Anaemia, iron status and vitamin A deficiency among adolescent refugees in Kenya and Nepal

2006 ◽  
Vol 9 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Bradley A Woodruff ◽  
Heidi Michels Blanck ◽  
Laurence Slutsker ◽  
Susan T Cookson ◽  
Mary Kay Larson ◽  
...  

AbstractObjectiveTo investigate the prevalence of anaemia (haemoglobin < 11.0 to 13.0 g dl−1depending on age and sex group), iron deficiency (transferrin receptor concentration > 8.3 μg ml−1) and vitamin A deficiency (serum retinol < 0.7 μmoll−1) in adolescent refugees.DesignCross-sectional surveys.SettingKakuma refugee camp in Kenya and seven refugee camps in Nepal.SubjectsAdolescent refugee residents in these camps.ResultsAnaemia was present in 46% (95% confidence interval (CI): 42–51) of adolescents in Kenya and in 24% (95% CI: 20–28) of adolescents in Nepal. The sensitivity of palmar pallor in detecting anaemia was 21%. In addition, 43% (95% CI: 36–50) and 53% (95% CI: 46–61) of adolescents in Kenya and Nepal, respectively, had iron deficiency. In both surveys, anaemia occurred more commonly among adolescents with iron deficiency. Vitamin A deficiency was found in 15% (95% CI: 10–20) of adolescents in Kenya and 30% (95% CI: 24–37) of adolescents in Nepal. Night blindness was not more common in adolescents with vitamin A deficiency than in those without vitamin A deficiency. In Kenya, one of the seven adolescents with Bitot's spots had vitamin A deficiency.ConclusionsAnaemia, iron deficiency and vitamin A deficiency are common among adolescents in refugee populations. Such adolescents need to increase intakes of these nutrients; however, the lack of routine access makes programmes targeting adolescents difficult. Adolescent refugees should be considered for assessment along with other at-risk groups in displaced populations.

2006 ◽  
Vol 9 (8) ◽  
pp. 955-960 ◽  
Author(s):  
Jiang Jingxiong ◽  
André Michael Toschke ◽  
Rüdiger von Kries ◽  
Berthold Koletzko ◽  
Lin Liangming

AbstractObjectiveThe objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD.DesignA cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China.SettingOne city (urban) and two counties (rural) were randomly selected from each province as survey areas.SubjectsAbout 200 children aged 0–6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration.ResultsVAD (serum retinol < 0.7 μmol l− 1) was observed in 957 out of 7826 children aged 0–6 years (12.2% of the entire study population), whereas severe VAD (serum retinol < 0.35 μmol l− 1) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%).ConclusionsVAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.


2008 ◽  
Vol 11 (7) ◽  
pp. 720-728 ◽  
Author(s):  
Andrew Seal ◽  
Emmanuel Kafwembe ◽  
Ismail AR Kassim ◽  
Mei Hong ◽  
Annie Wesley ◽  
...  

AbstractObjectiveTo assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification.DesignPre- and post-intervention study using a longitudinal cohort.SettingNangweshi refugee camp, Zambia.SubjectsTwo hundred and twelve adolescents (10–19 years), 157 children (6–59 months) and 118 women (20–49 years) were selected at random by household survey in July 2003 and followed up after 12 months.ResultsMaize grain was milled and fortified in two custom-designed mills installed at a central location in the camp and a daily ration of 400 g per person was distributed twice monthly to households as part of the routine food aid ration. During the intervention period mean Hb increased in children (0·87 g/dl;P< 0·001) and adolescents (0·24 g/dl;P= 0·043) but did not increase in women. Anaemia decreased in children by 23·4 % (P< 0·001) but there was no significant change in adolescents or women. Serum transferrin receptor (log10-transformed) decreased by −0·082 μg/ml (P= 0·036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (−8·5 %;P= 0·079). In adolescents, serum retinol increased by 0·16 μmol/l (P< 0·001) and vitamin A deficiency decreased by 26·1 % (P< 0·001).ConclusionsThe introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents. Centralised, camp-level milling and fortification of maize meal is a feasible and pertinent intervention in food aid operations.


