Vitamin A deficiency during pregnancy of HIV infected and non-infected women in tropical settings of Northwest Ethiopia.

BACKGROUND: Vitamin A deficiency (VAD) is known to be a major public health problem among women of reproductive age in South East Asia and Africa. In Ethiopia, there are no studies conducted on serum vitamin A status of HIV-infected pregnant women. Therefore, the present study was aimed at determining the level of serum vitamin A and VAD among pregnant women with and without HIV infection in tropical settings of Northwest Ethiopia. METHODS: In this cross-sectional study, blood samples were collected from 423 pregnant women and from 55 healthy volunteers who visited the University of Gondar Hospital. Serum concentration of vitamin A was measured by high performance liquid chromatography. RESULTS: After controlling for total serum protein, albumin and demographic variables, the mean ± SD serum vitamin A in HIV seropositive pregnant women (0.96 ± 0.42 µmol/L) was significantly lower than that in pregnant women without HIV infection (1.10 ± 0.45 µmol/L, P < 0.05). Likewise, the level of serum vitamin A in HIV seropositive non-pregnant women (0.74 ± 0.39) was significantly lower than that in HIV negative non-pregnant women (1.18 ± 0.59 µmol/L, P < 0.004). VAD (serum retinol < 0.7 µmol/L) was observed in 18.4% and 17.7% of HIV infected and uninfected pregnant women, respectively. Forty six percent of non-pregnant women with HIV infection had VAD while only 28% controls were deficient for vitamin A (P = 0.002). CONCLUSION: The present study shows that VAD is a major public health problem among pregnant women in the tropical settings of Northwest Ethiopia. Considering the possible implications of VAD during pregnancy, we recommend multivitamin (which has a lower level of vitamin A) supplementation in the care and management of pregnant women with or without HIV infection.

Association of low serum selenium with anemia among adolescent girls living in rural Vietnam.

OBJECTIVE: We investigated the prevalence of anemia and deficiency in trace elements in adolescent girls living in rural Vietnam. METHODS: Two hundred forty-five adolescent girls 11-17 y of age from three schools in rural province of Ha Nam, Vietnam, were assessed. RESULTS: The prevalence of anemia was 20.4%. The incidences of low serum selenium (Se), zinc, and copper in subjects were 15.9%, 26.5%, and 4.1%, respectively. The parameter significantly associated with anemia was the low serum levels of Se and vice versa (odds ratio [OR] 5.36, 95% confidence interval [CI] 2.57-11.18, P < 0.0001). Other risk factors for anemia were a body mass index <17.00 kg/m(2) (OR 2.72, 95% CI 1.37-5.37, P = 0.004) and years of age (OR 1.35, 95% CI 1.14-1.59, P < 0.001). A body mass index <17.00 kg/m(2) (OR 2.65, 95% CI 1.25-5.61, P = 0.011) was also found to be a risk factor for low serum Se. CONCLUSION: The findings of the present study demonstrate that low serum Se is independently associated with anemia in adolescent girls living in rural Vietnam. Interventions are required to gain insight into the potential role of Se on prevention and control of anemia.

Serum levels of trace elements and iron-deficiency anemia in adult Vietnamese.

This study was aimed at assessing the serum levels of vitamin A, copper, zinc, selenium, and iron among adult Vietnamese with and without iron-deficiency anemia. Blood was collected from adult Vietnamese living in the midland of northern Vietnam. One hundred twenty-three subjects in the age range 20-60 yr were included in the study. Anemia, where the concentration of hemoglobin in whole blood is less than 120 g/L in females and 130 g/L in males, was found in 30% (37/123) of the study population. The levels of vitamin Aand selenium in the sera of anemic subjects (n = 37) were significantly lower than that in nonanemic group (n = 86). On the other hand, no significant differences were observed in the concentrations of copper and zinc between the two groups. This study was the first to show serum levels of trace elements in adult Vietnamese, providing useful baseline information for further studies.

Micronutrient deficiencies and anemia among preschool children in rural Vietnam.

