[Effect of Onchocerca volvulus infestation on plasma vitamin A concentration in school children in a rural region of Cameroon].

Vitamin A deficiency is known to be associated with immune dysfunction and common childhood infections. However, little is known about the relationship between vitamin A deficiency and onchocerciasis in children. The aim of this study was to determine the prevalence of vitamin A deficiency and to investigate the relationship between vitamin A status and onchocerciasis. A total of 231 children, aged 6 to 15 years, were randomly selected between March 1995 and April 1996 at Yambassa and Balamba (central province of Cameroon). They were examined: we determined their vitamin A status and whether they had onchocerciasis. We diagnosed onchocerciasis by skin biopsy and the detection of antibodies against Onchocerca volvulus in the blood. We found that 101 of the 231 children examined (43.73%) had palpable nodules and/or microfilariae and the remaining 130 (56.27%) had been exposed to the parasite but had no clinical signs of infestation. Some children tested negative for skin microfilariae but positive by ELISA. Thus, 197 (85.28%) children were found to be infested with O. volvulus (group A) and the remaining 34 (14.72%) were found to have been exposed to the parasite but to have no clinical signs of onchocerciasis (group B). Plasma vitamin A concentrations were marginal, with concentrations below 0.7 mumol/l (20 mug/dl) recorded for 82.25% of the subjects. Children with onchocerciasis were more likely to have low vitamin A status. The mean plasma vitamin A concentration of infested children (0.52 +/- 0.14 mumol/l) was significantly lower (p < 0.05) than that of the children exposed but not infested. The parasite, O. volvulus, uses the vitamin A present in host tissues during its development, leading to a decrease in plasma retinol concentration.