2015 ◽  
Vol 18 (14) ◽  
pp. 2511-2522 ◽  
Author(s):  
Sandjaja ◽  
Idrus Jus’at ◽  
Abas B Jahari ◽  
Ifrad ◽  
Min Kyaw Htet ◽  
...  

AbstractObjectiveTo assess oil consumption, vitamin A intake and retinol status before and a year after the fortification of unbranded palm oil with retinyl palmitate.DesignPre–post evaluation between two surveys.SettingTwenty-four villages in West Java.SubjectsPoor households were randomly sampled. Serum retinol (adjusted for subclinical infection) was analysed in cross-sectional samples of lactating mothers (baselinen324/endlinen349), their infants aged 6–11 months (n318/n335) and children aged 12–59 months (n469/477), and cohorts of children aged 5–9 years (n186) and women aged 15–29 years (n171), alongside food and oil consumption from dietary recall.ResultsFortified oil improved vitamin A intakes, contributing on average 26 %, 40 %, 38 %, 29 % and 35 % of the daily Recommended Nutrient Intake for children aged 12–23 months, 24–59 months, 5–9 years, lactating and non-lactating women, respectively. Serum retinol was 2–19 % higher at endline than baseline (P<0·001 in infants aged 6–11 months, children aged 5–9 years, lactating and non-lactating women; non-significant in children aged 12–23 months;P=0·057 in children aged 24–59 months). Retinol in breast milk averaged 20·5 μg/dl at baseline and 32·5 μg/dl at endline (P<0·01). Deficiency prevalence (serum retinol <20 μg/dl) was 6·5–18 % across groups at baseline, and 0·6–6 % at endline (P≤0·011). In multivariate regressions adjusting for socio-economic differences, vitamin A intake from fortified oil predicted improved retinol status for children aged 6–59 months (P=0·003) and 5–9 years (P=0·03).ConclusionsAlthough this evaluation without a comparison group cannot prove causality, retinyl contents in oil, Recommended Nutrient Intake contributions and relationships between vitamin intake and serum retinol provide strong plausibility of oil fortification impacting vitamin A status in Indonesian women and children.


2011 ◽  
Vol 15 (4) ◽  
pp. 568-577 ◽  
Author(s):  
Avula Laxmaiah ◽  
Madhavan K Nair ◽  
Nimmathota Arlappa ◽  
Pullakhandam Raghu ◽  
Nagalla Balakrishna ◽  
...  

AbstractObjectiveTo assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.DesignA community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.SettingRural areas of eight states in India.SubjectsPre-school children and their mothers were covered.ResultsA total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8 %. The total ocular signs were significantly higher (P < 0·001) among boys (2·6 %) compared with girls (1·9 %) and in older children (3–4 years) compared (P < 0·001) with younger (1–2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95 % CI 2·9, 5·0), labourers (OR = 2·9; 95 % CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95 % CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95 % CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.ConclusionsThe study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.


2005 ◽  
Vol 8 (6) ◽  
pp. 564-571 ◽  
Author(s):  
Masahiro Hashizume ◽  
Momoko Chiba ◽  
Atsuko Shinohara ◽  
Shigehiro Iwabuchi ◽  
Satoshi Sasaki ◽  
...  

AbstractObjectivesTo investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population.DesignA cross-sectional design.SettingSchool-aged children in rural Kazakhstan.SubjectsSocio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and β-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured.ResultsAmong the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value <1.05 μmol l−1. Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis.ConclusionsAnaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.


2016 ◽  
Vol 115 (8) ◽  
pp. 1415-1423 ◽  
Author(s):  
Ke Chen ◽  
Hu Mina Xie ◽  
Weizheng Tian ◽  
Xiaoling Zheng ◽  
Alice C. Jiang

AbstractThe aim of this study was to explore the effect of single-dose albendazole and vitamin A intervention on the anaemic status and Fe metabolism of pre-school children. This study was a randomised, placebo-controlled and double-blinded intervention trial. All eligible anaemic pre-school children were randomly divided into three groups: group 1 received no intervention, which served as the control group, group 2 received 400 mg single-dose albendazole administration and group 3 received a 60000 μg vitamin A capsule combined with 400 mg single-dose albendazole at the beginning of the study. The follow-up period was for 6 months. Anthropometry and biochemical index about Fe metabolism were measured before and after intervention. A total of 209 pre-school anaemic children were randomly divided into three intervention groups (sixty-four, sixty-two and sixty for groups 1, 2 and 3, respectively). The mean age of the children in the study was 4·4 (sd 0·7) years and 50·5 % of the children were female (94/186). After a follow-up period of 6 months, the levels of serum retinol, ferritin, transferrin receptor-ferritin index and body total Fe content of children in group 3 were significantly higher compared with children in groups 1 and 2 (P<0·05). Moreover, the proportion of vitamin A deficiency, marginal vitamin A deficiency and Fe deficiency among children in group 3 were markedly lower compared with children in groups 1 and 2 (P<0·05). Albendazole plus vitamin A administration showed more efficacy on the improvement of serum retinol and Fe metabolic status.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. M. Hamdy ◽  
M. M. Abdel Aleem ◽  
A. A. El-Shazly

Background. Vitamin A deficiency (VAD) during pregnancy represents a major public health problem in developing countries. Anemia is a common consequence of VAD. We aimed to measure serum retinol concentrations of a sample of poor Egyptian mothers and correlate it with their Hb% and cord Hb%. Methods. This cross-sectional study included 200 healthy mothers and their healthy full term newborns. Maternal and cord blood samples were collected for CBC and measurement of serum retinol concentrations. Results. Forty-seven mothers (23.5%) had VAD and 50% were anemic. Mothers with VAD had a significantly lower mean Hb% and a significantly higher frequency of anemia (95.7%) compared to mothers without VAD (35.9%). The relative risk for anemia among mothers with VAD was 2.7 (CI = 2.12–3.3). Newborns of mothers with VAD had a significantly lower mean cord Hb% compared to newborns of mothers without VAD. Maternal serum retinol concentrations were positively correlated with maternal Hb% and cord Hb%. Conclusion. Maternal VAD during pregnancy among poor mothers is associated with maternal anemia and lower Hb% of newborns at birth. Vitamin A supplementation is highly recommended for this vulnerable group.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 647-647
Author(s):  
Cristina Guitron Leal ◽  
Teresa Shamah-Levy ◽  
Juan RIvera-Dommarco ◽  
Salvador Villalpando ◽  
Vanessa De la Cruz ◽  
...  

Abstract Objectives To examine the burden of anemia and micronutrient deficiencies, and associations between micronutrient status and anemia in children (1–11 y) in Mexico. Methods Data from the National Health and Nutrition Survey (ENSANUT 2018) were analyzed to determine the burden of anemia and micronutrient deficiencies (iron, vitamin B12, vitamin A) in a nationally-representative sample of 4,891 children 1 to 11 years of age (1 to &lt; 5 y: 1,337; 5–11 y: 3,554). Hemoglobin (Hb) was measured via HemoCue and venous blood samples were collected, processed, and stored at &lt; -80°C until analysis. Serum ferritin (SF), C-reactive protein (CRP) and vitamin B12 concentrations were measured via immunoassays. Serum retinol was measured via HPLC. Hemoglobin was adjusted for altitude; anemia (&lt; 5 y: Hb &lt; 11.0 g/dL; 5–11 y: &lt; 11.5 g/dL) and iron deficiency (ID; &lt; 5 y: &lt; 12.0 μg/L; 5–11 y: &lt; 15.0 μg/L) were defined using age-specific cut-offs. Iron insufficiency was defined as SF &lt; 20.0 μg/L, and inflammation as CRP &gt; 5.0 mg/L. Vitamin B12 deficiency and insufficiency were defined as &lt; 148 and &lt; 221 pmol/L, and vitamin A deficiency was defined as retinol &lt; 20 μg/dL. Survey linear and logistic regression were used to examine associations of micronutrient biomarkers with hemoglobin concentrations and odds of anemia. Results Serum ferritin concentrations (β [SE]: 0.0003, p &lt; 0.001) and serum retinol levels (0.0005, p &lt; 0.001) were associated with higher hemoglobin levels, while iron deficiency (–0.57 [0.03], p &lt; 0.001), iron insufficiency (–0.54 [0.02]; p &lt; 0.001), and vitamin A deficiency (–0.53 [0.01], p &lt; 0.0001) were associated with lower hemoglobin levels. In analyses of anemia, the odds of anemia were 11% lower per 10 μg/L increase in serum ferritin (OR [95% CI]: 0.89 [0.84–0.93], p &lt; 0.001) and 34% lower per 10 μg/dL increase in serum retinol (OR: 0.66 [0.57–0.77], p &lt; 0.001), while iron deficiency (OR: 2.22 [1.49–3.29], p &lt; 0.001) and iron insufficiency (OR: 1.74 [1.32–2.30]; p = 0.0001) were associated with higher odds of anemia. Conclusions Findings suggest that the burden of anemia and micronutrient deficiencies are high in children in Mexico, and lower iron and vitamin A status were associated with increased odds of anemia. Funding Sources ENSANUT was funded by The Ministry of Health of Mexico.


