Serum vitamin a levels and therapeutic test in preschool children attended in a health unit of Rio de Janeiro, Brazil

Authors

  • Rejane Andréa RAMALHO Universidade Federal do Rio de Janeiro
  • Luiz Antonio dos ANJOS Universidade Federal Fluminense
  • Hernando FLORES Universidade Federal de Pernambuco

Keywords:

vitamin A deficiency, child preschool, vitamin supplementary feeding, child

Abstract

The impact of a massive dose of vitamin A on preschool children attended in a health unit from Rio de Janeiro was evaluated. Initially, serum retinol levels and anthropometric measurements were determined in 175 preschool children attended in the Children’s Service of the Universidade Federal do Rio de Janeiro, after which a massive (200.000 IU) dose of vitamin A was provided. The children were requested to return to the unit after 30 days. Serum retinol levels were measured in the children who returned (n=99). The prevalence of low (below 1.05 μmol/L) levels of circulating retinol was of 34.3% in all children evaluated in the first attendance. After 30 days the prevalence was reduced from 42.4 to 3.0%. The lower the initial retinol levels the better the benefit from the massive dose. The proportion of children with protein-energy malnutrition was of 4.6%, but no clear association was found between vitamin A deficiency and protein-energy malnutrition. Vitamin A deficiency was independent of the household income and educational level of the parents. The response of children with vitamin A deficiency to the massive dose indicates that a low vitamin A intake may play an important role in the etiology of the problem. The prevalence figures also demonstrate that this problem is not exclusive of the traditionally poor areas of the country.

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References

ARAÚJO, C.R.C., FLORES, H. Improved spectrophotometric vitamin A assay. Chemical Chemistry, Washington DC, v.24, n.2, p.386, 1978.

ARAÚJO, R.L., ARAÚJO, M.B.D.G., MACHADO, R.D.P., BRAGA, A.A., LEITE, B.V., OLIVEIRA, J.R. Evaluation of a program to overcome vitamin A and iron deficiencies in areas of poverty in Minas Gerais, Brazil. Archivos Latinoamericanos de Nutrición, Guatemala, v.37, n.1, p.9-22, 1987.

ASSIS, A.M.O., PRADO, M.S., FREITAS, M.C.S., CRUZ, M.M.. Deficiência de vitamina A e desnutrição energético-protéica em crianças da localidade do Semi-Árido Baiano. Revista de Nutrição da PUCCAMP, Campinas, v.10, n.1, p.70-78, 1997.

BATES, C.J. Vitamin A. Lancet, London, v.345, n.8941, p.31-35, 1995.

BEATON, G.H., MARTORELL, R., L’ABBÉ, K.A., EDMONSTON, B., McCABE, G., ROSS, A.C., HARVEY, B. Efectividade de la suplementación con vitamina A em el control de la morbi-mortalidade da los niños em paises en desarrollo. Arlington, Virginia : USAID, 1993. p.14-21 (Vitamin A Field Support Project (VITAL): Informe IN-14).

BRUNKEN, G.S., FLORES, H. Consumption of vitamin A rich foods. Xerophtalmia Club Bulletin, London, v.54, p.3-4, 1993.

CAMPOS, F.A.C.S., FLORES, H., UNDERQOOD, B.A. Effect of an infection on vitamin A status of children as mensured by the Relatine Dose response (RDR). American Journal of Clinical Nutrition, Bethesda, v.46, n.1, p.91-94, 1987.

CARVALHO, C.M.G., FARFAN, B.C.W., VENCONSKY, R. Prevalência de hipovitaminose A em crianças da periferia do Município de São Paulo, Brazil. Cadernos de Saúde Pública, Rio de Janeiro, v.11, n.1, p.85-96, 1995.

COELHO, C.S.P., RAMALHO, R.A., ACCIOLY, E. O inquérito dietético na avaliação do estado nutricional de vitamina A em gestantes. Clínica Médica, Rio de Janeiro, v.6, n.28, p.44-60, 1995.

FAVARO, R.M.D., SOUZA, N.V., BATISTAL, S.M., FERRIANI, M.G.C., DESAI, I.D., DUTRA DE OLIVEIRA, J.E. Vitamin A status of young children in Southern Brazil. American Journal of Clinical Nutrition, Bethesda, v.43, n.5, p.852-858, 1986.

FAWZI, W.W., CHALMERS, T.C., HERRERA, M.G., MOSTELLER, F..Vitamin A supplementation and child mortality: a meta-analisis. Journal of the American Medical Association, Chicago, v.269, n.7, p.898-903, 1993.

FLORES, H., AZEVEDO, M.N.A., CAMPOS, F.A.C.S., BARRETO-LINS, M.H.C., CAVALCANTI, A.A., SALZANO, A., VARELA, R.M., UNDERWOOD, B.A. A Serum vitamin A distribution curve for children aged 2-6 known to have adequate vitamin A status: a reference population. American Journal of Clinical Nutrition, Bethesda, v.54, n.4, p.701-711, 1991.

FLORES, H. Frequency distribution of serum vitamin A levels in cross-sectional survey and in surveys before and after vitamin A supplementation. In: BRIEF Guide to Current Methods of Assessment of Vitamin A Status. Washington DC : The Nutrition Foundation, 1993. p.9-11 (International Vitamin A Consultative Group (IVAG), n.93-079228).

