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Serum retinol levels among preschool children in Central Java: demographic and socioeconomic determinants
C L Kjolhede1, R Y Stallings, M J Dibley
1Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA.
Insights
Vitamin A deficiency is a global health issue, especially in developing nations. This study in Indonesia found that land ownership and higher household income correlate with better vitamin A levels in children.
Area of Science:
- Nutritional science
- Public health
- Pediatrics
Background:
- Vitamin A deficiency is a major health concern in developing countries.
- Clinical signs of deficiency represent only a fraction of at-risk children.
- Demographic and socioeconomic factors are known risk factors for vitamin A deficiency.
Purpose of the Study:
- To investigate demographic and socioeconomic risk factors for vitamin A deficiency in children.
- To identify predictors of serum retinol levels in a rural Indonesian population.
- To inform targeted interventions for vitamin A deficiency prevention.
Main Methods:
- Population-based study in Central Java, Indonesia, involving 666 children aged 6-48 months.
- Collected census, socioeconomic, and serum retinol data.
- Employed t tests, ANOVA, and multiple variable linear regression for analysis.
Main Results:
- Serum retinol levels varied significantly by village, child's age, and sibship size.
- Socioeconomic factors including mother's occupation, parental education, household earnings, and land ownership were associated with retinol levels.
- Possession of assets like radios, tape players, watches, clocks, and access to natural wells showed some correlation with retinol levels.
Conclusions:
- Land ownership and higher household income are linked to elevated serum retinol levels.
- Serum retinol levels exhibited clustering by village.
- Children from larger families and infants had lower serum retinol levels, suggesting a need for targeted supplementation for mothers and infants.
Background:
Vitamin A deficiency is a significant problem in many countries in the developing world. Reports have noted demographic and socioeconomic risk factors for vitamin A deficiency. 'Deficiency' has usually been defined by clinical signs and symptoms which represent only a small proportion of those children at increased risk for vitamin A preventable morbidity and mortality.
Methods:
As part of a population-based trial of vitamin A to prevent childhood morbidity, we collected census data (n = 666), baseline socioeconomic data (n = 636) and sera (n = 666) from children aged 6-48 months in 25 adjacent villages in a rural area in Central Java, Indonesia; there was more than 95% participation. We used t tests, ANOVA, and a multiple variable linear regression model in our analyses.
Results:
Differences in mean retinol level were detected for the following variables: village (P < 0.001), child's age (P = 0.03), size of sibship (P < 0.001), mother's occupation (P < 0.01), mother's education (P = 0.05), father's education (P = 0.03), monthly household earnings (P = 0.02), land ownership (P = 0.03), possession of ducks (P = 0.06), radio or tape player (P = 0.02), or a watch or clock (P = 0.07), and presence of a natural well (P = 0.09). Our regression model verified the predictive value of village, age, sibship, land ownership and earnings.
Conclusions:
We found that owning land and that the highest and lowest categories of reported household income were associated with higher serum retinol levels. We also noted clustering of serum retinol levels by village and discovered that children from larger sibships and infants had significantly lower serum retinol levels. Vitamin A supplementation of lactating mothers, particularly of high parity, and/or their infants should be considered.