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Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children
V Persson1, F Ahmed, M Gebre-Medhin
1Section for International Maternal and Child Health, Uppsala University, Sweden. viveka.persson@ich.uu.se
Insights
This study found that low vitamin A status is linked to poorer iron levels in school children. Deworming and vitamin A supplementation are recommended to improve child health.
Area of Science:
- Nutritional biochemistry
- Public health
- Pediatrics
Background:
- Vitamin A and iron are essential micronutrients for child development.
- Intestinal helminths, such as Ascaris lumbricoides and hookworm, are prevalent in many low-income regions.
- Helminth infections can impair nutrient absorption and exacerbate deficiencies.
Purpose of the Study:
- To investigate the association between vitamin A and iron status indicators and helminth infections in primary school children.
- To determine if helminths influence micronutrient status independently of dietary intake.
Main Methods:
- A cross-sectional study was conducted in 164 primary school children (grades 3-5) in rural Bangladesh.
- Biochemical assessments included serum retinol, beta-carotene, hemoglobin, and ferritin.
- Dietary intake and helminth infection status were also evaluated.
Main Results:
- Low vitamin A status (serum retinol < 20 microg dl(-1)) was associated with significantly lower ferritin and hemoglobin levels.
- Hookworm infection was linked to a higher prevalence of iron deficiency anemia.
- Vitamin A status and hookworm infection appeared to independently affect iron status.
Conclusions:
- Interventions to improve iron status in children should integrate vitamin A supplementation and deworming strategies.
- Addressing both helminth infections and vitamin A deficiency is crucial for enhancing overall child health and nutritional well-being.
Objective:
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.
Setting:
Two rural governmental schools in northwestern Bangladesh.
Design:
Cross-sectional study.
Subjects:
The sample consisted of 164 children in grades 3-5.
Methods:
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.
Results:
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.
Conclusions:
Programmes to improve iron status should consider including both vitamin A prevention programmes and deworming.