Vitamin A deficiency and anaemia in young children living in a malaria endemic district of western Kenya

Background: Vitamin A deficiency makes children vulnerable to infections and influences the outcome of various infections. In 1993 vitamin A deficiency was found to be a public health problem in Bungoma district of western Kenya. Objective: To determine the prevalence of vitamin A deficiency, anaemia and malaria parasitaemia and to correlate these with haemoglobin, ferritin and acute phase response. Design: A cross-sectional study. Setting: Bungoma district of western Kenya. Subjects: Three hundred and three children aged one to three years were studied. Main Outcome Measures: Serum retinol, haemoglobin, serum ferritin, α-1 acid glycoprotein, C-reactive protein and malaria parasite density. Results: Twentynine percent of the children had severe vitamin A deficiency, 92% had anaemia (haemoglobin less than 10g/dl) 24(7%) of these were severely anaemic while 76% had malaria parasitaemia. There was no significant difference in the retinol levels of children with malaria parasitaemia and those without malaria parasitaemia (P = 0.6). Retinol levels were significantly lower among children with high C-reactive protein (P<0.001). Malaria parasitaemia negatively correlated with haemoglobin (r=-0.13, P<0.05) and C-reactive protein (r= 0.21, P < 0.01). There was no difference in haemoglobin level of children with normal serum retinol and those with low serum retinol (P = 0.16). Ferritin did not differ significantly among children with normal haemoglobin and those with low haemoglobin (P= 0.13). Conclusion: Vitamin A deficiency and anaemia are a public health problem among the children studied. The high prevalence of vitamin A deficiency may have resulted from acute phase response induced by infections.