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Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children

Published online by Cambridge University Press:  02 January 2007

V Persson*
Affiliation:
Section for International Maternal and Child Health (IMCH), Uppsala University, 75185, Uppsala, Sweden.
F Ahmed
Affiliation:
Institute of Nutrition and Food Science, Dhaka University, Dhaka 100, Bangladesh.
M Gebre-Medhin
Affiliation:
Section for International Maternal and Child Health (IMCH), Uppsala University, 75185, Uppsala, Sweden.
T Greiner
Affiliation:
Section for International Maternal and Child Health (IMCH), Uppsala University, 75185, Uppsala, Sweden.
*
*Corresponding author: Email viveka.persson@ich.uu.se
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Abstract

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Objective

To explore the relationships between biochemical indicators of vitamin A and iron status and the intestinal helminths Ascaris lumbricoides and hookworm in primary school children.

Setting

Two rural governmental schools in northwestern Bangladesh.

Design

Cross-sectional study.

Subjects

The sample consisted of 164 children in grades 3–5.

Methods

Serum retinol and β-carotene (by high-performance liquid chromatography, HPLC), haemoglobin (HemoCue), ferritin (enzyme-linked immunoadsorbent assay, ELIZA) and height and weight were measured. Dietary intake of vitamin A was assessed using a food frequency questionnaire and faecal analyses were done using Stoll's egg-count technique.

Results

The mean serum retinol was 26.8 μg dl−1 and 20% had a level of <20 μg dl−1, the cut-off value for low vitamin A status. There was a strong positive association between serum β-carotene and serum retinol (r = 0.44, P <0.001), suggesting those with higher retinol levels had a higher carotene intake. Thirty-one per cent were anaemic (Hb <11.5 g dl−1), 30% had iron deficiency (serum ferritin <12.0 μg l−1) and 14% were suffering from iron deficiency anaemia. Children with a serum retinol level of 20 μg dl−1 had significantly lower ferritin (14.0 compared to 26.0 μg l−1, P = 0.005) and Hb levels (11.7 compared to 12.4 g dl−1, P = 0.005) than those with higher levels. The proportion of iron deficiency anaemia was significantly greater among children with hookworm. Our data suggest that hookworm exerts its impact on iron status independently of the vitamin A status of the host.

Conclusions

Programmes to improve iron status should consider including both vitamin A prevention programmes and deworming.

Information

Type
Research Article
Copyright
Copyright © CABI Publishing 2000