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. 2018 Apr 2:12:13.
doi: 10.1186/s13031-018-0148-y. eCollection 2018.

Risk factors for vitamin A and D deficiencies among children under-five in the state of Palestine

Aeysha Bushra Chaudhry  1 , Shakoor Hajat  1 , Najwa Rizkallah  2 , Ala'a Abu-Rub  3
Affiliations

Risk factors for vitamin A and D deficiencies among children under-five in the state of Palestine

Aeysha Bushra Chaudhry et al. Confl Health. .

Abstract

Background: Vitamin A and D are essential for the proper growth and development of a child. Due to the complex political circumstances in the state of Palestine, research on micronutrient deficiency is scarce.

Methods: The Palestinian Ministry of Health (MOH) and UNICEF conducted a national cross-sectional survey in 2013 after the implementation of various micronutrient supplementation and fortification programs. Risk factors for levels of vitamin A (n = 1054) and vitamin D (n = 150) were assessed among children aged 6 to 59 months using chi-square tests and logistic regression with each of the outcome variables, vitamin A and D deficiencies. A child was considered to be deficient in vitamin A and D if he/she had a serum level < 1.05 μmol/L and < 50 nmol/L respectively. Multiple logistic regression models were developed to identify independent risk factors for vitamin deficiencies.

Results: The prevalence of vitamin A and D deficiency was 73.1% and 60.7% respectively. Children in Gaza were 1.34 (95%CI 0.78-2.31) and 1.96 times (95%CI 0.67-5.71) more likely to be deficient in vitamin A and D respectively compared to children in the West Bank. Anaemic children were 1.5 times more likely to be deficient in vitamin A (95%CI 1.08-2.10). Older children (> 1 year-old) were more likely to be deficient in vitamin D, and females were 2.72 times more likely to be deficient than males (95%CI 1.21-6.01). Results suggest no association between maternal education levels, feeding practices such as breastfeeding and complementary feeding and vitamin A and D deficiency. Although not reaching conventional levels of statistical significance, it was observed that children who received their vitamin drops from the MOH were more likely to have vitamin A and D deficiencies than those children receiving the supplements from the United Nations Relief and Works Agency for Palestine Refugees (UNRWA).

Conclusions: Using these results, the MOH may consider specifically targeting at risk children to increase adherence to the full supplementation regimen. Further research into effective methods of service delivery by health service providers is needed including an in depth look at the UNRWA maternal counselling and supplement provision protocols.

Keywords: Palestinian children; Risk factors; Vitamin A deficiency; Vitamin D deficiency.

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Conflict of interest statement

Al Quds University Research Ethics Committee in Jerusalem in 2012 provided the ethics approval for the Palestinian Micronutrient Survey. Each member of the study population provided verbal informed consent to participate in the study. The London School of Hygiene and Tropical Medicine Masters of Science Research Ethics Committee provided ethics approval to the conduct this secondary analysis, the reference number is 10883.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

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