Knowledge on Anemia Causes and Associated Risks Improve with Education and Better Socioeconomic Standards among Students of Medicine, Pharmacy, Nursing and Other Allied Health Professions in Palestinian Territories

doi:10.21203/rs.3.rs-1442578/v1

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Research Article

Knowledge on Anemia Causes and Associated Risks Improve with Education and Better Socioeconomic Standards among Students of Medicine, Pharmacy, Nursing and Other Allied Health Professions in Palestinian Territories

https://doi.org/10.21203/rs.3.rs-1442578/v1

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Introduction

Anemia is a global nutritional problem with consequent mortality and morbidity on females of reproductive age and infants and children.

Aims and Objectives:

The aims of this study was to assess knowledge about anemia and associated factors among Palestinian medical and allied health students and to evaluate their response to study course on the topic.

Methods

Data was collected using an electronic questionnaire that evaluated the students' knowledge on anemia, their sociodemographic variables, nutritional health and study of anemia as part of course that was offered to them in varying times. Anemia knowledge score was calculated and socioeconomic status scores (SES) were calculated. Collected data was analyzed using SPSS.

Results

117 students from schools of medicine, nursing, pharmacy and other health disciplines participated in the study. Average age was (19.9 ± 2.24 y), average score on anemia knowledge out of 26 was (19.4 ± 3.6 points). Only 29.9% of the study participants were males. Age, SES based on income and father education were the major significant predictors of knowledge on anemia score. Taking the nutrition course improved anemia knowledge score (p = 0.09) and specialty was not significant predictor of anemia knowledge.

Conclusion

Medical and health related profession student could benefit from taking nutrition courses on anemia

Anemia is estimated to affect 1.6 billion people worldwide. The world health organization defines anemia as a condition in which the number or the oxygen carrying capacity of red blood cells is lower than expected(Newhall et al., 2020). Anemia is responsible for 1 million deaths every year, most of it happens in South East Asia and Africa. The most common cause of anemia in developing countries especially among pregnant and preschool aged children is (iron, vitamin B12, folate and vitamin A) deficiency, acute and chronic inflammation and parasitic infection. Anemia is common among preschool children, adolescent females, pregnant and lactating women and people with chronic diseases(Malay et al., 2018). The aetiology of iron deficiency anemia is variable and is related to several risk factors including decrease in iron intake and absorption, increasing demand and loss, and often multiple etiologies exist in the same person. Sickle cell anemia is a result of genetic mutation in hemoglobin leading to what is called hemoglobin S. The oxygen carrying capacity and the lifespan of red blood cells is reduced in sickle cell anemia(Rouse and Hays, 1979) Increase in awareness about the consequences and prevalence of iron deficiency anemia could lead to early detection and management. Diagnosis can be easily done by measuring hemoglobin, serum ferritin, but in chronic inflammation conditions the measurement of transferrin saturation may be necessary(Cappellini et al., 2020). Iron deficiency anemia is very common among premenopausal women. Anemia prevalence is increased in sections of the society with lower socioeconomic status(Hussain and Shu, 2010). Low intake of meat, consuming black tea with food and other dietary behaviors are associated with iron deficiency anemia. Some pollutants such as benzene and cement dust of reconstruction works are associated with aplastic anemia(Farheen et al., 2017). On the other hand, kidney diseases are associated with suppressed erythropoiesis and red blood cells survival consequently anemia(Eschbach, 1989).

In a study among 300 pregnant women in Occupied Palestinian territories, anemia was prevalent 25.7% of studied women and iron deficiency was prevalent among 52% of studied sample(Srour et al., 2018).

In a study among Palestinian society, the prevalence of anemia in general was 7.8%(Natour et al., 2021). Favism or glucose-6-phosphate dehydrogenase deficiency is one of the most common disorders of red blood cells, leading to hemolytic anemia that affects 500 million person worldwide, Clinical symptoms of favism are pallor, jaundice, hematuria and acute hemolytic anemia occurs 24–48 h after consumption of fava beans, the genetic frequency for favism in middle east is over 25% (Aboud, 2012).

The awareness of anemia consequences and risk factors among young students in health professions could help to reduce the prevalence of anemia in the Palestinian society and among vulnerable groups and so the aims of this study is: to study the level of awareness of anemia among medical and allied health professions students at Najah National University in Nablus in Occupied Palestinian territories.

