High prevalence of subclinical vitamin A deficiency in Jordan: a forgotten risk

Abstract

This longitudinal study assessed growth and vitamin A status of schoolchildren after earlier surveys had linked stunting among Jordanian children to dietary zinc and iron inadequacies. A group of 1,023 subjects ages 5.5 to 9.9 years were randomly recruited for study from seven disadvantaged semirural districts. Baseline assessment included anthropometric and laboratory data with the relevant dietary information. Over nine months of study, the subjects received a daily snack meal. Immediately before the final assessment, each student received one 100,000 IU vitamin A capsule. At baseline there was a 19.9% prevalence of stunting, 18.8% for anemia, and 21.8% for subclinical vitamin A deficiency. Mean and median serum retinol concentrations were 248 (sd +/- 66) and 242 micrograms/L, respectively. In 98% of the cases, vitamin A-rich vegetables were consumed three or more days per week. About 60% of subjects had serum retinol levels in the range 200 to 300 micrograms/L. Only vitamin A foods from animal sources showed an influence (p < .05) on mean serum vitamin A values and growth score. Dietary and capsule supplementation had a significant positive impact only on serum retinol levels (p < .01) and on the anemia (p < .05) indicators. The conclusion underlines vitamin A deficiency among schoolchildren as a public health problem, and that the situation is anticipated to be more profound among preschool children, who are usually at greater risk of becoming deficient. Launching another, but controlled, intervention study in other sites, preferably with use of a tracer to rule out malabsorption in young children, is highly indicated.