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APHA Scientific Session and Event Listing

Recorded presentation

Jerry E. Vincent, OD MPH, Health Unit, International Rescue Committee, PO Box 213, CMU Post Office, Chiang Mai, 50202, Thailand, +66 53 806 735, jvincent@loxinfo.co.th

Vitamin A deficiency is the leading cause of childhood blindness in developing countries and is a contributing factor in excessive childhood morbidity and mortality in affected populations. Populations such as refugees are particularly vulnerable to vitamin A deficiency. We assessed vitamin A deficiency in three populations – Afghan refugees in Pakistan, mostly Sudanese refugees in Kenya and Burundi refugees in Tanzania. Using a two-stage cluster sampling and standard international protocols, we determined rates for three vitamin A deficiency indicators: maternal night blindness (MXN), childhood night blindness (XN) and Bitot spots (X1B). The rate (95% Confidence Interval) for each indicator in each population found were:

Pakistan MXN 9.6% (5.7%-13.4%) XN 0.7% (0.2%-1.6%) X1B 2.25% (0-4.9%)

Kenya MXN 9.9% (4.9%-14.9%) XN 1.3% (0.3%-2.1%) X1B 0.6% (0.1%-1.3%)

Tanzania MXN 3.3% (1.1%-5.4%) XN-0.5% (0.1%-1.2%) X1B 1.3% (0.1%-2.8%)

WHO Criteria MXN > 5.0% XN > 1.0% X1B > 0.5%

Rates in Pakistan and Kenya were over the WHO (World Health Organization) criteria of declaring a public health problem for all three indicators while rates in Tanzania exceeded the criteria in one indicator. The refugee children in all three of these countries are supplemented every 6 months with high strength vitamin A capsules per WHO guidelines. Our findings indicate that the 6-month supplementation interval does not provide adequate protection for these refugee children, and that more frequent supplementation is needed. As a result of these surveys, the International Rescue Committee will now begin supplementing these populations every 4 months.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize that refugee populations are more vulnerable to Vitamin A Deficiency
• Recognize that standard WHO guidelines for Vitamin A supplementation are not always adequate for refugee populations

Keywords: Refugees, Vulnerable Populations

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation