Anaemia, iron status and vitamin A deficiency among adolescent refugees in Kenya and Nepal.
OBJECTIVE
To investigate the prevalence of anaemia (haemoglobin<11.0 to 13.0 g dl(-1) depending on age and sex group), iron deficiency (transferrin receptor concentration>8.3 microg ml(-1)) and vitamin A deficiency (serum retinol <0.7 micromol l(-1)) in adolescent refugees.


METHODS
Cross-sectional surveys.


METHODS
Kakuma refugee camp in Kenya and seven refugee camps in Nepal.


METHODS
Adolescent refugee residents in these camps.


RESULTS
Anaemia was present in 46% (95% confidence interval (CI): 42-51) of adolescents in Kenya and in 24% (95% CI: 20-28) of adolescents in Nepal. The sensitivity of palmar pallor in detecting anaemia was 21%. In addition, 43% (95% CI: 36-50) and 53% (95% CI: 46-61) of adolescents in Kenya and Nepal, respectively, had iron deficiency. In both surveys, anaemia occurred more commonly among adolescents with iron deficiency. Vitamin A deficiency was found in 15% (95% CI: 10-20) of adolescents in Kenya and 30% (95% CI: 24-37) of adolescents in Nepal. Night blindness was not more common in adolescents with vitamin A deficiency than in those without vitamin A deficiency. In Kenya, one of the seven adolescents with Bitot's spots had vitamin A deficiency.


CONCLUSIONS
Anaemia, iron deficiency and vitamin A deficiency are common among adolescents in refugee populations. Such adolescents need to increase intakes of these nutrients; however, the lack of routine access makes programmes targeting adolescents difficult. Adolescent refugees should be considered for assessment along with other at-risk groups in displaced populations.
Maternal and Child Nutrition Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. BWoodruff@cdc.gov
Bradley A
BA
Woodruff
Heidi Michels
HM
Blanck
Laurence
L
Slutsker
Susan T
ST
Cookson
Mary Kay
MK
Larson
Arabella
A
Duffield
Rita
R
Bhatia
D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D002648:Child; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D000090463:Iron Deficiencies; D007630:Kenya / Q000453:epidemiology; D008297:Male; D009390:Nepal / Q000453:epidemiology; D009752:Nutritional Status; D016017:Odds Ratio; D012036:Refugees; D014802:Vitamin A Deficiency / Q000453:epidemiology*