The association between inflammation and infection status and vitamin A status of children 36 – 59 months of in a malaria-endemic rural area in Burkina Faso

Abstract

Background and objectives: Infections and micronutrient deficiencies are widespread health issues in Africa. Vitamin A (VA) deficiency remains an endemic public health concern, with its health consequences mostly affecting infants, young children and pregnant and lactating women. In Burkina Faso, VA deficiency is especially prevalent during the rainy season. The aim of this study was to assess the association between common infections and inflammatory status and VA status in children living in a malaria endemic rural area in Burkina Faso, and the effect of season on this association. Material and methodology: Two community-based cross- sectional studies were conducted in a malaria endemic area of Burkina Faso and have included 115 children of 36 - 59 months of age. The 13C-retinol isotope dilution test (RID) determined VA total body store (TBS) and total liver reserve (TLR). Malaria infection was assessed using rapid diagnosis test and malaria smear, intestinal parasites were assessed by stool microscopic examination, and inflammation indicators, C reactive proteins (CRP) and Alpha-1-acid glycoprotein (AGP) were assessed in venous blood by ELISA. The association between VA status and infection status was tested by a multiple linear regression. Results: No VA deficiency (<0.1 mol/g liver) was detected using sensitive RID method in the study population. TBS median (Q25-Q75) was 430.8 (289.9 – 620.6) mol and TLR median was 0.79 (0.55 - 1.20) mol/g liver. One-fourth of study participants were found to have hypervitaminosis A (>1.0 mol/g liver). Elevated CRP and AGP were respectively detected in 9% and 26% children. Malaria was diagnosed in 10 % of the children. Significant but weak association was found between CRP concentration and VA status (β=0.055, p=0.009). There was no association between malaria status, AGP and exposition to digestive parasites with VA status. The association between CRP and VA status has a seasonal pattern (β= 0.591, p= 0.001). Conclusion: In this area of Burkina Faso where infections are common none of the children had VA deficiency. An association was found between acute inflammatory markers and VA status, which was stronger during the rainy season.