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Human serum retinol and livestock milk retinol levels were assessed as part of a study on the health status of Chadian nomadic pastoralists and their livestock in close partnership between Chadian public health and livestock institutions. Of the examined women (n = 99), 43% were moderately retinol-deficient (0.35 mol/L < x < 0.7 mol/L 95% CI; 33-54%), and 17% severely retinol-deficient (< 0.35 mol/L 95% CI; 10-26%). None of the interviewed women (n = 87) reported the consumption of fruit, and only two of fresh vegetables were reported consumed in the past 24 hours. Milk is the almost exclusive source of vitamin A for these populations. Goats (n = 6) had the highest average milk retinol level (329 +/- 84 micrograms/kg [mean +/- SEM]), followed by cattle (n = 25; 247 +/- 32 micrograms/kg), and camels (n = 12; 120 +/- 18 micrograms/kg). Milk retinol levels did not differ between the rainy and dry seasons. Human serum retinol depends significantly on livestock milk retinol levels (partial slope 0.23; 95% CI: 0.008-0.47). Our study supports the use of goat and cow milk as an important source of vitamin A in pastoral nomadic settings. However, the levels still require to be complemented further by promoting green leafy vegetables, fruits, and supplements.

A visual aid tool was used in two communities of Chad to raise parents' awareness of the benefits of immunization. In one community, the tool was administered by social workers two weeks before national immunization days (NIDs) and in the other community by vaccinators during NIDs. Parents' awareness significantly rose in both communities but was more significant in the community where the tool was administered by social workers. A significant association was found between parents' unawareness and children who missed immunization in both communities.