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Journal of the American College of Nutrition, Vol. 21, No. 5, 381-387 (2002)
Published by the American College of Nutrition

Prevalence of Undernutrition and Vitamin A Deficiency in the Dogon Region, Mali

Jean-François Schémann, MD, MPH, Albert A. Banou, MD, Ando Guindo, MD, Vincent Joret, MD, MPH, Lamine Traore, MD and Denis Malvy, MD, PhD

African Institute of Tropical Ophthalmology (IOTA), Bamako (J.-F.S., A.G., L.T.), MALI
Mopti Regional Centre for Ophthalmology, Mopti (A.A.B.), MALI
GTZ Primary Health Care Project, Sévaré (V.J.), MALI
Centre René Labusquière, University Victor Segalen Bordeaux 2, Bordeaux, FRANCE (D.M.)

Address reprint requests to: Dr. Jean-François Schémann, 9 rue de Calais, 75009 Paris, FRANCE. E-mail: jfschemann{at}wanadoo.fr

Objectives: A representative sample of 1510 preschool children living in the Bandiagra circle (Mopti Region, Mali) was examined between March and April 1997 to determine the level of vitamin A deficiency.

Methods: Using a randomized two level cluster sampling, 20 clusters of 75 children aged six months to six years were selected for evaluating xerophthalmia (XN night blindness and/or X1B Bitot spot). Concurrently stature and weight were determined. A semiquantitative seven-day dietary questionnaire was applied to the mothers of 484 infants to assess consumption of vitamin A rich foodstuffs. The prevalence of biochemical deficiency was attested using the Modified Relative Dose Response test (MRDR) on a sub-sample of 192.

Results: Of the studied children, 4.3% (95% Confidence interval [CI]: 3.2–5.3) reported night blindness and 2% (95% CI: 1.3–2.7) had Bitot spots. Prevalence of xerophthalmia attested by at least one of these signs was 5.4% (95% CI: 4.2–6.5). The prevalence reached 10.5% at three years of age. The MRDR test proved abnormal in 77.1% of the subjects (95% CI: 70.3–82.7). Serum retinol was lower than 0.35 µmol/L in 43.8% (95.6% CI: 36.9–51.3) and less than 0.70 µmol/L in 92.7% of the children (95% CI: 87.8–95.8). Weekly consumption of vitamin A rich food was rare: 75.8% had not eaten any animal vitamin A rich food, and 22.1% had consumed less than seven times a vitamin A rich food of either vegetable or animal origin.

Conclusions: These data define vitamin A deficiency as a severe public health problem in the Bandiagara area of Mali.

Key words: xerophthalmia, vitamin A deficiency, Mali, MRDR, nutrition




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