Background Folate deficiency, vitamin B-12 deficiency, and anemia can have adverse effects on birth outcomes. Also, low vitamin B-12 reduces the formation of metabolically active folate. Objectives We sought to establish the baseline prevalence of and factors associated with folate deficiency and insufficiency, vitamin B-12 deficiency, and anemia among women of childbearing age (WCBA) in Belize. Methods In 2011, a national probability-based survey was completed among Belizean nonpregnant WCBA aged 15–49 y. Blood samples for determination of hemoglobin, folate (RBC and serum), and vitamin B-12 (plasma) and sociodemographic and health information were collected from 937 women. RBC and serum folate concentrations were measured by microbiologic assay (MBA). Folate status was defined based on both the WHO-recommended radioproteinbinding assay and the assay adjusted for the MBA. Results The national prevalence estimates for folate deficiency in WCBA, based on serum and RBC folate concentrations by using the assay-matched cutoffs, were 11.0% (95% CI: 8.6%, 14.0%) and 35.1% (95% CI: 31.3%, 39.2%), respectively. By using the assay-matched compared with the WHO-recommended cutoffs, a substantially higher prevalence of folate deficiency was observed based on serum (6.9% absolute difference) and RBC folate (28.9% absolute difference) concentrations. The prevalence for RBC folate insufficiency was 48.9% (95%CI: 44.8%, 53.1%). Prevalence estimates for vitamin B-12 deficiency and marginal deficiency and anemia were 17.2% (95% CI: 14.2%, 20.6%), 33.2% (95% CI: 29.6%, 37.1%), and 22.7% (95% CI: 19.5%, 26.2%), respectively. The adjusted geometric means of the RBC folate concentration increased significantly (P-trend < 0.001) in WCBA who had normal vitamin B-12 status relative to WCBA who were vitamin B-12 deficient. Conclusions In Belize, the prevalence of folate and vitamin B-12 deficiencies continues to be a public health concern among WCBA. Furthermore, low folate status co-occurred with low vitamin B-12 status, underlining the importance of providing adequate vitamin B-12 and folic acid intake through approaches such as mandatory food fortification.

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Antiretroviral therapy has had a great impact on the prevention of mother-to-child transmission (MTCT) of HIV-1. However, development of drug resistance, which could be subsequently transmitted to the child, is a major concern. In Honduras and Belize the prevalence of drug resistance among HIV-1-infected children remains unknown. A total of 95 dried blood spot samples was obtained from HIV-1-infected, untreated children in Honduras and Belize born during 2001 to 2004, when preventive antiretroviral therapy was often suboptimal and consisted of monotherapy with nevirapine or zidovudine. Partial HIV-1 pol gene sequences were successfully obtained from 66 children (Honduras n=55; Belize n=11). Mutations associated with drug resistance were detected in 13% of the Honduran and 27% of the Belizean children. Most of the mutations detected in Honduras (43%) and all mutations detected in Belize were associated with resistance to nonnucleoside reverse transcriptase inhibitors, which was expected from the wide use of nevirapine to prevent MTCT during the study period. In addition, although several mothers reported that they had not received antiretroviral therapy, mutations associated with resistance to nucleoside reverse transcriptase inhibitors and protease inhibitors were found in Honduras. This suggests prior and unreported use of these drugs, or that these women had been infected with resistant virus. The present study demonstrates, for the first time, the presence of drug resistance-associated mutations in HIV-1-infected Honduran and Belizean children.

Objectives Micronutrient deficiencies (MD) are a public health concern in preschool children in many developing countries, including Belize. MD can impair proper growth, motor and cognitive development, and functioning in children. We assessed the prevalence of vitamin A deficiency (vitAD), anemia (AN), iron deficiency (ID), iron deficiency anemia (IDA), red blood cell folate deficiency (RBCFD), vitamin B12 deficiency (B12D), and marginal deficiency (B12MD) among preschool children (6–59 months of age). Methods We conducted a national multistage cluster probability household biomarker survey of 971 preschool children. Demographic characteristics and blood samples were collected and analyzed. We used BRINDA regression adjustments for ferritin and retinol to account for inflammation. Prevalence and 95% CI of vitAD, AN, ID, IDA, RBCFD, B12D and B12MD were estimated. Results The national adjusted prevalence estimates showed very low prevalence of vitAD (&lt;22 mcg/L) 0.3% (95% CI: 0.0, 0.6). The national prevalence estimates for AN (hemoglobin &lt; 11 µ/dL), ID (ferritin &lt; 12µg/dL), IDA (ferritin&lt;µg/dL), and RBCFD(&lt;305 nmol/L) were: 20.1% (95%CI: 17.2, 23.3), 7.7% (95%CI: 5.9, 9.9), 19.9% (95% CI: 14.1, 27.2), and 33.5% (95% CI: 29.1, 38.3), respectively. The prevalences of B12D (&lt;148pmol/L) and B12MD (148–221 pmol/L) were 6.1% (95% CI: 4.5, 8.1) and 12.8% (95% CI: 10.4, 15.7), respectively. Conclusions Our study revealed a low prevalence of vitAD, Vitamin A deficiency has been practically eliminated in belize. In contrast, ID, IDA, B12D and B12MD are of mild public health concern. In contrast AN and RBCFD are a moderate public health concernthat should be addressed in this age group. Funding Sources None.