Vitamin A deficiency and anemia among children 12-71 months old in Honduras

Vitamin A deficiency (VAD) and iron deficiency anemia (IDA) have been recognized as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micronutrient Survey on 1.678 children 12-71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14 per cent of the children were subclinically vitamin A deficient (plasma retinol 20 ug/dL) and 32 per cent were at risk of VAD (plasma retinol 20-30 ug/dL). These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12-23 monts old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared with other children. That same doubled risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50 per cent of those mandated by Honduran law. There appears to be significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33 per cent of samples contained no retinol. Overall, 30 per cent of children were anemic (Hb 11 g/dL). Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33 per cent greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51 per cent and 21 per cent, respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it

Micronutrient deficiencies in the English-speaking Caribbean and in Guyana

Tres estudios recientes analizaron el grado de deficiencia de vitamina A, betacarotenos y hierro en Jamaica, Antigua y Barbuda, Dominica, San Vicente y las Granadinas y Guyana. Todos los estudios fueron efectuados por el Instituto Caribeño de Alimentación y Nutrición, o en colaboración con él. En todas las encuestas, que fueron similares en su estructura y resultados, se recolectaron muestras de sangre con el fin de determinar las deficiencias de micronutrientes. También se aplicaron cuestionarios para recoger información sobre los patrones de alimentación. Los principales grupos estudiados fueron los niños pequeños, los escolares y las mujeres embarazadas. La anemia por deficiencia de hierro fue la deficiencia de micronutrientes más común de las que se encontraron en los tres estudios. Aunque se hallaron pocos casos de deficiencia de vitamina A grave, fueron más comunes las deficiencias marginales. En los tres estudios se hicieron recomendaciones similares para hacer frente a las deficiencias detectadas en los diversos países. Es menester que los gobiernos y otras agencias sigan promoviendo la disponibilidad y el consumo de alimentos ricos en vitamina A y caroteno. Los programas contra la anemia deben dirigirse específicamente hacia los niños de 1 a 4 años de edad y las mujeres embarazadas

Vitamina A, citología conjuntival y complicaciones clínicas en niños hospitalizados por neumonía / Vitamin A, conjunctival cytology, and clinical complications in children hospitalized for pneumonia

Con el objetivo de estudiar la posible relación entre los niveles orgánicos de vitamina A y la gravedad de un proceso neumónico se investigaron los niveles séricos de retinol, la citología de impresión conjuntival y la gravedad clínica de 178 niños ingresados en un hospital pediátrico de La Habana por neumonía infecciosa aguda. La neumonía se consideró complicada (n=57) cuando el paciente presentó derrame pleural, abscesos pulmonares o ambos, de lo contrario, se consideró no complicada (n=121). Los valores de retinol sérico en ambos grupos fueron similares y no se halló asociación entre la gravedad de la neumonía y los niveles séricos de retinol. En cambio, en los niños con citología conjuntival alterada la neumonía complicada fue dos veces más frecuente que en los niños con citología normal (riesgo relativo=2.2, con un intervalo de confianza del 95

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Epidemiologia da carencia de vitamina A no Nordeste do Brasil / Epidemiology of vitamin A deficiency in Brazil Northeast

A deficiencia de vitamin A e responsavel por alteracoes em tecidos epiteliais especializados podendo levar a xeroftalmia e cegueira nutricional. Alemdisto, em anos recentes foi demonstrado que ofrecer suplementacao com vitamina A a criancas pre-escolares, em areas onde a deficiencia e endemica, pode reduzir a mortalidade de 23 per cento a 30 percento em media. Os primeiros relatos de carencia de vitamina A e xeroftalmia no Brasil ocorreram em 1864 e 1883, em escravos mal alimentados. Neste seculo, durante as secas periodicas na regiao Nordeste, houve relatos de cegueira noturna e de outras lesoes oculares. Nas ultimas decadas, diversos estudos determinaram niveis de retinol serico ou hepatico (este ultimo em amostras de necropsias) demonstrando que a hipovitaminose A e um problema de saude publica no Nordeste. No inicio da decada de 1980 encontraram-se lesoes oculares por deficiencia de vitamina A tanto em estudos epidemiologicos em campo, nos estados da Paraiba e Rio Grande do Norte, como tambem atraves do acompanhamento dos casos atendidos na enfermaria do Hospital Universitario de Joao Pessoa, Paraiba. Dentre os fatores de risco para a xeroftalmia corneal destacaram-se o desmame precoce, a idade abaixo de 12 meses e as infeccoes. Recentemente a deficiencia de vitamina A tem sido descrita na regiao Nordeste tambem em epocas de safras regulares, embora a maioria dos casos de xeroftalmia e cegueira nutricional tenham sido registrados durante periodos agudos de seca. Nesta regiao a carencia nutricional e permanente e qualquer fator precipitante pode romper o fragil equilibrio resultante das adaptacoes fisiopatologicas a desnutricao

National vitamin A survey in Panama

The prevalence of vitamin A deficiency in a nationally representative sample of children 12-59 months old in Panama was assessed using serum retinol levels and dietary indicators. The median serum retinol level found was 1.27 + 0.42 umol/L (38ug/dL); 6.0 percent of the study sample providing adequate blood specimens had levels below 0.7 umol/L (20ug/dL), indicating deficient vitamin A intake. The Panama City Metropolitan Area and the country's western region had the highest prevalences of low serum retinol levels (below 0.7 umol/L in 9 percent and 6 percent of the study children, respectively), as compared to overall prevalences of 5 percent in the two other regions studied. Low serum retinol levels were significantly more prevalent among Indians in the study group (primarily Guaymí Indians) than among non-Indians (13 percent versus 5 percent). Dietary information provided by the study children's mothers showed that high risk of inadequate dietary vitamin A intake closely paralleled low serum retinol levels; specifically, the highest prevalence of dietary inadequacy was found in the western region, especially among the Indians. The Panamanian Government is currently increasing distribution of high-dose vitamin A capsules to Indian preschoolers in Chiriquí and Bocas del Toro Provinces (AU)