi Arabia.

Cureus. 2022;14(9):e28860.

doi:10.7759/cureus.28860

Al Bahhawi T, Doweri AA, Sawadi RM, Awaji MY, Jarad

MM, Sulays ZY and Madkor KA. Consumption habits

of pregnant women in the Jazan region, Saudi Arabia:

a descriptive study. BMC Res Notes. 2018;11(1):817.

doi:10.1186/s13104-018-3921-5

Nemri A, Aslany S, Abulaban O, Sindi G, Zuhairy S, Farsi

R, Almosallam SA and Safdar OY. Folate deficiency

knowledge and use of folic acid among women of

childbearing age in the Kingdom of Saudi Arabia: A

population-based cross-sectional study. Int J Med Dev

Ctries. 2019;3(December 2018):60-66.

doi:10.24911/ijmdc.51-1542585084

Al-holy M, Eideh A, Epuru S, Abu-jamous D and Ashankyty

I. Awareness of Folic Acid Intake among Women in

the Childbearing Age in Hail Region — Saudi Arabia.

Food Nutr Sci. 2013;4(January):49-55.

Sabi EM, Mujamammi AH, Alturki N, Alzaid T, Almutairi

A, Algarni R, Almaziad D, Alhumaidhi N, Kurdee Z

and Sumaily KM. Level of Knowledge and Awareness

of Female Undergraduate Students and Determinants

of Knowledge of Folic Acid and Supplementation.

Med. 2022;58(8):1-8. doi:10.3390/medicina58080986

Al-Zahrani A and Al-Marwani S. The effectiveness of an

educational session about folic acid on pregnant

women’s knowledge in Yanbu City, Kingdom of

Saudi Arabia. AIMS Med Sci. 2022;9(3):394-413.

doi:10.3934/medsci.2022019

Hakami W, Dobie G, Alneami KA, Shaabi M, Essawi K,

Saboor M, Madkhali AM, Nahari MH, Almasoudi

HH, Akhter MS, Hakami FH, Zarbatan FA, Hakamy

A, Chandika RM, Fageehi AA, Mobarki AA and

Hamali HA. Assessing Nutritional Anemia Among

University Students in Jazan, Saudi Arabia: A Public

Health Perspective. J Blood Med. 2024;15:51-60.

doi:10.2147/JBM.S436673

AbdRabou MA. Awareness of Folic Acid Intake for

Prevention of Neural Tube Defects among Women in

Sakaka, Saudi Arabia. Int J Pharmacol. 2019;15:274-

Al-Akhfash AA, Abdulla AM, Osman AM, Abdulgafar JI

and Almesned AA. Maternal knowledge and use of

folic acid among Saudi females. Saudi Med J.

;34(11):1173-1178.

Bukhari AA, Bajouh OS, Aljehani MA, Alzahrani NJ, Al

Qahtani AM and Almrstani AM. The Awareness of

Folic Acid Supplements among Women of Child

bearing Age in King Abdulaziz University Hospital,

Jeddah-Saudi Arabia. Int J Life-Sciences Sci Res.

;2(5):592-598. doi:10.21276/ijlssr.2016.2.5.14

Alhakeem MM. Impact of education on knowledge and use

of folic acid among Saudi Women. Pakistan J Med

Sci. 2012;28(4):686-690.

Al-Hossani H, Abouzeid H, Salah MM, Farag HM and

Fawzy E. Knowledge and practices of pregnant

women about folic acid in pregnancy in Abu Dhabi,

United Arab Emirates. East Mediterr Heal J.

;16(4):402-407.

Al-Darzi W, Al-Mudares F, Farah A, Ali A and Marzouk D.

Knowledge of periconceptional folic acid use among

pregnant women at Ain Shams University Hospital,

Cairo, Egypt. East Mediterr Heal J. 2014;20(9):561-

Rasmussen MM, and Clemmensen D. Folic acid

supplementation in pregnant women. Dan Med Bull.

;57(1):A4134.

Al-Mohaithef M, Alaslani H, Javed NB and Chandramohan

S. Folic acid awareness and usage among females at

Saudi Electronic University in Jeddah, Saudi Arabia.

SAGE open Med. 2021;9:20503121211059680.

doi:10.1177/20503121211059682


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