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Vitamin A deficiency in poor, urban, lactating women in Bangladesh: factors influencing vitamin A status

Published online by Cambridge University Press:  22 December 2006

Faruk Ahmed*
Affiliation:
Nutrition Program-Division of International Health, School of Population Health, University of Queensland, Public Health Building, Herston Road, Herston, Queensland 4029, Australia
Asfia Azim
Affiliation:
Institute of Nutrition and Food Science, University of Dhaka, Dhaka – 1000, Bangladesh
Mohammad Akhtaruzzaman
Affiliation:
Institute of Nutrition and Food Science, University of Dhaka, Dhaka – 1000, Bangladesh
*
*Corresponding author: Email: [email protected]
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Abstract

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Aims:

To investigate the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh, and to examine the relationship between various factors and vitamin A status.

Design:

Cross-sectional study.

Setting:

Maternal and child health clinic in Dhaka City, Bangladesh.

Subjects and methods:

A total of 120 lactating women aged 17–37 years were randomly selected from women who attended a local maternal and child health clinic in Dhaka City for immunisation of their children. Various socio-economic, personal characteristics, dietary intakes of vitamin A and anthropometric data were collected. Serum retinol (vitamin A) concentration was determined as a measure of vitamin A status.

Results:

Of the subjects, 37% had low serum vitamin A levels (<30 μg dl−1), with 13.3% having sub-clinical vitamin A deficiency (<20 μg dl−1). Eighty-seven per cent had vitamin A intakes below the recommended dietary allowance. The lactating women who were either illiterate or received only informal education had significantly (P = 0.002) lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly (P = 0.05) higher serum vitamin A levels than those whose husbands were either illiterate or received only informal education. The serum vitamin A levels of women in households with poor sanitation/latrine practice were significantly (P = 0.03) lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly (P = 0.015) lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly (P = 0.034) lower serum vitamin A levels than women with a lactation period of less than 6 months. The women who consumed less than the median vitamin A intake (274.8 μg day−1) had significantly (P = 0.01) lower serum vitamin A levels than those who consumed more than the median vitamin A intake. By multiple regression analysis, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A were found to have significant independent relationships with serum vitamin A. The overall F-ratio (6.8) was highly significant (P = 0.000), the adjusted R2 was 0.16 (multiple R = 0.44).

Conclusion:

A significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Among the various factors, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A appear to be important in influencing the vitamin A status of these women.

