Displaced populations dependent on relief food are often vulnerable to micronutrient deficiencies. Recent evaluations in refugee populations in Kenya and Nepal have demonstrated widespread deficiencies of iron, vitamin A, and riboflavin among adolescents 10-19 years of age. In four refugee camps in Kenya, the prevalence of anemia was 43%-47% using World Health Organization-recommended cutoff values for hemoglobin. In the one camp where survey participants underwent additional testing, 60% of anemic adolescents had iron deficiency. In seven refugee camps in Nepal, 24% of adolescents were anemic, and 73% of anemic adolescents were iron deficient. Iron deficiency was also common in persons without anemia, affecting 24%-53% of nonanemic adolescents. Vitamin A deficiency was also common; 15% of adolescents in one camp in Kenya had subnormal serum retinol levels (< 0.7 umol/l), and 2% had levels < 0.35 umol/l. In Nepal, 30% of adolescents had subnormal retinol levels, and 1% had levels < 0.35 umol/l. During an outbreak of angular stomatitis, which is a sign of possible riboflavin deficiency, in the seven camps in Nepal, 86% of adolescents who had not received riboflavin supplementation had low riboflavin levels (activity coefficient < 1.7). In all populations of adolescents studied, consumption of foods containing substantial amounts of iron, vitamin A, and riboflavin was inadequate. In conclusion, relief food should be fortified with necessary micronutrients, and access to alternate food sources and the means to obtain micronutrient-rich foods should be ensured for displaced populations who lack the ability to purchase or produce their own food supply.
Learning Objectives: At the end of this session participants will be able to do the following: 1) Understand the importance of micronutrients and micronutrient deficiencies in displaced populations dependent on relief food. 2) Describe the methods used to evaluate micronutrient deficiencies in refugee populations.
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