title: Multiple micronutrient deficiencies persist during early childhood in Mongolia.
abstract: Data on the prevalence of micronutrient deficiencies in children in Mongolia is limited. We therefore determined the prevalence of anaemia, iron deficiency anaemia (IDA), and deficiencies of iron, folate, vitamin A, zinc, selenium, and vitamin D among young Mongolian children. Anthropometry and non-fasting morning blood samples were collected from 243 children aged 6-36 months from 4 districts in Ulaanbaatar and 4 rural capitols for haemoglobin (Hb), serum ferritin, folate, retinol, zinc, selenium, and 25-hydroxyvitamin D (25-OHD) assays. Children with alpha-1-glycoprotein >1.2mg/L (n=27) indicative of chronic infection were excluded, except for folate, selenium, and 25-hydroxyvitamin D assays. Of the children 14.5% were stunted and none were wasted. Zn deficiency (serum Zn <9.9 micromol/L) had the highest prevalence (74%), followed by vitamin D deficiency 61% (serum 25-OHD<25 nmol/L). The prevalence of anaemia (24%) and iron deficiency anaemia (IDA) (16%) was lower, with the oldest children (24-36 mos) at lowest risk. Twenty one percent of the children had low iron stores, and 33% had vitamin A deficiencies (serum retinol < 0.70 micromol/L), even though two thirds had received vitamin A supplements. Serum selenium values were low, perhaps associated with low soil selenium concentrations. In contrast, no children in Ulaanbaatar and only 4% in the provincial capitols had low serum folate values (<6.8 nmol/L). Regional differences (p<0.05) existed for anaemia, deficiencies of vitamin A, folate, and selenium, but not for zinc or IDA. Of the children, 78% were at risk of > or = two coexisting micronutrient deficiencies emphasizing the need for multimicronutrient interventions in Mongolia.
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Lander
authors.forename: Tserennadmid
authors.initials: T
authors.lastname: Enkhjargal
authors.forename: Jamiyan
authors.initials: J
authors.lastname: Batjargal
authors.forename: Karl B
authors.initials: KB
authors.lastname: Bailey
authors.forename: Sarah
authors.initials: S
authors.lastname: Diouf
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Green
authors.forename: C Murray
authors.initials: CM
authors.lastname: Skeaff
authors.forename: Rosalind S
authors.initials: RS
authors.lastname: Gibson
mesh_terms: D000740:Anemia / Q000097:blood / Q000453:epidemiology; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology; D000886:Anthropometry; D001827:Body Height / Q000502:physiology*; D015362:Child Nutrition Disorders / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000097:blood* / Q000172:deficiency*; D008986:Mongolia / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D012643:Selenium / Q000097:blood / Q000172:deficiency; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology; D015032:Zinc / Q000097:blood / Q000172:deficiency
chemical_list: D018977:Micronutrients; D012643:Selenium; D015032:Zinc