Prevalence of Vitamin a Deficiency among Infants Participating in the Mama SASHA Proof of Concept Project in Western Kenya
Frederick Grant *
International Potato Center, Nairobi, Kenya.
Donald Cole
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Kirimi Sindi
International Potato Center, Nairobi, Kenya.
Carol Levin
University of Washington, Seattle, USA.
Dean Garett
PATH, Seattle, USA.
Simon Kariuki
Kenya Medical Research Institute, Kisumu, Kenya.
Hermann Ouedarogo
International Potato Center, Nairobi, Kenya.
Cornelia Loechl
IAEA, Vienna, Austria.
Rhona Baingana
Makerere University, Kampala, Uganda.
Mary Oyunga
Kenya Agriculture Research Institute, Kisumu, Kenya.
Jan Low
International Potato Center, Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Vitamin A (VA) deficiency (VAD) is a significant burden among children under-5-years-old and pregnant and lactating women in sub-Saharan Africa. We assessed the levels of VA and prevalence of VAD among children age 6-23 mo in 2 counties in western Kenya.
Methods: Dry-Blood-Spot (DBS) samples were obtained from 1838 infants in a community-based cross-sectional survey. Laboratory analysis of retinol-binding protein (RBP) and C-reactive protein (CRP) was carried out using a rapid EIA to estimate VA and subclinical inflammation statuses, respectively. A validation of DBS as a matrix using 60 matching serum-DBS samples was carried out. Values were adjusted for influence of inflammation using CRP (CRP, >5 mg/L) and population prevalence of VAD (RBP<0.825 µmol/L, biologically equivalent to 0.70 µmol/L retinol) estimated.
Results: Mean (geometric±SD) concentration of RBP was adequate (1.56±0.79 µmol/L) with inflammation-adjusted mean (±SE) prevalence of VAD being high (18.3±1.1%). The level of CRP was within normal range (1.06±4.95 mg/L) whilst 18.4±0.9% had subclinical inflammation (CRP>5 mg/L). VAD was not associated with child sex (Chi-squared, Χ2=0.42, P=0.51), child nutritional status (wasting (P=0.68) and stunting (P=0.91), reported child intake of VA capsule within the past 1 year (P=0.84), maternal VA nutritional knowledge (Χ2=0.10, P=0.80), or reported maternal intake of VA capsule within 2 months of delivery (P=0.27). Older children had a 10% increased risk of VAD.
Conclusions: Prevalence of VAD in this sample of infants was high irrespective of intake of VA capsule or maternal VA nutrition knowledge. A sustainable food-based intervention in this area of western Kenya to combat VAD especially in pregnant women and infants is warranted.