title: Vitamin A intake and infection are associated with plasma retinol among pre-school children in rural Zambia.
abstract: OBJECTIVE
  To determine the prevalence of vitamin A deficiency, infection and adequacy of vitamin A intakes among Zambian children, and the contribution of dietary vitamin A and infection to vitamin A status.
  
  
  METHODS
  A cross-sectional survey of vitamin A intakes by the 24 h recall method, vitamin A status by plasma retinol and the modified relative dose-response test, and infection by acute-phase proteins.
  
  
  METHODS
  Rural communities in Central and Eastern Provinces of Zambia.
  
  
  METHODS
  Children 2-5 years of age.
  
  
  RESULTS
  The prevalence of vitamin A deficiency was 56 % by plasma retinol, 48 % with infection-adjusted plasma retinol and 22 % by the modified relative dose-response test. The majority of children (61 %) had a current infection. Vitamin A intakes were relatively high (331 to 585 μg retinol activity equivalents/d in the harvest/early post-harvest and late post-harvest seasons, respectively) and the prevalence of inadequate intakes was <1 % when compared with the Estimated Average Requirement (210 and 275 μg retinol activity equivalents/d for children aged 1-3 and 4-8 years, respectively). Elevated α-1-acid glycoprotein was negatively associated with plasma retinol (P < 0·0 0 1) and vitamin A intake was positively associated with plasma retinol (P < 0·05), but only when estimated assuming a 26:1 retinol equivalence for provitamin A from green and yellow vegetables.
  
  
  CONCLUSIONS
  Infection and vitamin A intakes were significant determinants of plasma retinol. We cannot conclude which indicator more accurately represents the true vitamin A status of the population. Reasons for the persistent high prevalence of vitamin A deficiency in the presence of adequate vitamin A intakes are unclear, but the high rates of infection may play a role.
authors.affiliation: HarvestPlus, International Food Policy Research Institute, 2033 K Street NW, Washington, DC 20006, USA. christinehotz.to@gmail.com
authors.forename: Christine
authors.initials: C
authors.lastname: Hotz
authors.forename: Justin
authors.initials: J
authors.lastname: Chileshe
authors.forename: Ward
authors.initials: W
authors.lastname: Siamusantu
authors.forename: Uma
authors.initials: U
authors.lastname: Palaniappan
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kafwembe
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis / Q000378:metabolism; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood; D008297:Male; D009961:Orosomucoid / Q000032:analysis; D012044:Regression Analysis; D012424:Rural Population; D014675:Vegetables; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology*; D015024:Zambia / Q000453:epidemiology
chemical_list: D000209:Acute-Phase Proteins; D009961:Orosomucoid; D014801:Vitamin A