Determination of the Vitamin A Status and Body Pool Size of Ghanaian Infants Given Fortified Home Based Complementary Foods.

ABSTRACT

Objectives: Vitamin A deficiency is a public health problem which can be addressed using micronutrient powders in single dose sachets known as “Sprinkles”. This food-based approach offers an alternative to high dose Vitamin A supplements given directly to young infants. This strategy was evaluated by assessing the Vitamin A body pool using deuterium or 13C-retinol as a tracer. The primary objective was to investigate the impact of Vitamin A home fortification on the infant’s Vitamin A pool size using stable 13C2-retinol as a tracer among children who receive Sprinkles with or without VA. The Vitamin A status of infants at baseline was assessed using the modified relative dose response (MRDR) test and the 13C-retinol dilution test at follow-up. Methods: This was a community-based study involving 93 infants aged 7-9 months and randomised to receive daily Sprinkles with or without Vitamin A. Mothers were instructed to mix a single sachet of Sprinkles with a small amount of food which was given to the child. Infants were followed for 5 months. Results: At baseline the mean ratio (95%CI) of MRDR for infants in the intervention group was 0.032 (0.025-0.038) compared to 0.031(0.024-0.038) in the control group (p =0.80). At end line the mean Vitamin A concentration of infants in the intervention and control group 304.711 µmol vs. 252.207 µmol respectively but difference was not statistically significant. Conclusions: The vitamin A status of the infants was found to be adequate and the study demonstrated the use of stable isotopes as tracers to quantitatively estimate total body stores.