During corona restrictions students at medicine other allied health faculties were taught virtual course on clinical nutrition that included study material on anemia. A questionnaire was developed based on the study material to assess knowledge on anemia that included 26 questions: 4 questions on definition of anemia in different groups, 5 questions on morbidities associated with anemia, other questions on causes and different types of anemia. Another part of the questionnaire collected data on sociodemographic variables, course timing, speciality and parents education, nutritional deficiencies. The questionnaire was distributed on social media course webpage on social media and on university course webpage on moodle. Students were asked to agree to participate and provide answers for questions. A convenient sample of 117 were recruited to study due to corona restriction we use electronic platforms to announce for the study.

Statistical Analysis

The score on knowledge anemia was calculated by summing answer for the 26 points anemia knowledge questionnaire. For each answer a score of 1 was given to correct answer and 0 for incorrect answer. For income and mother education an ordinal score was give based on the level of income and education, with lowest education, or income given 0 and highest education or number given highest score about the number of groups. From this we calculated Socioeconomic score rank based on (income + mother education + father education) or (income + mother education) or (income + father education). Anemia score was compared across study variables’ groups using ANOVA for multiple groups variable and t-test for bivariables. Also, exploratory multiple regression model was used to assess the relationship between anemia knowledge score. A significant p-value was less than 0.05. The data was analyzed using SPSS.

117 students participated in the study (19.9±2.2 years), of whom 70.1% were females. A total score out of 25 was given to full answer on questionnaire questions related to awareness of anemia. The range of score was (9, 25) and the average score was (19.4±3.6). The normal distribution of total score on anemia is shown in graph 1.

3.3% of the students took the nutrition course last semester or in summer of the same year, but 18.8% took the course the year before data collection, and most the students are taking the nutrition course at the same time of doing the study and were not yet educated about the anemia study material. The study included students from pharmacy, medicine, nursing and other health professions as presented in Table 1. Most of the study group were living in village or city in West Bank. The income of this study group ranged from less than 3000 shekel to more than 6000 shekel.

Slightly more than 50% of the study group had mothers with less than Tawjihi education and 42% had mothers with college or bachelors university education, only 4 students had mothers with higher than bachelors education. In terms of fathers’ education, slightly more than 50% achieved Tawjihi or less education, whereas 33.3% had college or Bachelor University education and 15% had father with more than bachelors education. Self-reported vitamin D and vitamin B12 deficiency were equally reported in the study group (slightly more than 20%), and self-reported anemia was present in 10.3% of studied group.

A total 26 questions were asked about anemia including definition, risk groups, associated comorbidities and possible causes. The questions’ answers were yes or no and are summarized in Table 2. Questions with higher mistake answers included: if mild anemia could be asymptomatic, if anemia could be a result of folate or vitamin B12 deficiency, if exposure to pollution could increase risk for anemia, if thalassemia is considered a type of anemia, if favism is considered a type of anemia, or if timing of cutting or clamping the umbilical cord after delivery, or early introduction of cow milk could influence the risk of anemia.

A total score on the questions asked about anemia was calculated and compared according to education and sociodemographic category (Table 3). The students who took the nutrition course last year or semester tended to score higher grades than those who did not study about anemia yet. There was no differences in the score between students according to specialty. There were no difference in the education according to income, place of residence or mother education. However, students with fathers who have bachelors or college education tended to have the highest score on anemia knowledge (p=0.05). Students with vitamin D deficiency had higher score on anemia knowledge, but other micronutrients deficiency did not affect the relationship.

In multiple regression model (data not shown) Age significantly and positively was associated with increase in knowledge about anemia (B= 0.41±0.17, t=2.52, p=0.014). We found significant interaction between parents education, sex and income and so we converted socioeconomic status into score based on income, mother and father education, or income and mother education or income and father education. We studied the score on anemia knowledge based on SES score for total sample, males and females (Table 3). Father education and income SES score was the most likely to be associated with significant differences in anemia knowledge, students with lowest income and father education had the lowest score whereas students with higher score in SES related to income and father education had improved score of knowledge on anemia, this was particularly more significant in females relative to males. Mother education and income SES score was associated with improved score on anemia knowledge, but this did not reach statistical significance.

