Temple Victor J, Kaira Cecily, Vince John D, Kevau Isi H, Willie Nigani
Micronutrient Research Laboratory, Division of Basic Medical Sciences, School of Medicine and Health Sciences, University of Papua New Guinea, PO Box 5623, Boroko, National Capital District 111, Papua New Guinea.
P N G Med J. 2011 Mar-Jun;54(1-2):4-16.
Assessing the vitamin A status among pre-school-age children is essential for evaluating the magnitude and public health status of vitamin A deficiency in a population. This cross-sectional study assessed the vitamin A status of children aged 6 to 59 months resident in the National Capital District (NCD), Papua New Guinea. Children attending the Children's Outpatient Clinic at Port Moresby General Hospital participated in this study. Informed consent was obtained from parents before using blood samples from their children. Assay of plasma retinol was carried out using the 'Clin-Rep' complete kit for assay of vitamins A and E in plasma by high performance liquid chromatography (HPLC). A commercial enzyme immunoassay kit was used to assay C-reactive protein (CRP) in plasma. Of the 132 children in the study 108 (82%) had received vitamin A capsules. The median plasma retinol concentration of the 132 children was 0.98 micromol/l and the interquartile range 0.65-1.38 micromol/l. Of the 132 children, 35 (27%) had a plasma retinol concentration below 0.70 micromol/l. 75 children (57%) had normal plasma CRP levels and in 57 (43%) the CRP levels were elevated. The median plasma retinol concentration of the children with normal plasma CRP was 1.19 micromol/l and the interquartile range 0.93-1.50 micromol/l. The prevalence of vitamin A deficiency (VAD) in the children with normal plasma CRP was 11%, indicating a moderate public health problem. 74 (56%) males and 58 (44%) females were included in the study. The prevalence of VAD in the male and female children with normal plasma CRP was 14% and 8%, respectively, indicating a moderate public health problem among the male children and a mild public health problem among the female children. The prevalence of subclinical (mild to moderate) and marginal VAD among the children with and without elevated CRP strongly suggests the need for continuous monitoring of the vitamin A status of the vulnerable groups in NCD.
评估学龄前儿童的维生素A状况对于评估人群中维生素A缺乏的严重程度和公共卫生状况至关重要。这项横断面研究评估了居住在巴布亚新几内亚首都地区（NCD）的6至59个月大儿童的维生素A状况。在莫尔斯比港总医院儿童门诊就诊的儿童参与了本研究。在使用其子女的血样之前，已获得家长的知情同意。使用“Clin-Rep”全套试剂盒通过高效液相色谱法（HPLC）测定血浆视黄醇。使用商用酶免疫分析试剂盒测定血浆中的C反应蛋白（CRP）。在该研究的132名儿童中，108名（82%）接受了维生素A胶囊。132名儿童的血浆视黄醇浓度中位数为0.98微摩尔/升，四分位间距为0.65 - 1.38微摩尔/升。在132名儿童中，35名（27%）的血浆视黄醇浓度低于0.70微摩尔/升。75名儿童（57%）的血浆CRP水平正常，57名（43%）的CRP水平升高。血浆CRP正常的儿童血浆视黄醇浓度中位数为1.19微摩尔/升，四分位间距为0.93 - 1.50微摩尔/升。血浆CRP正常的儿童中维生素A缺乏（VAD）的患病率为11%，表明存在中度公共卫生问题。该研究纳入了74名（56%）男性和58名（44%）女性。血浆CRP正常的男童和女童中VAD的患病率分别为14%和8%，表明男童中存在中度公共卫生问题，女童中存在轻度公共卫生问题。CRP升高和未升高的儿童中亚临床（轻度至中度）和边缘性VAD的患病率强烈表明需要持续监测NCD中弱势群体的维生素A状况。
