Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Abstract

Abstract.A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (< 0.70 μmol/L). Giardiasis and severe ascariasis were significantly associated with low serum retinol levels ( P = 0.004 and P = 0.018, respectively). Logistic regression confirmed the significant association of giardiasis with low serum retinol (odds ratio = 2.7, 95% confidence interval = 1.3-5.5). In conclusion, vitamin A deficiency is still a public health problem in rural Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status. 18 Iintensity of infection was graded as heavy, moderate, or light according to criteria proposed by the World Health Organization.19 Scores for intensity of infections were given to each soil-transmitted helminth species (light = 1, mild = 2, and severe = 3) and mixed infections with a worm score ≥ 5 were included in the analysis. Samples were also examined for Giardia duodenalis trophozoites or cysts by using the trichrome staining technique.Assessment of vitamin A status. Approximately 2-3 mL of venous blood were collected from each participant into tubes for biochemical analysis. Blood was left at room temperature to ensure clot formation. The tubes were then centrifuged at 3,000 rpm for 10 minutes to obtain serum that was stored at -20°C until further analysis. Serum retinol concentrations were determined using a reverse-phase high performance liquid chromatography (LC-10AD; Shimadzu, Kyoto, Japan) as described. 16,20 One hundred microliters of ethanol containing retinyl acetate as an internal standard was added to 100 μL of serum. Refiltered petroleum ether (RPE) (500 μL) was added and the mixture was mixed with a vortex mixer for 1 minute and centrifuged at 5,000 rpm for 10 minutes. A 150-μL sample from the refiltered petroleum ether layer was transferred into a clean test tube and evaporated. The extract was dissolved in 200 μL of ethanol. Eighty microliters of this mixture was injected into the high performance liquid chromatography apparatus. Methanol:water (95:5 [v/v]) was used as the mobile phase and all-trans retinol was used as the standard. For quality control, 20% of the samples were randomly selected and examined in duplicate. Serum retinol was measured in picomoles per liter.Use of serum retinol to assess vitamin A status may be influenced by inflammation and reductions in plasma retinol, which have been described during the acute phase of a wide range of infections. 21 The design of this study did not consider the inflammatory status of the...

Burden of Giardia duodenalis Infection and Its Adverse Effects on Growth of Schoolchildren in Rural Malaysia

“…Previous studies have identified Giardia as a significant predictor of weight and height [17], [21], [40]. Moreover, Giardia infection has been identified as a significant risk factor of vitamin A deficiency among Aboriginal children in rural Malaysia [9].…”

“…Previous cross-sectional studies among Aboriginal children in peripheral and rural areas of Selangor and Pahang identified Giardia infection as a significant risk factor of malnutrition and poor vitamin A status [9], [21]. However, these studies were based on a single point data analysis (cross-sectional).…”

“…Often, patients suffering from acute infection present with diarrhoea, abdominal pain and the clinical manifestations of malabsorption [7]. Chronic infection is usually associated with clinical manifestations of malnutrition and micronutrient deficiencies, especially vitamin A deficiency (VAD) and iron deficiency anaemia (IDA) [8], [9]. A significant association between the chronic infection and poor cognitive function has also been reported among children [6].…”

Nutrition assessment of vitamin A and vitamin D in northeast Chinese population based-on SPE/UPLC/PDA

“…Our results indicated a similar trend, wherein severe VA deficiency was only observed in younger school-age students (6-11 years), and marginal deficiency was observed in elder students (12-17 years), but there was no deficiency in adults. VA plays an important role in the adverse effects of virus and bacterial infections [21] and as parasitic infections [22]. Vitamin A deficiency can affect immune function and lead to higher morbidity and mortality due to respiratory and digestive tract infections in children [23,24].…”

Development of a Garden-Based Curriculum Content Model for Indigenous Primary School Students

“…Hence, various efforts have been made by diverse government agencies including the Ministry of Education and Jabatan Hal Ehwal Orang Asli Malaysia itself [3]. Several studies have been carried out to identify the contributing factors to academic achievement among the Orang Asli community including the aconomic factor, geography, family, and individual personality [4][5][6][7][8], societal factor [7] and also nutrition factor [9][10][11].…”