Prevalence of infant Vitamin A deficiency and undernutrition in the Republic of Congo.
OBJECTIVE
A representative sample of 5722 pre-school children living in rural and urban areas of the Congo was examined between July and September 1999 for assessing Vitamin A deficiency.


METHODS
Using a randomized two-level cluster sampling method, 190 clusters of 30 children aged from 6 months to 6 years were selected in order to assess the prevalence of active xerophthalmia (night blindness and/or Bitot spots). Concurrently, the children's height and weight were determined. A semi-quantitative seven-day dietary questionnaire was applied to the mothers of 5722 children to estimate the latter's consumption of Vitamin A rich foodstuffs. The prevalence of biochemical deficiency was assessed based on the serum retinol concentrations analyzed in dried blood spots from a sub-sample of 300 children living in the Pointe-Noire area.


RESULTS
Among the 5722 children studied, 0.7% were found to suffer from night blindness and 7.7% had Bitot spots. The weekly intake of Vitamin A rich foods was estimated in 5722 children. Our data suggest that Vitamin A rich food consumption was lower in rural zones than in urban area according to the food frequency method threshold values. The serum retinol levels were lower than 10 microg/dl in 18% (95% confidence interval [C.I.]: 13.7, 22.3) [8.04+/-2.87 microg/dl] and less than 20 microg/dl in 49% (95% C.I.: 43.4, 54.6) [15.05+/-2.76 microg/dl] of the 300 studied children. We have established a significant relation between mean serum retinol levels and high rate of Vitamin A food intake (chi-square=59.64, 2 d.d.l., p<0.05) in the sample studied. The mean serum retinol concentrations did not differ significantly between the various Z-scores of weight for age (W/A) and height for age (H/A) patterns. But children with a weight for height (W/H) ratio below -2 standard deviation (S.D.) had significantly lower serum retinol values [9.33+/-1.3 microg/dl] than those with a W/H ratio greater than or equal to -2S.D. [10.82+/-4.84 microg/dl].


CONCLUSIONS
These data suggest that Vitamin A deficiency is still a serious public health problem in rural areas of the Congo in which this study was carried out.
Service des Maladies tropicales, Hôpital Saint André, University Hospital Center of Bordeaux and Centre René Labusquière (Tropical Diseases Branch), EA 3677, University Victor Segalen Bordeaux 2, F-33076 Bordeaux, France.
C
C
Samba
F
F
Tchibindat
P
P
Houze
B
B
Gourmel
D
D
Malvy
D001827:Body Height; D001835:Body Weight; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003223:Congo / Q000453:epidemiology; D005260:Female; D005502:Food; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009752:Nutritional Status; D015995:Prevalence; D012424:Rural Population; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage; D014802:Vitamin A Deficiency / Q000453:epidemiology*
D014801:Vitamin A