In a study that represented health professions students including pharmacy, medicine, nursing and other students. We found high level of knowledge about anemia before or after taking study material on the topic under nutrition course which was offered as part of curriculum. Females were more likely to participate in this study and refugee camps were underrepresented in this study group. Duration of taking the course on nutrition, vitamin D deficiency, mother, father education and SES tended to modulate the total score on anemia awareness specifically for female who tended to have the best knowledge of anemia if their mother had high education and income and the lowest level of knowledge on anemia if their fathers had less income and education.

Vitamin B12 is common in Palestinian territories, but the awareness about the relationship between vitamin B12 and anemia is lower than that for other nutrients (i.e Iron and folate). In a study done on Palestinian female university students, iron deficiency anemia was present in 20.4% of the studied group, whereas vitamin B12 was lower in anemic group (212.9 ± 62.8 pg/mL) relative to healthy group (286.9 ± 57.1 pg/mL)(Sirdah et al., 2014). In this group 20.5% reported having vitamin B12 deficiency and 10.3% reported having anemia, but this was not associated with better knowledge about anemia. Vitamin B12 deficiency can is reversible megaloblastic anemia and demyelinating neurological disease. Its deficiency is common in elderly and people who lacks intrinsic factor necessary for its absorption(Stabler, 2013). Awareness of vitamin B12 supplementation in high risk groups such as diabetics was very low (Chaitanya Shree et al., 2021). In another study among regular blood donor, 42% and 31.6% of study group were aware of aspects of anemia and vitamin B12, but only 20% knew about accepted level of hemoglobin to donate blood. This is important because of the prevalence of low vitamin B12 in Palestine and its possible impact on neurological health of Palestinian population.

In general, the students had good basic knowledge of anemia which is consistent with what was found before (Yadav et al., 2014; Sivapriya and Parida, 2015; Malay et al., 2018). Most of the study participants knew the good sources for iron and that tea and coffee interferes with iron absorption. Since majority of the study are premenopausal females and young adults, awareness of anemia is particularly important for better control of anemia in the society. However, 40.5% of the study participants did not know about the relationship between anemia and pollutants and majority of the study participants did not know about delaying the clamping of pulsing umbilical cord could help decrease anemia in infancy that regardless of taking a course in nutrition. This indicates that in our society, even students who learned about anemia in their medical curriculum fail to value the importance of this global and local health problem. It is well known that anemia is a health condition that is associated with morbidity and mortality and hence special educational programs should target youth to educate them about the significance of the problem(Malay et al., 2018).

The score for anemia awareness was the lowest for students who did not take the course on anemia, and was slightly higher for the ones who took it last year and the highest for the ones who covered the material in the same year, but specialty did not influence the score on anemia as there were no difference between medicine, pharmacy and nursing students

Education is associated with anemia awareness (Waggiallah and Alzohairy, 2013). Paternal education affected the score on anemia, with students who have father with bachelors and college degree having highest score. In this study there was interaction between mother, father education, gender of student and income. When we scored the socioeconomic status based on mother, father education and income, females with lowest SES scores had the lowest score on anemia and the middle SES scores had the highest scores on anemia. When we further stratified score based on either mother education or father education, father education had more significant on total study group and on female participants specifically. The students with lowest score were females with low SES score based on father education and income, whereas the highest score was for female students with highest SES scores for income and mother education. In a study on Indian children from National Healthy survey, poverty index and mother education were significant predictors of anemia(Goswmai and Das, 2015). Parents education plays role in other aspects of health(He et al., 2014; Al-lela et al., 2014). In this study we did not assess the level of parents' awareness of anemia but rather scored their education as yes or no because the data was not available to us. It is worthy to mention that parents relationship to health awareness may vary according to specialty and background and location in SES stratum(Al-lela et al., 2014). In a study by Erola, father education had more effect on offspring during young adulthood in comparison to mothers who had more effect during childhood. The effect of parents education on awareness level could be related to relationship between education, income, poverty and psychological wellbeing at different stages of life(Erola et al., 2016). On the other hand, academic achievement and motivation could be higher in females relative to males during university as was shown by others(Nasir, 2012).

Vitamin D deficiency is associated with improved score on anemia knowledge. This could be thought of as health consciousness which controls how patients receive and behave towards health information. Individuals with higher health consciousness are ready to undertake preventive measures(Hong, 2009). As the measurement of the relationship between health consciousness and health behavior is still emerging in literature, more work in this aspect is needed to understand how understanding health impact anemia in a specific population.

