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. 2022 Jan;18 Suppl 1(Suppl 1):e13305.
doi: 10.1111/mcn.13305. Epub 2021 Dec 13.

Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6-59 months in Nepal

Stanley Chitekwe  1 , Kedar Raj Parajuli  2 , Naveen Paudyal  1 , Karan Courtney Haag  1 , Andre Renzaho  3 , Abukari Issaka  4 , Kingsley Agho  5
Affiliations

Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6-59 months in Nepal

Stanley Chitekwe et al. Matern Child Nutr. 2022 Jan.

Abstract

Iron, vitamin A and zinc deficiencies are the top three micronutrients contributing to disability-adjusted life years globally. The study assessed the factors associated with iron, vitamin A, and Zinc deficiencies among Nepalese children (n = 1709) aged 6-59 months using data from the 2016 Nepal National Micronutrient Status Survey. The following cut-off points were applied: iron deficiency [ferritin < 12 μg/L or soluble transferrin receptor (sTfR) > 8.3 mg/L], vitamin A deficiency (retinol-binding protein < 0.69 μmol/L) and zinc deficiency (serum zinc < 65 μg/dl for morning sample and <57 μg/dl for afternoon sample). We used multiple logistic regression adjusted for sampling weights and clustering to examine the predictors of micronutrient deficiencies. The prevalence of iron depletion (ferritin), tissue iron (sTfR), vitamin A and zinc deficiencies were 36.7%, 27.6%, 8.5% and 20.4%, respectively. Children were more likely to be iron deficient (ferritin) if aged 6-23 months, stunted, and in a middle-wealth quintile household. Vitamin A deficiency was associated with development region and was higher among children living in severe food-insecure households and those who did not consume fruits. Zinc deficiency was higher among children in rural areas and the poorest wealth quintile. The Government of Nepal should focus on addressing micronutrient deficiencies in the early years, with emphasis on improving food systems, promote healthy diets, among younger and stunted children and provide social cash transfer targeting high-risk development regions, poorest and food insecure households.

Keywords: Nepal National Micronutrient Status Survey; ferritin; hidden hunger; iron deficiency; vitamin A; zinc.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Determinants of hidden hunger used in the study based on the modified conceptual framework on causes of malnutrition (UNICEF, 1990) using variable available in the NNMSS. The basic factors are considered national level while the nutrition outcomes and immediate factors are considered household level and underlying factors are considered household level
Figure 2
Figure 2
Prevalence and 95% confidence interval concentrations of micronutrients, one, two and three micronutrients status among children aged 6–59 months in Nepal
See this image and copyright information in PMC

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