A COMMUNITY-BASED STUDY OF VITAMIN-A AND VITAMIN-E STATUS OF ADOLESCENT GIRLS LIVING IN THE SHIRE VALLEY, SOUTHERN MALAWI

Objective: To assess vitamin A and E status and anaemia in non-pregnan t Malawian adolescent iris. Design: A cross-sectional study in rural v illage communities in the Shirt Valley, Southern Malawi. Subjects: Ado lescent girls, n = 118, aged between 10 and 19 y, 112 of whom were unm arried. Methods: Socio-demographic information was collected by questi onnaire, heights and weights were measured. Vitamin A was assessed by the Modified Relative Dose Response (MRDR) test, in addition to serum retinol values. Blood samples were collected 4-5 h after administratio n of 3,4-didehydroretinyl acetate. Retinol and alpha-tocopherol levels were measured by HPLC. Serum retinol results for non-pregnant girls w ere compared with values for 43 adolescent pregnant girls which were a vailable from a previous study. Results: 26.6% of non-pregnant girls h ad serum retinol values ( 0.70 mu mol/L; 40.2% had an MRDR ratio > 0.0 60. In 59.3%, serum tocopherol levels were < 11.5 mu mol/L and the toc opherol/cholesterol ratio was < 2.2 in 23.9%. 11.3% had a haemoglobin greater than or equal to 12 g/dl. Vitamin A levels were significantly related to age, and younger girls were more likely to be deficient. Si gnificant correlations were found between serum retinol, MRDR values a nd serum tocopherol. Girls with a low body mass index for age had toco pherol cholesterol ratios < 2.2. Low serum retinol values occurred sig nificantly more often in stunted girls (P=0.01). Serum retinol values of adolescent pregnant girls were significantly lower than those of no n-pregnant adolescents (P = 0.002). Conclusions: Vitamin A and E defic iency and anaemia were common in adolescent non-pregnant girls, and th ought to partly result from increased growth requirements. Girls a ho become pregnant at an early age are at risk of depletion of their nutr itional reserves. Measures to reduce nutritional deficiencies before t he first pregnancy are needed.