This study is not without limitation including its cross sectional design, inclusion of convenient sample number because data was collected during time of corona. Also males and participants from refugee camps were under-represented. However, this study according to author knowledge is the first to address knowledge about anemia is related to health and general education.

In conclusion, in a sample of female and male students from schools of medicine, pharmacy and nursing schools who were taught on anemia as part of teaching material in a clinical nutrition offered as part of curriculum. Students show good level of nutrition awareness especially on causes and consequences of anemia. Aspects such as anemia in infancy and some forms of anemia such as favism and sickle cell anemia needs further work. Amongst several micronutrients deficiency, vitamin D deficiency was associated with better knowledge of anemia indicating better health consciousness. Income, gender, parents education seem to be important factor in health knowledge achievement.

Competing interest

None

Author Contributions:

NN designed and implemented the study, MA and MS revised the study and helped in content validity

Funding

None

Ethics Approval and Consent to Participate

This study was approved by Najah University IRB board. The goals of the study were discussed in social media platforms and participants were asked to fill online survey if they want to participate in the study (Informed consent was obtained). All methods were carried out in accordance with relevant guidelines and regulations (declaration of helsinki).

Consent for publication

Acknowledgement

We would like to thank members of the Palestinian society who participated in this study

Data Availability

Data can be accessed through the following link

https://docs.google.com/spreadsheets/d/1ochq_DSLLNEaxdMN7pB_newDSMHaCttk/edit?usp=sharing&ouid=112120034684817700818&rtpof=true&sd=true

Aboud LN. (2012) Occurrence of" G6PD" Enzyme Deficiency among Children Suffering from Hemolytic Anemia in Gaza-Palestine.
Al-lela OQB, Bahari MB, Salih MR, et al. (2014) Factors underlying inadequate parents’ awareness regarding pediatrics immunization: findings of cross-sectional study in Mosul-Iraq. BMC pediatrics 14: 1–7.
Cappellini M, Musallam K and Taher A. (2020) Iron deficiency anaemia revisited. Journal of internal medicine 287: 153–170.
Chaitanya Shree P, Priya J, Devi G, et al. (2021) Awareness on Vitamin B12 Supplementation in Patients with type Ii Diabetes Mellitus. Annals of the Romanian Society for Cell Biology: 2601–2608.
Erola J, Jalonen S and Lehti H. (2016) Parental education, class and income over early life course and children's achievement. Research in Social Stratification and Mobility 44: 33–43.
Eschbach JW. (1989) The anemia of chronic renal failure: pathophysiology and the effects of recombinant erythropoietin. Kidney international 35: 134–148.
Farheen A, Hazari MAH, Khatoon F, et al. (2017) Hematological parameters are acutely effected by cement dust exposure in construction workers. Annals of Medical Physiology 1: 31–35.
Goswmai S and Das KK. (2015) Socio-economic and demographic determinants of childhood anemia. Jornal de pediatria 91: 471–477.
He L, Zhai Y, Engelgau M, et al. (2014) Association of children’s eating behaviors with parental education, and teachers’ health awareness, attitudes and behaviors: a national school-based survey in China. The European Journal of Public Health 24: 880–887.
Hong H. (2009) Scale development for measuring health consciousness: Re-conceptualization. that Matters to the Practice: 212.
Hussain T and Shu LY. (2010) Awareness of iron deficiency anemia among women of Reproductive age in Hubei Province, China. Asian Journal of Medical Sciences 1: 12–13.
Malay KK, Duraisamy R, Brundha M, et al. (2018) Awareness regarding anemia among 1 st year dental undergraduate students. Drug Invention Today 10.
Nasir M. (2012) Demographic characteristics as correlates of academic achievement of university students. Academic Research International 2: 400.
Natour N, Al-Tell M and Al-Ayedi M. (2021) Food Label Use and Associated Factors: A Cross Sectional Study from Occupied Palestinian Territories. Austin J Nutri Food Sci 9: 1155.
Newhall D, Oliver R and Lugthart S. (2020) Anaemia: A disease or symptom. Neth. J. Med 78: 104–110.
Rouse L and Hays G. (1979) Dental considerations in sickle cell anemia. General dentistry 27: 18–19.
Sirdah MM, Yassin MM, Shekhi SE, et al. (2014) Homocysteine and vitamin B 12 status and iron deficiency anemia in female university students from Gaza Strip, Palestine. Revista brasileira de hematologia e hemoterapia 36: 208–212.
Sivapriya S and Parida L. (2015) A study to assess the knowledge and practices regarding prevention of anemia among antenatal women attending a tertiary level hospital in Pune. IJSR NET 4: 1210–1214.
Srour MA, Aqel SS, Srour KM, et al. (2018) Prevalence of anemia and iron deficiency among Palestinian pregnant women and its association with pregnancy outcome. Anemia 2018.
Stabler SP. (2013) Vitamin B12 deficiency. New England Journal of Medicine 368: 149–160.
Waggiallah HA and Alzohairy M. (2013) Awareness of anemia causes among Saudi population in Qassim Region, Saudi Arabia. Natl J Integr Res Med 4: 35–40.
Yadav RK, Swamy M and Banjade B. (2014) Knowledge and Practice of Anemia among pregnant women attending antenatal clinic in Dr. Prabhakar Kore hospital, Karnataka-A Cross sectional study. Literacy 30: 18.

