SERUM CONCENTRATION OF MICRONUTRIENTS IN RELATION TO SCHISTOSOMIASIS AND INDICATORS OF INFECTION - A CROSS-SECTIONAL STUDY AMONG RURAL ZIMBABWEAN SCHOOLCHILDREN

Objective: To study the relation between indicators of infection and S chistosoma mansoni and S. haematobium infection, and serum concentrati ons of zinc, ferritin and retinol. Design: Cross-sectional. Setting an d subjects: 313 rural Zimbabwean schoolchildren (144 boys and 169 girl s, 11-17 years). Variables: S. mansoni and S. haematobium egg output, concentration of C-reactive protein, neutrophil count, questionnaire d ata on fever and diarrhoea, and serum concentrations of retinol, ferri tin and zinc. Results: Age, elevated CRP, fever and S. mansoni egg out put were significant predictors of the concentration of retinol. The r egression coefficient for age was positive, and negative for elevated CRP, fever and S. mansoni egg output. As S. mansoni, but not S. haemat obium, was of significance, it is unlikely that low retinol level incr eased susceptibility to infection. The effect of S. mansoni on retinol level was 0.03 mu mol/l (95% CI: 0.002-0.06, P = 0.03) for each 100 e ggs/g increase in egg output. Neither indicators of infection nor age and sex were predictors of concentration of zinc and log,, concentrati on of ferritin. Conclusion: S. mansoni infection reduced retinol level , when indicators of infection and age were controlled for. High inten sities of S. mansoni infection may induce vitamin A deficiency among c hildren with marginal vitamin A status. The study emphasizes the impor tance of controlling for age and metabolic response to concurrent infe ctions in studies using serum retinol as a measure of vitamin A status . Sponsorship: Danish International Development Assistance. Descriptor s: Cross-sectional study, schoolchildren, Zimbabwe, infection, Schisto soma mansoni, Schistosoma haematobium, retinol, ferritin, zinc