Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children.

V Persson,M Gebre-Medhin,F Ahmed,T Greiner

doi:10.1017/s1368980000000100

V Persson, M Gebre-Medhin + Show 2 more

Open Access

https://doi.org/10.1017/s1368980000000100

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Abstract

To explore the relationships between biochemical indicators of vitamin A and iron status and the intestinal helminths Ascaris lumbricoides and hookworm in primary school children. Two rural governmental schools in northwestern Bangladesh. Cross-sectional study. The sample consisted of 164 children in grades 3-5. Serum retinol and beta-carotene (by high-performance liquid chromatography, HPLC), haemoglobin (HemoCue), ferritin (enzyme-linked immunoadsorbent assay, ELIZA) and height and weight were measured. Dietary intake of vitamin A was assessed using a food frequency questionnaire and faecal analyses were done using Stoll's egg-count technique. The mean serum retinol was 26.8 microg dl(-1) and 20% had a level of < 20 microg dl(-1), the cut-off value for low vitamin A status. There was a strong positive association between serum beta-carotene and serum retinol (r = 0.44, P < 0.001), suggesting those with higher retinol levels had a higher carotene intake. Thirty-one per cent were anaemic (Hb < 11.5 g dl(-1)), 30% had iron deficiency (serum ferritin < 12.0 microg l(-1)) and 14% were suffering from iron deficiency anaemia. Children with a serum retinol level of 20 microg dl(-1) had significantly lower ferritin (14.0 compared to 26.0 microg l(-1), P = 0.005) and Hb levels (11.7 compared to 12.4 g dl(-1), P = 0.005) than those with higher levels. The proportion of iron deficiency anaemia was significantly greater among children with hookworm. Our data suggest that hookworm exerts its impact on iron status independently of the vitamin A status of the host. Programmes to improve iron status should consider including both vitamin A prevention programmes and deworming.

Highlights

Anthropometry Seventeen per cent of the children were taller than the maximum reference value used for W/H25 and the results are based on data for only 83% of the sample
The lack of absence of differences in nutritional status between boys and girls may be due to selection bias, with boys from slightly better-off families being sent to private schools
Vitamin A status The study showed that 20% of the children had levels below 20 mg dl−1 for serum retinol, a cut-off value defined as low vitamin A status and an additional 50% were below 30 mg dl−1

Summary

Introduction

Iron deficiency anaemia Helminthiasis Retinol Beta-carotene Haemoglobin Ferritin Dietary intake A study of 242 school children in urban Dhaka[10], aged 5–12 years found that about 20% of the children had serum retinol levels of less than 30 mg dl−1. Only a limited number of studies with small sample sizes have been published on vitamin A status as measured by serum retinol in school-aged children living in rural areas of Bangladesh.

Results

Conclusion