Prevalence and Predictors of Vitamin a Deficiency Among Infants in Western Kenya Using a Cross-Sectional Analysis

Abstract

Vitamin A (VA) deficiency (VAD) is a major nutritional public health problem among children under-5-years-old in the developing world including Kenya. A community-based crosssectional survey among 1,630 children (aged 6-23 mos) was undertaken in Western Kenya. A questionnaire was administered to collect demographic, socio-economic and dietary intake information. Prevalence of low retinol-binding protein (RBP) concentrations was assessed using Dried Blood Spot (DBS) methodology. Analysis of RBP was carried out using rapid enzyme immunoassay (EIA) and C-reactive protein (CRP) was carried out using enzyme linked immunosorbent assay (ELISA) to estimate VA and sub-clinical inflammation statuses, respectively. Values were adjusted for influence of inflammation using CRP (CRP >5 mg/L) and population prevalence of VAD (RBP <0.825 µmol/L, biologically equivalent to 0.70 µmol/L retinol) estimated. Anthropometric data gave three indices: stunting, wasting and underweight-all of which took age and sex into consideration. Mean (geometric± SD) concentration of RBP was adequate (1.56±0.79µmol/L) but the inflammation-adjusted mean (±SE) prevalence of VAD was high (20.1±1.1%) in this population. The level of CRP was within normal range (1.06±4.95 mg/L) whilst 18.4±0.9% of the children had subclinical inflammation (CRP>5 mg/L). Intake of VA capsule (VAC) by a child was a predictor of VAD with children who have not taken VA during the past 1 year prior to the survey having a 30% increased risk of VAD (OR (CI): 1.3 (1.1-1.7); p=0.025. Additionally, age of the child was a predictor with older children (18-23 mos) having a 30 % increased risk of VAD (OR (CI): 1.3 (1.1-1.9); p=0.035); the caretaker's knowledge on VA and nutrition was also a predictor of VAD with children whose caretaker's had poor knowledge having a 40 % increased risk of VAD (OR (CI): 1.4 (1.0-1.9); p=0.027. A child's district of residence was also a significant predictor of VAD. Prevalence of VAD in this sample of infants was high. Predictors of VAD included child intake of VAC in the last 1 year before the survey, older children, children whose caretakers had poor VA and nutritional knowledge and a child's district of residence. There is a need to improve knowledge on nutrition and VA of caretakers; undertake a targeted VAC distribution, particularly in children older than 1 year and above and use a sustainable food-based intervention in the areas with severe VAD.

Food Consumption Patterns among Pre-School Children 3 - 5 Years Old in Mateka, Western Kenya

“…This becomes an exacerbating factor to increased prevalence of Vitamin AD eficiency [VAD] considering that Western Kenya has the lowest Vitamin A Supplementation [VAS] coverage at 19.8% compared to 30.3% nationally [11]. [23] in three counties (Busia, Vihiga and Bungoma) in Western Kenya showed that despite the high prevalence of VAD in the area, most of pre-natal and post-natal mothers were not aware about VAD, VAS and the importance of consumption of vitamin A rich foods in their household diets.…”

Metagenomic Analysis of Plant Viruses Associated With Papaya Ringspot Disease in Carica papaya L. in Kenya

“…The levels of vitamins A and C from one medium-sized papaya (whose edible portion is about 350 g) exceed the Dietary Reference Intakes of 3000 IU for vitamin A and 90 mg for vitamin C, as established by the United States Food and Nutrition Board for adult minimum daily requirements (Ming et al, 2008). Consumption of this fruit is important in preventing vitamin A deficiency, a cause of childhood blindness in many developing countries, including Kenya (Oyunga et al, 2016). The fruit is reasonably priced and is rich in nutrients, making it a "common man's" fruit.…”

From disagreements to dialogue: unpacking the Golden Rice debate

“…For example, polarized narratives in research addressing the intersecting goals of food security and biodiversity conservation are driven by the underpinning conceptualization of the problem as either technical or socio-political (Loos et al 2014 ; Glamann et al 2015 ). Similarly, the narrative explaining food insecurity as a result of insufficient production and population growth contrasts with explanations based on unequal distribution of social power as well as economic and physical resources (Sen 1981 ; Legwegoh and Fraser 2015 ). In the agricultural biosciences, calls for gene patenting, corporate funding of public institutions and public–private partnerships conflict with arguments that seeds should be regarded as public goods (Scoones 2002 ; Stone 2015 ).…”

“…Similarly, the narrative explaining food insecurity as a result of insufficient production and population growth contrasts with explanations based on unequal distribution of social power as well as economic and physical resources (Sen 1981 ; Legwegoh and Fraser 2015 ). In the agricultural biosciences, calls for gene patenting, corporate funding of public institutions and public–private partnerships conflict with arguments that seeds should be regarded as public goods (Scoones 2002 ; Stone 2015 ). Such polarization presents serious challenges for sustainability science, not simply in terms of conflicting policy prescriptions, but also in the perceived legitimacy of the science itself (Bäckstrand 2003 ).…”

“…The severity of conflicts around the use of GMOs in agriculture has been likened to that of a war (Lang and Heasman 2004 ; Waltz 2009 ; Stone 2015 ). Proponents see in genetically modified (GM) crops powerful tools to increase yields (Carpenter 2010 ), improve crop quality, decrease pesticide use (Christou et al 2006 ), fight micronutrient deficiencies, adapt plants to climate change and facilitate economic growth (Phillips 2002 ).…”