Type
Research Article
Copyright
Copyright © The Authors 2003

References

1World Health Organization (WHO). Nutrition for Health and Development. A Global Agenda for Combating Malnutrition. WHO/NHD/2006.6. Geneva: WHO, 2000.Google Scholar
2Beaton, GH, Martorell, R, Aronson, KJ, Edmonston, B, McCabe, G, Ross, AC, et al. Effectiveness of Vitamin A Supplementation in the Control of Young Child Morbidity and Mortality in Developing Countries. ACC/SCN State of the Art Series Nutrition Policy Discussion Paper No. 13GenevaAdministrative Committee on Coordination, Sub-Committee on Nutrition (ACC/SCN), 1993.Google Scholar
3Sommer, A, West, KP Jr.Vitamin A Deficiency: Health, Survival and Vision. New York: Oxford University Press, 1996.CrossRefGoogle Scholar
4Sommer, A. Nutritional Blindness: Xerophthalmia and Keratomalacia. New York: Oxford University Press, 1982.Google Scholar
5Ahmed, F, Barua, S, Mohiduzzaman, M, Shaheen, N, Bhuyan, MAH, Margetts, BM, et al. Interaction between growth and nutrient status in school age children of urban Bangladesh. American Journal of Clinical Nutrition 1993; 58: 334–8.CrossRefGoogle ScholarPubMed
6Mejia, LA, Chew, F. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. American Journal of Clinical Nutrition 1988; 48: 595600.CrossRefGoogle ScholarPubMed
7Katz, J, Khatry, SK, West, KP Jr, Humphrey, JH, LeClerq, SC, Pradhan, EK, et al. Night blindness during pregnancy and lactation in rural Nepal. Journal of Nutrition 1995; 125: 2122–7.CrossRefGoogle ScholarPubMed
8Christian, P, West, KP Jr, Khatry, SK, Katz, J, Shrestha, SR, Pradhan, EK, et al. Night blindness of pregnancy in rural Nepal – nutritional and health risks. International Journal of Epidemiology 1998; 27: 231–7.CrossRefGoogle ScholarPubMed
9Stoltzfus, RJ, Hakimi, M, Miller, KW, Rasmussen, KM, Dawiesah, S, Habicht, JP, et al. High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects on the vitamin A status of mother and infant. Journal of Nutrition 1993; 123: 666–75.CrossRefGoogle ScholarPubMed
10Rice, AL, Stoltzfus, RJ, de Francisco, A, Chakraborty, J, Kjolhede, CL, Wahed, MA. Maternal vitamin A or β-carotene supplementation in lactating Bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency. Journal of Nutrition 1999; 129: 356–65.CrossRefGoogle Scholar
11West, KP Jr, Katz, J, Khatry, SK, LeClerq, SC, Pradhan, EK, Shrestha, SR, et al. Double blind, cluster randomised trial of low dose supplementation with vitamin A or β-carotene on mortality related to pregnancy in Nepal. British Medical Journal 1999; 318: 570–5.CrossRefGoogle ScholarPubMed
12Helen Keller International (HKI)/Institute of Public Health Nutrition (IPHN). Bangladesh Nutritional Blindness Study, 1982–83. Dhaka, Bangladesh: HKI/IPHN, 1985.Google Scholar
13Huffman, SL, Chowdhury, A, Chakraborty, J, Simpson, NK. Breast-feeding pattern in rural Bangladesh. American Journal of Clinical Nutrition 1980; 33: 144–54.CrossRefGoogle ScholarPubMed
14Baqui, AH, Palyor, N, Nahar, Q, Slimperi, DR. Infant and Child Feeding Practices in Dhaka Urban Slums. Urban RP/MCH Working Paper No. 6DhakaInternational Centre for Diarrhoeal Disease ResearchBangladesh, 1993; 1015.Google Scholar
15Roy, SK, Islam, A, Molla, A, Akramuzzaman, SM, Jahan, F, Fuchs, G. Impact of a single megadose of vitamin A at delivery on breastmilk of mothers and morbidity of their infants. European Journal of Clinical Nutrition 1997; 51: 302–7.CrossRefGoogle ScholarPubMed
16Helen Keller International (HKI)/Institute of Public Health Nutrition (IPHN)/Institute of Nutrition and Food Science (INFS). Vitamin A status throughout the lifecycle in rural Bangladesh. National Vitamin A Survey, 1997–98. Dhaka, Bangladesh: HKI/IPHN/INFS, 1999.Google Scholar
17de Pee, S, Bloem, MW. 24-VASQ Method for Estimating Vitamin A Intake. Indonesia: Helen Keller International – Asia Pacific, 1999.Google Scholar
18Ahmed, F, Hasan, N, Kabir, Y. Vitamin A deficiency among adolescent female garment factory workers in Bangladesh. European Journal of Clinical Nutrition 1997; 51: 698702.CrossRefGoogle ScholarPubMed
19SPSS, Inc. Statistical Package for Social Sciences, SPSS/PC+ Version 10.0. Chicago, IL: SPSS, Inc, 1999.Google Scholar
20Ross, DA, Trowbridge, FL. Review of USAID/VITAL Supported Vitamin A Deficiency Surveys. Arlington, VA: VITAL, International Science and Technology Institute, Inc., 1994.Google Scholar
21Brown, KH, Akhter, NA, Robertson, AD, Ahmed, MG. Lactation capacity in marginally nourished mothers: relationship between maternal nutritional status and quantity and proximate composition of milk. Pediatrics 1986; 78: 909–19.CrossRefGoogle Scholar
22Underwood, BA. Maternal vitamin A status and its importance in infancy and in early childhood. American Journal of Clinical Nutrition 1994; 59(Suppl. 2): 517S–22S.CrossRefGoogle Scholar
23Ahmed, F, Khan, MR, Jackson, AA. Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. American Journal of Clinical Nutrition 2001; 74: 108–15.CrossRefGoogle ScholarPubMed