The prevalence of trace elements deficiencies, vitamin A deficiency, anemia, and their relationships were investigated in a cross sectional study involving 243 children aged from 12 to 72 months in rural Vietnam. Serum levels of copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometer and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The prevalence of deficiencies in zinc, selenium, magnesium, and copper was 86.9%, 62.3%, 51.9%, and 1.7%, respectively. On the other hand, 55.6% were anemic and 11.3% had vitamin A deficiency. Deficiency in two or more micronutrient was found in 79.4% of the children. Parameters associated significantly with anemia were selenium deficiency (OR 2.80 95% CI 1.63-4.80, p=0.0002) and serum retinol<1.05 micromol/L (OR 1.83, 95% CI 1.10-3.05, p=0.021). Magnesium deficiency (OR 3.09 95% CI 1.36-7.03) was found to be a risk factor for zinc deficiency and vice versa. The results indicate that micronutrient deficiencies are prevalent among preschool children in Vietnam. In addition, the results also demonstrate a strong relationship between selenium deficiency and anemia. Clearly, sustainable strategies are urgently required to overcome the problems in the country.

Vitamin A deficiency in patients with diarrhea and HIV infection in Ethiopia.

Diarrhea, micronutrient deficiencies and HIV/AIDS are major public health problems in developing countries, especially in sub-Saharan Africa. This study was aimed to investigate serum levels of vitamin A in diarrheic patients with and without HIV co-infection compared to healthy controls. Two hundred eleven diarrheic patients (110 HIV infected), 87 apparently healthy controls and 41 asymptomatic HIV seropositive blood donors who visited the University of Gondar Hospital, in Gondar, Ethiopia were included. Stool samples were examined for enteropathogens following the standard procedures. Serum vitamin A levels were measured by high performance liquid chromatography. Shigella species were isolated from 8.5% of the patients while intestinal parasites were detected in 32.2% without significant difference by HIV serostatus. The mean+/-SD serum vitamin A in diarrheic patients with (0.82+/-0.59 micromol/L) and without (0.84+/-0.54 micromol/L) HIV co-infection and in asymptomatic HIV infected blood donors (0.96+/-0.52 micromol/L) was significantly lower than that in healthy controls (1.52+/-0.71 micromol/L), p<0.001. Vitamin A deficiency (VAD, serum retinol < 0.70 micromol/L) was observed in 52.7% and 45.5% of diarrheic patients with and without HIV co-infection, respectively. About 13% of healthy controls and 29.3% of asymptomatic HIV infected blood donors were deficient in vitamin A. The levels of serum vitamin A were not associated with the presence of intestinal parasites or Shigella species. The findings demonstrate that VAD is a severe public health problem among diarrheic patients in Gondar, Ethiopia. Intervention programmes involving health and nutrition education and supplementation of vitamin A might help in reducing morbidity in such patients.

Sub clinical vitamin A deficiency and anemia among Vietnamese children less than five years of age.

The objective of the study was to assess the prevalence of sub clinical vitamin A deficiency and anemia in Vietnamese children. For this, a cross-sectional survey was conducted in 40 villages (clusters) of four ecological regions in Vietnam during Apr-May 2001. In total 1657 children less than 5 years old were included by a cluster random sampling method. The prevalence of sub clinical vitamin A deficiency (serum retinol <0.70 mumol/l) was 12.0% and the prevalence of anemia (hemoglobin <110g/l) was 28.4 %. 35.1%. In the children under 6 months the prevalence of sub clinical vitamin A deficiency was 35.1 % whereas the prevalence of anemia in this group was as high as 61.7%. The prevalence of children with both sub clinical vitamin A deficiency and anemia was 6.1%. Sub clinical vitamin A deficiency and anemia prevalence differed significantly across the regions, with highest prevalence in the Northern Mountainous areas for vitamin A deficiency and in the Northern Mountainous area and Mekong River Delta for anemia. It is concluded that sub clinical vitamin A deficiency and anemia are still important public health problems in Vietnam. Sustainable strategies for combating vitamin A deficiency and nutritional anemia are needed and should concentrate on target groups, especially infants and malnourished children in high risk regions.