Vitamin A deficiency (VAD) is a leading cause of child morbidity and mortality worldwide. This analysis aimed to estimate the prevalence of VAD and identify VAD risk factors among a cohort of Bolivian infants.
Healthy infants from 2 hospitals in El Alto, Bolivia were recruited and followed. Blood taken at 2, 6 8, and 12 18 months was analyzed for retinol-binding protein (RBP), C-Reactive Protein (CRP), and alpha(1)-acid-glycoprotein (AGP). VAD was defined as inflammation-corrected RBP < 0.7 µmol/L. Logistic regression models were used to assess VAD risk factors (chosen a priori) in each age group (N = 365, 310, 168 respectively).
The prevalence of VAD was 75% at 2 months, 17% at 6 8 months, and 6% at 12 18 months (all comparisons significantly different, p < 0.01). Exclusive breastfeeding (infant currently receiving only breast milk: 60% at 2 months, 8% at 6 8 months) was significantly associated with VAD at 2 months (OR 1.11 [1.01 1.21], p = 0.03) and 6 8 months (OR 1.17 [1.00 1.37)], p = 0.044). None of the behavioral or sociodemographic variables investigated were significantly associated with VAD at 12 18 months.
VAD prevalence was high in young infants in this cohort (75% at 2 months), but decreased significantly in older infants, potentially suggesting initiation of supplementation earlier than current recommendations (6 months). Breastfeeding was significantly associated with increased odds of VAD in younger infants, but no behavioral or sociodemographic risk factors were identified in older infants, suggesting other etiologies.