Detection of vitamin A deficiency in Brazilian preschool children using the serum 30-day dose-response test.
BACKGROUND
Vitamin A deficiency (VAD) is endemic in Brazil and health professionals have difficulty in recognizing its subclinical form. In addition, serum retinol concentrations do not always represent vitamin A status in the organism.


OBJECTIVE
To identify VAD in preschool children by the serum 30-day dose-response test (+S30DR) and to examine its potential as a tool for the assessment of vitamin A status in the community.


METHODS
A prospective transverse study in which blood samples were obtained from 188 preschool children for the determination of serum retinol concentrations and the children were submitted to ocular inspection and anthropometric measurements. Information about the presence of diarrhea and/or fever during the 15 days preceding the study was also obtained. The children received an oral dose of 200,000 IU vitamin A immediately after the first blood collection. A second blood sample was obtained 30-45 days after supplementation in order to determine the +S30DR.


RESULTS
In all, 74.5% (140/188; 95% confidence interval: 68.3-80.7%) of the children presented +S30DR values indicative of low hepatic reserves. The mean serum retinol concentration was significantly lower before supplementation (0.92 and 1.65 micromol/l, respectively; P < 0.0001). No child presented xerophthalmia; 3.7% (7/188) of the children were malnourished. The presence of fever and/or diarrhea during the 15 days preceding the first blood collection did not affect the +S30DR value.


CONCLUSIONS
The prevalence of VAD in the study group was elevated. +S30DR proved to be a good indicator of subclinical VAD in children from an underdeveloped country.
Ferraz
I S
IS
Department of Child Care and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil. isferraz@uol.com.br
Daneluzzi
J C
JC
Vannucchi
H
H
Jordão
A A
AA
Ricco
R G
RG
Del Ciampo
L A
LA
Martinelli
C E
CE
Engelberg
A A D
AA
Bonilha
L R C M
LR
Flores
H
H
D000886:Anthropometry; D001938:Brazil / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D002675:Child, Preschool; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology
D014801:Vitamin A