Table 1: Proportions of Study Variables Subcategories

Mean and Proportions

Variable

19.9±2.24

19.4±3.6

Age (year)

Score (points)

82 (70.1%)
35 (29.9%)

Sex

Female

Male

91 (77.8%)

4 (3.4%)

22 (18.8%)

Course time

I took the course this semester

I took this course this year last semester

I took this course before year

45 (38.5%)
9 (7.7%)

16 (13.7%)

47 (40.2%)

Specialty

Medicine

Pharmacy

Other health specialty

Nursing

50 (42.7%)
64 (54.7%)
3 (2.6%)

Place of residence

City

Village

Refugee Camp

31 (26.5%)

44 (37.6%)

40 (34.2%)

Income

Less than 3000 shekel

3000-6000 shekel

More than 6000 shekel

63 (54%)

46 (39.7%)

7 (6.0%)

Mother education

Less than Tawjihi

College and University Bsc

More than Bsc

61 (52.1%)

38 (32.5%)
18 (15.3%)

Father education

Less than Tawjihi

College or Bsc

More than Bsc

97 (82.9%)
20 (17.1%)

Malnutrition

Yes

104 (88.9%)

12 (10.3%)

Anemia

Yes

92 (79.3%)
24 (20.6%)

Vitamin D deficiency

Yes

93 (79.5%)

24 (20.5%)

Vitamin B12 deficiency

Yes

Table 2. Summary for Questionnaire on Anemia Knowledge Proportions

Variable/Answer

Proportions

Is anemia low level of hemoglobin

Yes

14 (12.2%)

101 (87.8%)

Does anemia happens at level less than 120g/L

Yes

17 (14.7%)

99 (85.3%)

Does anemia in males happen at level less than 130 g/L

Yes

24 (20.9%)

91 (79.1%)

Does anemia happens at level less than 110-115 g/L

Yes

20 (18%)

91 (82%)

Mild anemia does not have symptoms

Yes

46 (39.7%)

70 (60.3%)

Severe anemia is associated with mortality

Yes

2 (1.7%)

114 (98.3%)

Iron deficiency is the main cause of iron

Yes

8 (7%)

107 (93%)

Anemia could result from folate deficiency

Yes

30 (26.0%)
85 (74.0%)

Anemia could result from vitamin B12 deficiency

Yes

35 (30.2%)

81 (69.8%)

Fish and meat are good sources for vitamin B12

Yes

6 (5.2%)

110 (94.8%)

Tea and coffee prevents iron absorption

Yes

4 (3.4%)

112 (96.6%)

Exposure to pollutants like lead can cause anemia

Yes

47 (40.5%)

69 (59.5%)

Pregnancy can be associated with anemia

Yes

10 (8.6%)

106 (91.4%)

Thalasemia is one type of anemia

Yes

48 (41.3%)

68 (58.7%)

Favism is associated with anemia

Yes

25 (21.3%)

92 (78.7%)

Infection in stomach and ameba with parasites could lead to anemia

Yes

23 (20.2%)

91 (79.8%)

Chronic diseases is associated with anemia

Yes

20 (17.5%)

94 (82.5%)

Heavy menstruation could be associated with anemia

Yes

12 (10.3%)

104 (89.7%)

