title: Vitamin A deficiency in poor, urban, lactating women in Bangladesh: factors influencing vitamin A status.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Maternal and child health clinic in Dhaka City, Bangladesh.
  
  
  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 microg x dl-1), with 13.3% having sub-clinical vitamin A deficiency (<20 microg x 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 lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly 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 lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly 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 microg day-1) had significantly 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 the adjusted R2 was 0.16 (multiple ).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nutrition Program-Division of International Health, School of Population Health, University of Queensland, Public Health Building, Herston Road, Herston, 4029, Australia. F.Ahmed@sph.uq.edu.au
authors.forename: Faruk
authors.initials: F
authors.lastname: Ahmed
authors.forename: Asfia
authors.initials: A
authors.lastname: Azim
authors.forename: Mohammad
authors.initials: M
authors.lastname: Akhtaruzzaman
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007774:Lactation / Q000378:metabolism* / Q000502:physiology; D018673:Nutrition Policy; D009751:Nutritional Requirements; D010298:Parity; D011203:Poverty; D016036:Seroepidemiologic Studies; D014505:Urban Population; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood*; D014802:Vitamin A Deficiency / Q000453:epidemiology*; D016387:Women's Health
chemical_list: D014801:Vitamin A