Retinol Assessment Among Women and Children in Sahelian Mobile Pastoralists

M Bechir,L Crump,E Schelling,F Schweigert,M Tanner,K Kraemer,J Zinsstag,B Bonfoh

doi:10.1007/s10393-012-0781-7

Abstract

Micronutrient deficiencies are widespread in developing countries, particularly in remote communities such as mobile pastoralists. The nutritional and vitamin A status of this population is not well-documented in Chad. This study assessed serum retinol levels among women and children under five-year-old in nomadic and semi-nomadic pastoralist and rural-settled communities, who are similarly exposed to risk factors such as gastrointestinal parasitic infection, anaemia and emaciation. The novel method of portable fluorometry was used for the first time to measure β-carotene and retinol levels in a pastoral nomadic area. Moderate level blood retinol deficiency (<0.7 μmol/L) was observed in 5% (CI 1–11) of nomadic, 29% (CI 13–45) of semi-nomadic and 22% (CI 8–35) of sedentary women. In children, 1% (CI 0.1–4), 17% (CI 9–25) and 28% (CI 18–39), respectively, had moderate level blood retinol deficiency. In nomadic communities, women and children had blood retinol levels close to normal. Deficiency of retinol was strongly linked with lifestyle (nomadic, semi-nomadic and settled) among women and lifestyle and age among children. The results support an ecological linkage between human retinol levels and livestock milk retinol. This study shows the feasibility of portable retinol and β-carotene measurement in human blood as well as human and animal milk under remote field conditions, but the approach requires further validation.

Highlights

Worldwide, 250 million school children are estimated to be vitamin A deficient, and night blindness affects 5.2 million preschool aged children and 9.8 million pregnant women, (McLaren and Frigg 2002; World Health Organization (WHO) 2009)
This study showed the interdependencies of vitamin A in infants, who are nourished mainly through mother’s milk
At the end of the wet season, nomadic pastoralists have higher blood retinol concentration compared to semi-nomadic and sedentary women and children, who seem to be more vulnerable to deficiency

Summary

Introduction

250 million school children are estimated to be vitamin A deficient, and night blindness affects 5.2 million preschool aged children and 9.8 million pregnant women, (McLaren and Frigg 2002; WHO 2009). The majority of Remote communities, such as Sahelian mobile pastoralists, have limited access to health services (Wyss et al 2004; Zinsstag et al 2005), and their micronutrient status is not well-documented in Chad. One of the few studies done in a Chadian mobile pastoralist population found that the primary source of dietary retinol was milk and 40% of women were deficient (Zinsstag et al 2002). Blood samples were transported from Chad to Switzerland for high-performance liquid chromatography analysis. Both food consumption and community socio-cultural aspects determine vitamin A levels. In Ethiopia, Demissie et al (2009) found an association between VAD and age or household characteristics

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Conclusion