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ABSTRACT

This investigation centered on Vitamin A and anthropometric status of 400 children aged 6-24 months in urban and rural communities in Kaduna South local government area, Nigeria. Selection of children was through systematic sampling technique. Two hundred children from each community, ninety four males (94) and one hundred and six (106) females from Makera (urban) and ninety three males (93) and one hundred and seven (107) females from Kinkinau (rural) communities completed the study. A structured questionnaire was used to collect information on maternal socioeconomic characteristics, living conditions, health care, and 24-hour dietary recall.  Knowledge, attitude and practice of healthy life style and Vitamin A supplementation were assessed using focus group discussion. The anthropometric status of the children were measured longitudinally for 6 months with wooden length board, and UNICEF weighing scale.  Serum retinol levels of a subsample of 100 subjects were determined. Blood samples were collected by venipuncture to obtain serum for measurement of retinol concentration using high performance liquid chromatography. The data was analyzed using anthropometric z scores and categorized using WHO Anthro software (2007). Comparison was done using Chi square test for categorical variables and ANOVA and t-test for continuous variables. All statistical analysis were done using SPSS version 15 and significance judged at p<0.05.As judged by the result, stunting (49.8%) was the major nutritional problem identified in most of the children. However, 14.1% and 7.5% were underweight and wasted, respectively. The composite index of anthropometric failure (CIAF) counted for a total of 55.3% of the children that had anthropometric failures. However, 70.0 % (weight-for-length), 46.5 % (length-for-age) and 83.5 % (weight-for-age) fell within the normal region in all anthropometric indicators. The prevalence of overweight and obesity (combined) was high in the rural (37%) as against 8.0% in the urban location. A total of 84.5% of the urban children had normal weight-for-length compared to 55.5% of the rural children.  Location significantly (p<0.05) influenced weight-for-age status. However, the percentage of children wasted in both locations was similar (7.5%). Urban children had higher (55.0%) length-for-age value than the rural (46.5%) children.  Stunting was more prevalent in the rural (49.8%) than in the urban (42.0%) areas. There was strong association between location and length-for-age status (p<0.05). The rural children had higher weight-for-age percentage (85.0%) than the urban (82.0%) children.  Underweight was more prevalent in the urban (16.0%) than in the rural (12.0%). However, location had no effect (p>0.05) on the weight-for-age status. Age had no relationship with underweight, stunting and wasting in the locations and gender. However, age group (6-10 months) influenced (p<0.05%) the prevalence of overweight only in rural females. The growth velocities fluctuated within the study period.   The weight velocities of the male subjects were higher (p<0.05) than those of the females while length velocities of the females were higher (p<0.05) than those of the males. The weight velocities of the rural children were higher (p<0.05) compared to those of the urban children, while length velocities of the urban children were higher than those of the rural children. None of the children was Vitamin A deficient. The mean serum retinol concentration (SRC) was 53.56µg/dl. The majority (69.0%) of the children had high SRC and 31.0% had satisfactory level. However, there was no difference (p>0.05) between the SRC of those with high and satisfactory levels. The mean SRC of the males in the urban (49.50µg/dl) was significantly (P<0.05) lower than the mean SRC of the males in the rural (56.10µg/dl).  The mean SRC of the females in the urban (54.52µg/dl) was similar (P>0.05) to the mean SRC of the females in the rural (54.08µg/dl) area. Comparison of mean SRC with CIAF showed that children that were both wasted and underweight had highest (59.33µg/dl) mean SRC. The levels of income, size of household and infections affected nutritional status of the children. Mothers were aware of the importance of Vitamin A supplementation. However, dietary diversification, growth monitoring and nutrition education were poor in both communities. The improvement of Vitamin A status of the children has narrowed Vitamin A deficiency in the two communities.