Iron and Vitamin A Deficiency in Long-Term African Refugees,

Abstract

Five cross-sectional surveys were conducted in African refugee camps to assess the level of iron deficiency anemia and vitamin A deficiency in populations dependent on long-term international food aid and humanitarian assistance. The prevalence of anemia in children [hemoglobin (Hb) <110 g/L] was high, with >60% affected in 3 of 5 camps. Iron deficiency [serum transferrin receptor (sTfR) >8.5 mg/L] was also high, ranging from 23 to 75%; there was also a strong ecological correlation between the prevalence of iron deficiency and anemia among different camps. Within camps, sTfR predicted the concentration of Hb with adjusted R(2) values ranging from 0.19 to 0.51. Although children were more affected, anemia was also a public health problem in adolescents and women. The effect of recent recommendations on Hb cutoff values for African populations was assessed and found to produce decreases in the prevalence of anemia of between 5 and 21%; this did not affect the public health categorization of the anemia problem within the most affected camps. Mean serum retinol in children, after adjustment for infection status, ranged from 0.72 +/- 0.2 to 0.88 +/- 0.2 micromol/L in the 4 camps assessed and vitamin A deficiency (<0.7 micromol/L) was present at levels ranging from 20.5 to 61.7%. In areas in which vitamin A capsule distribution programs were in effect, coverage ranged from 3.5 up to 66.2%. The high level of micronutrient deficiencies seen in long-term refugees argues in favor of further enhancements in food aid fortification and the strengthening of nutrition and public health programs.

Nutritional situation among Syrian refugees hosted in Iraq, Jordan, and Lebanon: cross sectional surveys

“…A study of Bhutanese refugee children in Nepal documented a prevalence of 43.3 % in 2007, prior to introduction of micronutrient supplementation [35]. A study of refugees in long-term African refugee camps found even higher prevalence estimates among children in camps in Kenya (61.3 %), Uganda (72.9 %), and Ethiopia (62.9 %) [8]. High prevalence of anemia among refugees has been attributed in part to the reliance on food rations in camps, an explanation consistent with our finding that prevalence among the camp based refugees in Za’atri was higher than in non-camp based refugees in Jordan and in Lebanon [7, 8, 35].…”

“…A study of refugees in long-term African refugee camps found even higher prevalence estimates among children in camps in Kenya (61.3 %), Uganda (72.9 %), and Ethiopia (62.9 %) [8]. High prevalence of anemia among refugees has been attributed in part to the reliance on food rations in camps, an explanation consistent with our finding that prevalence among the camp based refugees in Za’atri was higher than in non-camp based refugees in Jordan and in Lebanon [7, 8, 35]. In our assessments of non-camp based refugee populations, anemia levels were more consistent with the host populations.…”

“…In the context of prolonged conflict, affected populations often become dependent on humanitarian assistance for food and as a result experience reduced dietary diversity and meal frequency [6–8]. Separation of children from caretakers as a result of the conflict and displacement, also often affects infant and young child feeding (IYCF) practices [9, 10].…”

Food Insecurity and Risk of Depression Among Refugees and Immigrants in South Africa

“…Food insecurity can affect health and quality of life either directly or indirectly through nutritional status [7], and is linked to mental illness in several ways [8]. Refugees represent an “at risk” population for nutrient deficiencies, such as vitamin B12 and iron [9–11], which could predispose them to depression [12]. Added to this, the psychological distress individuals may experience as a result of not being able to afford food, not having adequate access to nutritious or culturally appropriate food or being able to feed their families, further compounds this risk of depression.…”

Evaluation of the effectiveness of stainless steel cooking pots in reducing iron-deficiency anaemia in food aid-dependent populations

“…Refugees and other populations dependent on food aid are potentially at greater risk of anaemia and Fe deficiency (3)(4)(5) . Food rations provided to such populations are frequently deficient in Fe and other micronutrients (6,7) .…”