Thursday, October 30, 2014
Posted By: Nomonanoto Sidama | At: 10/30/2014 06:57:00 AM
Gebreselassie, Samson Gebremedhin, Gase, Fikre Enquselassie, Deressa, Melaku Umeta, Journal of Health Population and Nutrition
Vitamin A is an essential micronutrient required for the normal functioning of the vision system,immunity, epithelial integrity, cellular differentiation, growth and development, and possiblyreproduction (1,2). The World Health Organization (WHO) defines vitamin A deficiency (VAD)as tissue concentrations of vitamin A (VA) low enough to have adverse health consequences, evenif there is no evidence of clinical deficiency (3).
VAD remains a serious public-health problem in the developing world (4). Preschool childrenand pregnant women suffer the most widespread and severe effects of VAD (2). According toWHO, VAD is of moderate to severe public-health importance in 122 countries (2). Globally, 190million preschool children and 19 million pregnant women have low serum retinol concentration(2). In countries at risk of VAD, 33.3% of preschool children and 15.3% of pregnant women aredeficient (2).
Several studies linked prenatal VAD with various adverse pregnancy and birth outcomes,including anaemia (5,6), preterm delivery (6-9), intra-uterine growth retardation (8,10), lowbirthweight (5,9,11), malformations (12), infection (13), pre-eclampsia/ eclampsia (11,13-15),vertical transmission of HIV (16), poor infant growth (5,11), neonatal and infant mortality (5,17),and maternal mortality (17,18). Nevertheless, the negative effects of prenantal VAD on birthoutcomes are still controversial.
Studies conducted over decades consistently indicated the public-health significance of VAD inEthiopia (19). However, the full extent of the problem in pregnant women is not clearly known asmost of the studies were carried on preschool children. Although WHO estimated 13.2%prevalence of VAD in pregnant women in Ethiopia (2), the available three studies (20-22)conducted in the southern and north-western part of the country reported higher prevalencefigures ranging from 17 to 27%.
The objectives of the current study are to assess the prevalence and potential risk factors ofprenatal VAD in Sidama zone, Southern Ethiopia, where an earlier survey (21) reported seriouslyhigh (27%) prevalence of VAD. The current study explored wide range of potential risk factors,including maternal literacy level, income, age, gestational age, household wealth index, agro-ecological zone, zinc deficiency (ZD), parity, birth interval, history of breastfeeding, level of C-reactive protein (CRP), dietary diversity (DD), type of staple food, distance from the nearbyhealth facility, antenatal care (ANC), and history of nutrition education during pregnancy. Aprevious study (23) has already presented the prevalence and correlates of ZD among similargroup of study subjects.
MATERIALS AND METHODS
This is a community-based, cross-sectional study, with descriptive and analytic designs.
The study was conducted in January 2011 in 18 kebeles of Sidama zone, Southern Ethiopia. Akebele is the smallest administrative unit in Ethiopia, comprising approximately 1,000households. Sidama zone is one of the 15 zones of Southern Nations Nationalities and PeoplesRegional State (24). The zone has a population of 2,966,652 and population density of430/[km.sup.2] (24). In terms of agro-ecological zone, approximately 50%, 30%, and 20% of thepeople dwell in the midlands (1,750-2,300 m above sea-level (ASL)), highlands (>2,300 m ASL)and lowlands (<1750 m ASL) respectively (25). Livelihood of about 85% of the populationdepends on subsistent farming. Major crops grown in the area are enset (Enset ventricosum),coffee, and maize (25).
Single proportion sample-size calculation formula was used in determining adequate sample-sizefor estimating the prevalence of VAD. The sample-size of 666 pregnant women was computedbased at 95% confidence level, 5% margin of error, design effect of 2, 27% expected prevalence ofVAD (21), and 10% non-response rate. …
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