Fauzi, Norshila
(2018)
Nutritional status, haematological and immunological changes and heavy metal exposure in victims post massive flood in Tumpat, Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Massive flood known as “Bah Kuning” that hit Kelantan in December 2014
was the worst in the history of the state affecting health and socioeconomic status of
the victims. There were immediate and delayed effects of the flood from the
haematological and immunological aspects. There are limited studies pertaining to the
physiological changes post disaster. This study aimed to assess the sociodemographic
factors, nutritional status, heavy metal exposure, haematological & immunological
parameters of the victims reflecting the impact of the 2014 massive flood. A crosssectional
study among flood victims was conducted in Tumpat district of Kelantan
from May until August 2015 involving 297 participants. The study was done 4 months
post-event. Participants were recruited from house visits to answer questionnaires
regarding sociodemographic and food security related questions. Blood samples were
taken from two adults (female and male) in a household. The blood samples were then
tested for full blood count (FBC), ferritin, lymphocyte subset analysis, serum
immunoglobulin levels (IgG, IgA and IgM), red blood cell folate (RBC folate) and
heavy metals analyses (cadmium, arsenic, plumbum and mercury). As a part of this
study, a cross-sectional comparative study was done to compare the laboratory profiles
among the flood and non-flood victims. The finding from the food security assessment
showed that 71.6% were classified as food insecure category. Socioeconomic
parameters were significantly associated with household food security, p=0.001. Eight
participants were found anaemic and all participants had normal RBC folate while 27had high serum ferritin. There was no direct association between food security and
laboratory parameters. In comparison with control participants (non-flood victims),
haemoglobin was significantly lower (p=0.02) and total white blood cell (TWBC) was
significantly higher (p=0.012) in male flood victims. Monocytes counts were found
higher in both male and female victims, p=0.003 and p=0.048 respectively. The
percentages and absolute counts of CD4 were higher while the percentages of CD8
showed significantly lower in male flood victims, p<0.05. Besides that, CD4:CD8 ratio
was also significantly different in males, p=0.012 while serum immunoglobulins were
all significantly higher in female flood victims, p<0.05. Heavy metals were detected
in participants’ blood samples and in one well water sample but below the harmful cut
off levels. In conclusion, the flood might have contributed to some subclinical health
risk especially from the immunological changes seen among the victims. Although the
findings could not be confirmed directly related to the flood effect, the result could be
used to predict possible health complications that could occur if the socioeconomic
problems and food-water securities were not handled appropriately post-event.
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