Prevalence and Associated Factors of Vitamin A Deficiency among Children and Women in Senegal

Abstract

Background: Like many developing countries, Senegal does not have data on the extent of vitamin A deficiency (VAD) that is representative of its population. The present survey was conducted to fill this gap and to identify factors associated with VAD, prior to the introduction of a large-scale vitamin A oil fortification program. Procedures: A nationwide representative cross-sectional survey involving 1887 children 12 to 59 months old and 1316 women of reproductive age (WRA) was conducted. Blood samples were collected and plasma concentrations of retinol (PR), C-reactive protein (CRP), and alpha-1-acidglycoprotein were measured. PR was adjusted for subclinical inflammation using the BRINDA regression methodology. Multivariate logistic regression was used to identify factors associated with VAD. Findings: The adjusted prevalence of VAD (PR ≤ 0.7 μmol/L) in children was 15.3% and differed by age group, area of residence, and socioeconomic status and half of them had subclinical inflammation. Among WRA, VAD was low (2.3%) and 18.1% had vitamin A insufficiency (VAI). Pregnant women were more affected by VAI (28.4%) and Dakar had lower figures compared with other cities and rural strata. Prevalence of VAI decreased with increasing wealth quintile. In logistic regression, abnormal CRP, poverty, scarce consumption of poultry, oysters, melon, red palm oil, palm kernel oil, Saba senegalensis fruit pulp (Maad) and cowpea, frequent consumption of leeks and consumption of Leptadenia hastata leaves (Mbuum tiakhat), were associated with VAD in children. For women, lower socioeconomic status, fair or poor health status and anemia were negatively associated with VAI. Conclusions: In Senegal, VAD is a moderate public health problem in children and slight among women. Particular attention should be paid to children older than 23 months, pregnant women, rural populations, and poorest households. Nutritional interventions should be implemented alongside morbidity prevention and control. Keywords: vitamin A deficiency, children 12-59 months, women of reproductive age, Senegal.