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.