RESUMO
Objectives: Plasma zinc concentration (PZ) is influenced by many factors leading to over-estimate the real prevalence of zinc deficiency (ZD). This study aimed to assess changes in PZ in 12-59- months-old Senegalese boys and girls after adjusting for the overall known confounding factors. Methods: During a national representative cross sectional survey in Senegal, blood was collected in 583 girls and 568 boys according to procedures recommended by IZiNCG. PZ, CRP and AGP were determined. Published correction factors (Thurnham et al., 2005) were used to adjust PZ to infections. Measured and adjusted values were compared. General Linear Model (GLM) was used to compare PZ changes in girls and boys after adjustment for CRP, AGP, time of blood collection, recent meal and elapsed time from blood draw to centrifugation. Results: Mean PZ were 63.5±14.5 and 63.9±14.3 μg/dL for boys and girls, respectively. PZ was not correlated with CRP, time from last meal to blood draw, but was negatively related to AGP (p <0.0001), time of the sample collection (p <0.001), and was positively related to time between blood draw and centrifugation (P<0.05). After adjusting for infections, PZ increased significantly in boys (66.2±16 μg/dL), and girls (66.5±16 μg/dL), leading to a decreased prevalence of ZD in both sexes without any significant difference. Using GLM, PZ for boys (65.5±3.3) and girls (66.8±3.2) were significantly greater than the measured values (P<0.0001) but were comparable between gender. Conclusions: Blood collection procedures and infection status should be considered during measurement of plasma zinc concentration when assessing zinc status in population.
RESUMO
Objectives: Reliable data on the micronutrient status of women and children was needed in Senegal to guide evidence-based decision making on interventions to reduce micronutrient deficiencies (MND). This study presents the findings of the first ever national MND survey carried out in Senegal in 2010. Methods: A cross sectional household survey sampled 1,810 households stratified by two urban and two rural zones. Data were collected on biochemical indicators of iron, vitamin A and zinc deficiency from 1,316 women 15-49 y and 1,887 children 12-59 mo. The analysis adjusted for subclinical inflammation. Results: Subclinical inflammation affected 27.7% of women and 49.5% of children. 44.7% women and 61.5% children had serum ferritin below 15 or 12 μg/l, respectively. 2.1% women and 18.2% children had serum retinol <0.70μmol/l; 66.7% women and 39.6% children had serum zinc below cutoff. Only 12.8% of women and 11.6% of children had no MND; 18.4% of women and 15.4% of children had at least 3 coexisting MND. The risk of a child having iron (OR 2.70; [1.49, 4.88]) or vitamin A (OR 13.66; [4.07, 45.84]) deficiency was higher in households where a woman had iron or vitamin A deficiency. Child anemia (66%) and zinc deficiency were not related to the status of women in the household. Women and children in rural areas were more affected by iron and vitamin A deficiencies compared to urban areas. Conclusions: MND affect a large proportion of women and children in Senegal. Further study of factors contributing to Intra-household clustering and rural/urban differences of MND is warranted.