Malabsorption of water miscible vitamin A in children with giardiasis and ascariasis

Mahalanabis, Dilip; Simpson, Thomas; Chakraborty, Manidip; Ganguli, C; Bhattacharjee, A K; Mukherjee, K L

doi:10.1093/ajcn/32.2.313

Cited by 93 publications

(34 citation statements)

References 6 publications

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“…Several studies reported that the absorption of vitamin A is impaired in children infected with A. lumbricoides 14,15 and G. duodenalis . 31,32 A study on vitamin A absorption in patients with ascariasis concluded that absorption is an important contributing factor in causing clinical VAD, particularly in populations with a 14 These authors showed that the eradication of these infections in infected children promptly led to a significant improvement in vitamin A absorption and restoration of normal vitamin A concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 A study on vitamin A absorption in patients with ascariasis concluded that absorption is an important contributing factor in causing clinical VAD, particularly in populations with a marginal intake of vitamin A. 14 These authors showed that the eradication of these infections in infected children promptly led to a significant improvement in vitamin A absorption and restoration of normal vitamin A concentrations. Similarly, another study demonstrated the importance of A. lumbricoides as a risk factor for ocular manifestations of VAD among children in Nepal, and suggested that a reduction in the prevalence and intensity of ascariasis might reduce the incidence of xeropthalmia in the community studied.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Intestinal parasitic infections also contribute significantly to the web of causation of VAD. [14][15][16] Despite great development in socioeconomic status throughout the 52 years of independence, intestinal parasitic infections and malnutrition are still public health problems in Malaysia, particularly among Aboriginal children in rural areas. Little is known about the vitamin A status of Aboriginal schoolchildren in rural Malaysia.…”

Section: Introductionmentioning

confidence: 99%

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Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Al-Mekhlafi¹,

Surin²,

Sallam³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract.A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (< 0.70 μmol/L). Giardiasis and severe ascariasis were significantly associated with low serum retinol levels ( P = 0.004 and P = 0.018, respectively). Logistic regression confirmed the significant association of giardiasis with low serum retinol (odds ratio = 2.7, 95% confidence interval = 1.3-5.5). In conclusion, vitamin A deficiency is still a public health problem in rural Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status. 18 Iintensity of infection was graded as heavy, moderate, or light according to criteria proposed by the World Health Organization.19 Scores for intensity of infections were given to each soil-transmitted helminth species (light = 1, mild = 2, and severe = 3) and mixed infections with a worm score ≥ 5 were included in the analysis. Samples were also examined for Giardia duodenalis trophozoites or cysts by using the trichrome staining technique.Assessment of vitamin A status. Approximately 2-3 mL of venous blood were collected from each participant into tubes for biochemical analysis. Blood was left at room temperature to ensure clot formation. The tubes were then centrifuged at 3,000 rpm for 10 minutes to obtain serum that was stored at -20°C until further analysis. Serum retinol concentrations were determined using a reverse-phase high performance liquid chromatography (LC-10AD; Shimadzu, Kyoto, Japan) as described. 16,20 One hundred microliters of ethanol containing retinyl acetate as an internal standard was added to 100 μL of serum. Refiltered petroleum ether (RPE) (500 μL) was added and the mixture was mixed with a vortex mixer for 1 minute and centrifuged at 5,000 rpm for 10 minutes. A 150-μL sample from the refiltered petroleum ether layer was transferred into a clean test tube and evaporated. The extract was dissolved in 200 μL of ethanol. Eighty microliters of this mixture was injected into the high performance liquid chromatography apparatus. Methanol:water (95:5 [v/v]) was used as the mobile phase and all-trans retinol was used as the standard. For quality control, 20% of the samples were randomly selected and examined in duplicate. Serum retinol was measured in picomoles per liter.Use of serum retinol to assess vitamin A status may be influenced by inflammation and reductions in plasma retinol, which have been described during the acute phase of a wide range of infections. 21 The design of this study did not consider the inflammatory status of the...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Al-Mekhlafi¹,

Surin²,

Sallam³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Among symptomatic children the most important signs are persistent diarrhoea and loss of weight. However, a wide range of other symptoms has also been noted, including nausea, malabsorption of lactose, carbohydrate, fats, and vitamins A and B 12 [6,7], macrocytic anaemia due to folate deficiency and retardation of growth and development [8,9].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for infection with Giardia duodenalis in pre-school children in the city of Salvador, Brazil

et al. 2003

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SUMMARYA cross-sectional study of 694 children aged 2 to 45 months selected from 30 clusters throughout the city of Salvador, Bahia (pop. 2 . 3 million) was carried out as part of a longitudinal study of diarrhoea in order to identify risk factors for infection with Giardia duodenalis. Variables studied included three social and demographic factors (such as mother's education and marital status), five relating to the peri-domestic environment (rubbish disposal, open sewers, paving of the street), seven relating to the home itself (house construction, susceptibility to flooding, water supply and sanitation) as well as a score for hygiene behaviour based on structured observation. After multivariate analysis using a hierarchical model, only four significant risk factors were found : (a) number of children in the household under five years (b) rubbish not collected from the house (c) presence of visible sewage nearby, and (d) absence of a toilet. All four were significant at the 1% level.

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“…Olsen et al (2003) also reported that supplementation with multiple micronutrients significantly decreased Schistosoma mansoni reinfection rates. The reduction in parasite disease burden and infection rates associated with supplementation may lead to decreased micronutrient malabsorption, reduced malnutrition and, consequently, reduced growth retardation (Mahalanabis et al, 1979;Schorling et al, 1990). These findings suggest that the indirect effects of supplementation on parasite outcomes and subsequent micronutrient malabsorption among children might explain the inconsistencies found in supplementation trials.…”

Section: Introductionmentioning

confidence: 96%

Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial

et al. 2009

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Background: The efficacy of micronutrient supplementation on growth may be modified by specific gastrointestinal parasite infections Methods: We carried out a double-blind placebo-controlled trial to evaluate the effect of vitamin A and zinc supplementation on gastro-intestinal pathogen infections and growth among 584 infants in Mexico City. Children aged 5-15 months were assigned to receive either a vitamin A supplement every 2 months (20 000 IU of retinol for infants p; 1 year or 45 000 IU for infants 41 year), a daily supplement of 20 mg of zinc, a combined vitamin A-zinc supplement or a placebo, and were followed up for 1 year. Weight and length were measured once a month and morbidity histories were recorded twice a week for 12 months. Monthly stool samples were screened for Giardia duodenalis, Ascaris lumbricoides and Entamoeba spp. Growth velocity slopes, generated from the linear regression of individual child length, and height-for-age z-scores on time were analyzed as end points in regression models, adjusting for the presence of parasite infections Results: The main effect of vitamin A supplementation was in height improvement (Po0.05), and was only found in the model evaluating infants with any parasite. There was an interaction effect of slower growth (Po0.05) found in infants infected with any parasite and supplemented with vitamin A in slower growth (Po0.05). In addition, the interaction of zinc supplementation and Giardia duodenalis or A. lumbricoides was associated with reduced growth (Po0.05). Conclusion: Gastro-intestinal parasite infections may modify the effect that zinc or vitamin A supplementation has on childhood growth.

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Malabsorption of water miscible vitamin A in children with giardiasis and ascariasis

Cited by 93 publications

References 6 publications

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Risk factors for infection with Giardia duodenalis in pre-school children in the city of Salvador, Brazil

Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial

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