Hematologic effect of vitamin A supplementation in anemic Pakistani children

To assess the prevalence of vitamin A deficiency in anemic Pakistani children and investigate the hematologic response to vitamin A supplementation, 4-8 year old primary school children from the slum areas of Karachi were surveyed for anemia. Of 101 anemic children selected, 16% had low level of vitamin A ( < 20 micrograms/dl) and an additional 2% had deficient level ( < 10 micrograms/dl). Serum Retinol level showed positive associated with serum iron, ferritin, hemoglobin, hematocrit and Mean cell hemoglobin concentration. A non-randomized control trial was then carried out. Oral vitamin A capsules were given to 42 children and 53 children served as controls. After 6 weeks, there were significant differences between the two groups for Retinol, Retinol-Binding-Protein and Hematocrit. However, no significant difference could be found for Hemoglobin, RBC count, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin, Mean Corpuscular Hemoglobin Concentration, Serum iron, ferritin or transferrin. A single vitamin A supplement improved the hematocrit in 6 weeks. Long-term studies are needed to find if the WHO recommended periodic massive doses of vitamin A besides improving the morbidity and mortality will also improve the overall picture of anemia in children.