Mild riboflavin deficiency is highly prevalent in school-age children but does not increase risk for anaemia in Cote d'Ivoire

There are few data on the prevalence of riboflavin deficiency in sub-Saharan Africa, and it remains unclear whether riboflavin status influences the risk for anaemia. The aims of this study were to: (1) measure the prevalence of riboflavin deficiency in children in south-central Cdte d'Ivoire; (2) estimate the riboflavin content of the local diet; and (3) determine if riboflavin deficiency predicts anaemia and/or iron deficiency. In 5- to 15-year-old children (n 281), height, weight, haemoglobin (Hb), whole blood zinc protoporphyrin (ZPP), erythrocyte glutathione reductase activity coefficient (EGRAC), serum retinol, C-reactive protein (CRP) and prevalence of Plasmodium spp. (asymptomatic malaria) and Schistosoma haematobium (bilharziosis) infections were measured. Three-day weighed food records were kept in twenty-four households. Prevalence of anaemia in the sample was 52 %; 59 % were iron-deficient based on an elevated ZPP concentration, and 36 % suffered from iron deficiency anaemia. Plasmodium parasitaemia was found in 49 % of the children. Nineteen percent of the children were infected with S. haematobium. Median riboflavin intake in 5- to 15-year-old children from the food records was 0.42 mg/d, similar to 47 % of the estimated average requirement for this age group. Prevalence of riboflavin deficiency was 65 %, as defined by an EGRAC value > 1.2. Age, elevated CRP and iron deficiency were significant predictors of Hb. Riboflavin-deficient children free of malaria were more likely to be iron deficient (odds ratio; 3.07; 95 % CI 1.12, 8.41). In conclusion, nearly two-thirds of school-age children in south-central Cote d'Ivoire are mildly riboflavin deficient. Riboflavin deficiency did not predict Hb and/or anaemia, but did predict iron deficiency among children free of malaria.