MATERIAL AND METHODS
Pattani Province is one of five provinces in
southern Thailand near the Gulf of Siam, with
an area of approximately 1,940 km2. The province
is well known for its poverty, low education
and socio-cultural barriers.
Our cross-sectional survey was conducted
from March to October 1997 in five randomly
selected districts (Panalae, Yarang, Mayor, Mung
and Nongjig) out of nine districts in the Province.
A random sample of 30 out of 57 health centers
(HC) was chosen. Sixty villages served by these
selected HC were randomly chosen based on the
requirement of having at least three women at 32-
40 weeks gestation. In each selected village, all
eligible PW (32-40 weeks gestation) without any
overt diseases were invited to join the study. A
total of 180 consent PW participated.
Each PW was interviewed at her own home
with a structured questionnaire by a trained female
Muslim interviewer, holding bachelor’s degree
in Food and Nutrition. Dietary assessment
was based on recall of the previous 4 months.
Ninety-two local food items were identified using
a semi-quantitative food frequency questionnaire
(FFQ). Photographs of various standard
portion sizes of the identified foods were used
to facilitate assessment. Information included the
use of iron supplements during each trimester,
the number of visits to the antenatal clinic, receiving
iron tablets each visit, and the level of
compliance with the iron tablets (regular use or
not). In addition, the community health center
records of subjects selected were reviewed to
extract basic demographic and iron tablet
supplementation information.
Ten milliliters of blood was drawn by nurses
from a nearby hospital with eight milliliters being
kept in a special test tube for serum iron (SI),
total iron binding capacity (TIBC), transferrin
saturation (TS) and serum ferritin (SF); and two
milliliters were kept in a bottle containing ethylene
diamine tetraacetic acid (EDTA) as an anticoagulant
for performing a complete blood count
(CBC). One drop of blood was smeared on a
slide for microscopic study of red blood cell
morphology. The participant was asked to provide
a fresh stool sample, which was kept in a
specific plastic bottle. Blood and stool specimens
were transported to the laboratory at the
university hospital, and analysed within two
hours.