Childhood anemia and vitamin A deficiency in rural Bangladesh

The study aimed to assess the prevalence of anemia and vitamin A deficiency in preschool children in rural Bangladesh. A cross-sectional study was done on eight randomly-selected sub-districts of rural Bangladesh. Children (n=1,302) aged 2-6 years were studied. Families of 43% of the study participants had a monthly household expenditure of US$ 60 or less. Fifty-six percent of the children were underweight, and 17% were severely underweight; 18% were wasted, and 1% were severely wasted; and 45% were stunted while 20% were severely stunted. The mean ± SD serum retinol of the children was 1.0 ± 0.4 μmol/l, and 3% of them had serum retinol levels of <0.35 μmol/l, about one-fifth (20%) had a serum retinol level of <0.70 μmol/l and 55% had serum retinol levels of <1.05 μmol/l. The mean hemoglobin concentration of the children was 110 ± 11 g/l, and 48% had a Hb of <11 g/l signifying anemia in this age group. Thirty-one percent (31%) of children had low serum ferritin (<12 μg/l), and 14% had elevated CRP (≥5 mg/l) indicating the presence of a sub-clinical infection. Male and female children had similar nutritional status and biochemical profiles although boys tended to be heavier than girls (p=0.013). The proportion of children with anemia and iron deficiency anemia (IDA) declined significantly (p<0.001) with advancing age. Five percent of the study children had IDA and concomitant low serum retinol. The proportion of children with IDA and serum retinol also declined significantly with increasing age from 8% in children aged 35 months or younger, to 3% in children aged 60 months and more (p=0.025). Results of our study clearly demonstrated the public health importance of anemia and vitamin A deficiency among children of rural Bangladesh.