Nutritional status, feeding practice and incidence of infectious diseases among children aged 6 to 18 months in northern mountainous Vietnam.

OBJECTIVE: To assess the prevalence of undernutrition, incidence of infectious diseases and the situation of feeding practices to determine the risk factors for undernutrition among children aged 6 to 18 months in rural Vietnam. DESIGN: A cross-sectional study was conducted among one hundred eighty-eight mother-child pairs in Bac Giang, Vietnam. Weight and height of the children were measured and referred to data from the WHO/CDC/NCHS. Incidence of infectious diseases was diagnosed based on the WHO Recommended Surveillance Standards. Data on socio-demographic variables and feeding practices were obtained through a structured questionnaire. RESULT: The prevalence of underweight, stunting and wasting was 19.7%, 23.4% and 5.3%, respectively. The incidence of diarrhea and acute respiratory infections (ARIs) during the last 14 days of the interview was 12.2% and 20.2%, respectively. Although 99% of the children were breastfed, the prevalence of exclusive breastfeeding in the first 4 mo was 21.3%. Non-exclusive breastfeeding in the first 4 month (OR 3.95, p=0.025) and low birth weight (OR 4.38, p=0.009) were associated with underweight in the children, while incidence of infectious disease was not (OR 1.16, p=0.734). CONCLUSION: Undernutrition is highly prevalent in the study site and non-exclusive breast feeding is one of the risk factors.

Determination of serum retinol by HPLC applied to assess the vitamin A status of Vietnamese children

The analysis using HPLC method to determine serum retinol (vitamin A) concentrations has been developed in Micronutrient Laboratory - the National Institute of Nutrition, to assess the subclinical vitamin A deficiency in Vietnam. This method with high sensibility, high precision and good accuracy (CV% intraassay [3.5 + 5] and inter assay [4.8 + 1.7]), can detect very low serum retinol levels, and recognized by the international system on vitamin A - quality control. Applying to assess the vitamin A status of the children <5 year old in the Red River Delta and the North Mountainous Areas, the result showed that 4.2% and 21.9% of the subjects were suffered from sub-clinical vitamin A deficiency, respectively. The rate of low retinol levels in infants < 6 month olds was 32.7%, significantly higher than other groups.

The nutrition status of children 5-8 months of age and the mother's knowledge and practice at Dong Hy district, Thai Nguyen province

The study showed that the prevalence of underweight children stunting children was 3.1% and 11.5%, respectively. The concentrations of Hb, zinc, and serum vitamin A of these children were low; the prevalence of zinc and vitamin A deficiency were very high. The prevalence anemia was 73.1%, zinc deficiency 37.8%, and vitamin A deficiency 38.1%. There was concomitant deficiency of two or more micronutrients. Mothers’ knowledge and practice on nutrition was limited. 37.8% of neonates were breast-fed within the first 30 minutes, 60.5% of infants were weaned inappropriately, and 25.3% of infants were fed with meat and vegetable. Children’s dietary was inadequate both quantities and qualities, energy of dietary was 37-72% of recommended dietary allowances; particularly dietary iron levels reached only 44.4%.

The nutritional status, chronic diseases, and some related factors in the older people living in a rural commune of the Northern delta area

The older people (aged from 50-74 years old) in a rural commune of the Northern delta area were carried out the nutritional status, chronic diseases, and some related factors. The results indicated that the high rate (38.5%) of chronic energy deficiency (CED); the main chronic diseases are the osteoporosis/arthrosis (19.9%), the digestive system (14.2%), and the hypertension (12.5%). The nutritive values of food consumption was deficient 17% of energy, on protein and some essential micronutrients for older people such as calcium, phosphor, iron, vitamin C. Some at risk factors (occupation, food habit, life style) related to chronic diseases are the followings: the hypertension with high BMI, alcohol drinks, the digestive disease with smoking, tea, femented vegetables; Bone disease is more frequent in the farmer than the salaries

Trend of vitamin A defiency and anemia in Vietnam during recent years, and news measures recommended for controlling program

A meta-analyze on vitamin A (VA) and anemia surveys in the year 1995 and 2000. The results showed that anemis is reducing during the recent years, particularly more in pregnancy women, and less in young infants. However anemis is still a public health significant problem (PHS). Clinical VA lesions are continuously lower than PHS. While the sub-clinical VA deficiency is still a PHS, of which majority is in mild and moderate levels. It was recognized that the problem is more severe in young infant < 6 months. Low VA content in breast-milk is more than 50% among lactating women. The recommendations, such as social marketing on the using iron tablet, iron fortification into several foods have been developed for control of anemia; VA capsule supplementation of 50,000 IU to the infant < 6 months combined with immunization of PDT on 6, 10, 14 weeks; Increasing doses of VA for women after delivery. Weekly supplementation of iron combined with low dose VA to pregnance women

Lipid content and fatty acid compostion in breast-milk of Vietnamese lactating women living in red river delta

Lipid concentration and 38 fatty acids in breast milk of Vietnam lactating women living in Red River Delta were determined by gas chroma to graphy. The results of study could be use as reference for Vietnam breast-milk composition that has not yet published in “Table of nutritive composition of Vietnam food”, which is applied to calculate the food consumption of Vietnam infant. The results showed also the variable contents of lipids and fatty acids of various individuals and communities concerning the quantity and quality of lipid dietary intake. Several essential unsatured fatty acids (C18:1 oleic acid, C18:2 linolenic acid, C18:3 linolenic acid) existed in quite high level in Vietnam’s breast milk.

