Abstract
Objectives
The objective was to assess serum retinol concentration in women of reproductive age from Haiti by HPLC and a portable photometer, as well as the presence of anemia and hemoglobin (Hb) concentration.
Methods
Cross-sectional comparative study design. Women of reproductive age from the program to improve food security in Haiti (AKOSAA) were eligible to participate. Weight and height were measured and Body Mass Index (BMI) was calculated. A sample of venous blood (5 mL) was collected to assess serum retinol (SR) using HPLC and a portable photometer. Hemoglobin concentration was determined using HemoCue and C-reactive protein (Spinreact E-17176, St Esteve de Bas), was used as a marker of inflammation.
Results
Age range among participants (n = 163) was 15–50 years old. Low weight was identified in15% (n = 24) of enrolled women according to BMI. Vitamin A deficiency (VAD) was identified in 55% (n = 90) of the study population according to serum retinol assessed by HPLC (reference method) versus 26.4% identified using the portable photometer (weighted Kappa = 0.10), which is considered extremely poor. Severe VAD was not found but mild and severe VAD was identified in 38.7% and 16% of women, respectively. When the difference and average of measurements of both methods were compared, bias was 0.20 (IC 95%: 0.14, 0.27). Lin's concordance coefficient (ρc), an analysis of accuracy and precision that assesses how every pair of observations falls over the line of identity (45°), was extremely poor, because it was found below 0.90 (ρc = 0.19). On the other hand, 45% (n = 73) of participants had anemia (Hb < 12 g/dL). No inflammation was observed, since C-reactive protein was below 6 mg/L.
Conclusions
In Haiti VAD as well as anemia were found to be a public health problem. As long as the socioeconomical situation does not substantially improve in this región, supplementation policies and food fortification must be implemented to be able to fight hidden hunger.
Funding Sources
International Atomic Energy Agency (IAEA) CRP contract No. 18,223. Sight and Life donated the iCheckFluoro® equipment and reagents.