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Community and International Nutrition

Iron and Vitamin A Deficiency in Long-Term African Refugees^1,2

Andrew J. Seal³, Paul I. Creeke, Zahra Mirghani^*, Fathia Abdalla^*, Rory P. McBurney, Lisa S. Pratt, Dominique Brookes, Laird J. Ruth and Elodie Marchand

Centre for International Child Health, Institute of Child Health, London, WC1 1EH; ^* United Nations High Commissioner for Refugees, Geneva, Switzerland; and Consultant for United Nations World Food Programme

³To whom correspondence should be addressed. E-mail: a.seal{at}ich.ucl.ac.uk.

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 R² 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 µmol/L in the 4 camps assessed and vitamin A deficiency (<0.7 µmol/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.

KEY WORDS: • micronutrient malnutrition • refugee • anemia • vitamin A deficiency

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				T. D. Dye Contemporary Prevalence and Prevention of Micronutrient Deficiencies in Refugee Settings Worldwide Journal of Refugee Studies, March 1, 2007; 20(1): 108 - 119. [Abstract] [Full Text] [PDF]