A severe anemia, vitamin A deficiency status in infants aged from 5-8 months old, belong to district Dong Hy, Thai Nguyen province

Study was carried out in 323 bottle-fed infants od 5-6 months old in Dong Hy District – Thai Nguyen province in 2002 year. Malnourhished occurred in a high incidence, 11.5% have had a substandard height, 74.6% anemia and 39.3% vitamin A deficiency. Anemia and vitamin A deficiency were correlated positively. Anemia infants have had 2.3 times higher of vitamin A deficiency than normal infants and in contrary. Ethnic minority infants have had a gap rate of anemia and vitamin A deficiency 2 times higher than Kinh infants. In mothers, knowledge and practice of nutrition and breastfeeding, and of infant care were very limited. Nutrition supplements was not appropriate

The subclinical vitamin A deficiency at four ecological areas in Vietnam in the year 2000

Subclinical vitamin A deficiency (SCVAD) was studied basing on serum vitamin A levels in children, vitamin A levels in another breast milk in the 1st year breastfeeding. The data were collected in four ecological areas: Northern mountain area (A1), Red River plain (A2), Southern Vietnam Centre (A3) and MeKong delta (A4) in the year 2000. SCVAD in A1, A2, A3, A4 was 21.9%, 4.2%, 10.5% and 12.9% respectively. In breast milks, the data were 51.1%, 43.1%, 57.6% and 63.5

Vitamin A status of children and lactating mother in the communes with protein energy malnutrion (PEM) < 30% and < 15%

Children aged 6-36 months old and breastfeeding mother in 2 groups of communes with a malnutrition prevalence <15% (group 1) and <30% 9group 2). Measuring the height, the weight, using HPLC to analyse, to quantify serum vitamin A level of children and breast milk. Results showed that serum vitamin A was similar in 2 groups, while vitamin A level of breast milk in grup 1 is higher considerably than in group 2. In the group 1, diet regimen of the group 1 is better, concerning the quantity as the quality. However, there is a supply of only 50% of recommended vitamin A, so the programme of high doses of vitamin A in gel capsula can be continued and vitamin A supplement in food is need

[Efficacy of daily and weekly iron supplementation for the control of iron deficiency anaemia in infants in rural Vietnam]. / Efficacité de la supplémentation en fer quotidienne et hebdomadaire pour le contrôle de l'anémie chez le nourrisson en milieu rural au Vietnam.

In Vietnam the high prevalence of iron deficiency anaemia in infants and young children speaks for implementing early interventions. This study aimed to evaluate the efficacy of the daily iron supplementation in infants given by their mothers and of the weekly iron supplementation. Two hundred and seventy infants aged 5 to 12 months, were divided into four groups. Group 1 received a placebo daily and group 2 a daily dose of 15 mg iron (2.0 +/- 0.3 mg iron/day/kg body weight) which was given by their mothers for three months. Group 3 received a daily dose of 15 mg iron and group 4 a weekly dose of 15 mg iron given during 6 months by health auxiliaries. The hemoglobin concentration (Hb) was measured before the intervention and after 3 months of supplementation in all groups, and again after 6 months of supplementation in groups 3 and 4. After 3 months of iron supplementation, the hemoglobin concentration increased significantly by 21.6 +/- 12.3 g/l and the prevalence of anaemia decreased from 81.3% to less than 9% in group 2. The weekly iron supplementation was significantly less effective than the daily supplementation: after 3 months, Hb increased by 15.4 +/- 13.3 g/l in group 3 and by 11.2 +/- 10.2 g/l in group 4 (p = 0.04) and the prevalence of anaemia was 17.9% and 41.5% in groups 3 and 4, respectively. After 6 months of supplementation, changes in Hb were not significantly different between group 3 (22.0 +/- 12.1 g/l) and group 4 (20.0 +/- 10.0 g/l, p = 0.30). However, the final hemoglobin concentration was significantly lower in group 4 (120.5 +/- 7.2 g/l) than in group 3 (123.6 +/- 7.8, p = 0.02). Moreover, nearly 8% of the children were still anemic in group 4 versus 0% in group 3. Since the early developmental period, when the brain and other specific organs are especially sensitive to iron deficiency, is critical, 3-month daily iron supplementation of infants from the age of 6 months has to be recommended, followed by a weekly iron supplementation until the age of 15 months. The community approach, where mothers informed on the importance of iron deficiency anaemia and on the consequences for the health of their infants gave the iron supplements, was shown to be effective. However, its sustainability would depend on the availability of low-cost iron supplements affordable by populations with limited economic resources. Other interventions, such as iron supplementation of women during fertile age, especially during pregnancy and lactation periods, and the use of complementary food to breast milk, fortified with micronutrients, should be associated.