Kidney diseases can be associated with anemia

Yes

19 (10.5%)

97 (89.5%)

Anemia can increase abortion risk

Yes

9 (7.7%)

107 (92.3%)

Anemia can lead to premature delivery

Yes

21 (18.1%)

96 (11.9%)

Anemia can lead to small-birth infant

Yes

14 (12.1%)

101 (17.9%)

Anemia can be related to cutting umbilical cord after delivery

Yes

66 (57.9%)

48 (42.1%)

Anemia could be related to early introduction of cow milk to infant

Yes

72 (63.2%)

42 (36.8%)

Anemia could decrease cognitive performance

Yes

20 (17.4%)

95 (82.6%)

Variable (n)

Anemia Knowledge Score

Test Statistics

p-value

Gender

Male (35)

Female (82)

19.4±0.65

19.4±0.40

T=0.04, p=0.97

Time for nutrition course

Took the nutrition course before a year (22)

Took the nutrition during the same year (4)

Currently taking this course, yet to study anemia (91)

20.7±0.64

21.8±.1.0

19±0.4 (9, 25)

F= 2.82, p=0.063

Specialty

Medicine

Nursing

Pharmacy

Other health sectors

19.0±0.61

19.5±0.52

18.0±0.90

20.8±0.71

F=1.49, p=0.22

Place of residence

City (50)

Village (64)

Camp (3)

19.9±0.56

19.0±0.43

20.7±0.88

F=1.0, p=0.36

Income

Less than 3000 shekel (40)

3000-6000 shekel (44)

More than 6000 shekel (31)

18.9±0.66

19.8±0.52

19.8±0.57

F=0.68,p=0.51

Mother education

Less than Tawjihi (63)

College and Bachelors (46)

More than Bachelors (7)

19.3±0.41

19.6±0.57

20.0±2.0

F=0.15, p=0.86

Father Education

Less than Tawjihi (61)

College and Bachelors (38)

More than Bachelors (18)

18.8±0.49

20.5±0.44

19.2±1.0

F=2.42, p=0.09

Malnutrition

0 (97)

1 (20)

19.6±0.35

18.5±1.0

t=1.3,p=0.197

Anemia

0 (104)

1 (12)

19.5±0.35

18.2±1.3

t=1.2, p=0.23

Vitamin D deficiency

0 (92)

1 (24)

19.1±0.39

20.6±0.65

t=-1.9,p=0.06

Vitamin B12 deficiency

0 (93)

1 (24)

19.4±0.40

19.4±0.55

T=-0.01,p=0.99

Table 3. Relationship between SES and Anemia Awareness

Anemia Awareness Score

Total Sample

Male

Females

Total SES Score

17.91±1.22 (11)

18.0±0.83 (23)

20.1±0.43 (41)

20.1±0.64 (34)

18.9±1.92 (7)

21.0 (1)

F=1.78, p=0.122

17±3.0(2)

18.0±1.5(6)

20.5±1.00(13)

19.2±1.2(13)

21.0 (1)

F=0.7,p=0.60

18.1±1.4 (9)

17.9±1.0 (17)

19.9±0.44 (28)

20.6±0.73 (21)

18.9±1.92 (7)

F=1.88,P=0.12

Father Education+Income Score

17.1±0.98 (16)

19.9±0.6 (35)

19.6±0.51 (53)

20.4±0.34 (13)

F=2.9, p=0.038

17.7±1.86(3)

20.1±1.17(11)

18.5±1.13 (15)

21.5±0.56

F=1.24,p=0.31

16.9±1.16 (13)

19.8±0.70 (24)

20.0±0.55 (38)

19.4±1.0 (7)

F=2.67,P=0.05

Mother Education+Income Score

18.4±0.85 (17)

18.9±0.61 (42)

20.3±0.45 (50)

19.0±1.6 (8)

F=1.77, p=0.158

17.7±1.86

19.6±1.2

20.5±0.8

16.0±2.27

F=1.8,p=0.17

18.6±0.98(14)

18.6±0.71(31)

20.2±0.54(33)

22.0±1.0(4)

F=2.1,p=0.11

No competing interests reported.

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Knowledge on Anemia Causes and Associated Risks Improve with Education and Better Socioeconomic Standards among Students of Medicine, Pharmacy, Nursing and Other Allied Health Professions in Palestinian Territories

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