Author(s):  
F. Lusamaki Mukunda ◽  
E. Solomo ◽  
Mosisi Moleka ◽  
Omekomba Konde ◽  
L. E. Likaka ◽  
...  

Summary: Vitamin A is an essential micronutrient needed by the body for various physiological functions. Its deficiency is associated with several functional disorders. The objective of this study is to determine blood vitamin A levels in malnourished and healthy children. Methods: It is a cross-sectional analytical study, consisting of determining the vitamin A content in the blood of children suffering from malnutrition and those in good nutritional status. Our sampling was casual and 59 children aged 6 to 59 months were retained. Among them 30 healthy children chosen from those attending preschool consultation at U HC and 29 malnourished children from those followed at M TNU for the management of malnutrition. The serum vitamin A assay was performed according to the method described by Tietz. Children with serum vitamin A level below 30 μg / 100 ml had vitamin A deficiency and those with a serum level greater than or equal to 30 μg / 100 ml had good vitamin A status. Percent, average and standard deviation calculations were performed. The Chi square statistical test was used to compare serum vitamin A content in healthy and malnourished children, as well as other maternal parameters for a significance level of 0.05.  Results: from 59 children examined, 30 or 50.8% were 6-17 months old, the average age was 21.9 ± 13 months. 45.7% had a serum retinol level between 50-59 μg/100 ml; the average value was 46.84 μg ± 14.27.  The prevalence of VAD was 20.3% and this deficit was more marked in children aged 6-17 months that is 50% (P<0.014). Among 12 children with VAD, 10 or 83.3% were the wealthy and two were the malnourished, the difference was statically significant (P< 0.011). Conclusion: Vitamin A deficiency remains a major health problem in the DRC. This affect all children regardless of their current nutritional status. Supplementation with this vitamin remains one of the palliative solutions.


2015 ◽  
Vol 87 (1) ◽  
pp. 463-470 ◽  
Author(s):  
FERNANDA B.S. RESENDE ◽  
LARISSA Q. DE LIRA ◽  
EVELLYN C. GRILO ◽  
MAYARA S.R. LIMA ◽  
ROBERTO DIMENSTEIN

The influence of gestational diabetes on vitamin A deficiency in lactating women and, consequently, in their newborn has been verified through a cross-sectional case-control study conducted with volunteer puerperal women. The control group consisted of healthy women and the test group was composed of women with gestational diabetes. One hundred and seven women were recruited, corresponding to 71 controls and 36 cases. Personal, gestational and newborn data were collected directly from medical records during hospitalization. The retinol was determined in maternal colostrum and serum by High Performance Liquid Chromatography. Postpartum women with gestational diabetes were older, had more children and a higher prevalence of cesarean delivery. No difference was found in retinol concentration in maternal milk and serum between the groups. However, it was observed that 16.7% had vitamin A deficiency in the group of patients with diabetes and only 4.1% had such deficiency in the control group. Although no difference was found in colostrum and serum retinol concentration between women with and without gestational diabetes, the individual analysis shows that those with diabetes are at higher risk of being vitamin A deficient.


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