JOINT WORKING GROUP OF THE CANADIAN PAEDIATRIC SOCIETY AND HEALTH CANADA. Nutrition recommendation update: dietary fats and children. Nutrition Reviews, Lawrence, v.53, n.12, p.367-375, 1995.

KAFWEMBE, E.M., SUKW, T.Y., MANYANDO, C., MWANDU, D., CHIPIPA, J., CHIPAILA, P. The Vitamin A status of Zambia chlidren attending an under five clinic as evaluated by the Modified Relative Dose Response (MRDR) test. International Journal for Vitamin and Nutrition Research, Geneve, v.66, n.3, p.190-196, 1996.

LOHMAN, T.G., ROCHE, A.F., MARTORELL, R. Anthropometric standardization reference manual. Champaign, Illinois : Human Kinetics Books, 1988.

McAULIFFE, J., SANTOS, L.M., DINIZ, A.S., BATISTA-FILHO, M., BARBOSA, R.C.C. A deficiência de vitamina A e estratégias para o seu controle: um guia para as Secretarias Municipais de Saúde. Fortaleza : Project HOPE, 1991. 29p.

MORA, O.J. Situação actual de la deficiencia de vitamina A en America Latina y el Caribe. Arlington, Virginia : USAID, 1993. p. 41-44. (Vitamin A Field Support Project (VITAL), Iinforme IN-14).

NILSSON, A. Fortificação de alimentos com micronutrientes. Arlington, Virginia : USAID, 1993. p.93-96. (Vitamin A Field Support Project (VITAL), IN-14).

ORGANIZACIÓN MUNDIAL DE LA SALUD. Medición del cambio del estado nutricional. Genebra, 1983. 105p.

RAMALHO, R.A., ANJOS, L.A., FLORES, H. Hipovitaminose A em recém-nascidos em duas maternidades públicas no Rio de Janeiro, Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v.14, n.4, p.821-827, 1998.

RONCADA, M.J., WILSON, D., MAZZILLI, R.N., GANDRA, Y.R. Hipovitaminose A em comunidades do Estado de São Paulo, Brasil. Revista de Saúde Pública, São Paulo, v.15, n.3, p.338-349, 1981.

RONCADA, M.J., WILSON, D., OKANI, E.T., AMINOS, S. Prevalência da hipovitaminose A em pré-escolares do município de área metropolitana de São Paulo. Revista de Saúde Pública, São Paulo, v.18, n.3, p.218-224, 1984.

SINHA, D.P., BANG, F.B. Effect of massive doses of vitamin A on vitamin A deficiency in preschool children. American Journal of Clinical Nutrition, Bethesda, v.29, n.1, p.110-115, 1976.

SOMMER, A., TARWOTJO, I., MELE, L., DJUNAEDI, E., WEST, K.P., LOEDEN, A., TILDEN, R. Impact of supplementation on childhood mortality: a randomized controlled community trial. Lancet, London, v.1, n.8491, p.1169-1173, 1986.

SOMMER, A., TARWOTJO, I., KATZ, J. Incresaed risk of xerophthalmia following diarrhea and respiratory disease comparison to rat tissue retinol binding protein. American Journal of Clinical Nutrition, Bethesda, v.45, n.5, p.977-980, 1987.

SOMMER, A. New imperatives for an old vitamin (A). Journal of Nutrition, Bethesda, v.119, n.1, p.96-100, 1989.

SOMMER, A. Vitamin A deficiency and its consequences: a field guide to detection and control: Epidemiology. 3.ed. Geneva: World Health Organization, 1995. 65p.

TANUMIHARDJO, A.S., CHENG, J.C., MUHILAL, A., KARYADI D., OLSON, J.A. Refinement of the modified relative-dose-response test as a method for assessing vitamin A in field setting: experience with Indonisean children. American Journal of Clinical Nutrition, Bethesda, v.64, n.6, p.966-971, 1996.

UNDERWOOD, B.A. Estrategias a largo plazo para el control de las deficiencias de micronutrientes. Arlington, Virginia : USAID, 1993. p.70-76. (Vitamin A Field Support Project (VITAL), IN-14).

WEST, K.P., KATZ, J., SHRESTHA, S.R., LECLERQ, S.C., KHATRY, S.K., PRADHAN, E.K. Mortality of infant < 6 mo of age supplemented with vitamin A: a randomized, double-masked trial in Nepal. American Journal of Clinical Nutrition, Bethesda, v.62, n.1, p.143-148, 1995.

WORLD HEALTH ORGANIZATION. Global prevalence of vitamin A deficiency. micronutrient deficiencies information system: working paper Nº. 2. Geneva, 1995a. 116p.

WORLD HEALTH ORGANIZATION. Physical Status: the use and interpretation of anthropometry. Geneva, 1995b, Chapter 5:161-262. (WHO Technical Report Series, 854).

WORLD HEALTH ORGANIZATION. Indicators for assessing Vitamin A deficiency and their application in monitoring and avaluating intervention programmes. Geneva, 1996. 66p. (Micronutrient Series, WHO/NUT. 10).

Published

2001-04-25

How to Cite

Andréa RAMALHO, R. ., dos ANJOS, L. A., & FLORES, H. . (2001). Serum vitamin a levels and therapeutic test in preschool children attended in a health unit of Rio de Janeiro, Brazil. Brazilian Journal of Nutrition, 14(1). Retrieved from https://seer.sis.puc-campinas.edu.br/nutricao/article/view/8943

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ORIGINAL ARTICLE