The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

Objective: To investigate the prevalence of selected micronutrient deficiencies amongst anaemic adolescent schoolgirls in rural Bangladesh and to examine their relationship with haemoglobin (Hb) levels. Design: A cross- sectional study. Setting: Girls' high schools in rural areas of Dhaka District in Bangladesh. Subjects and methods: Three hundred and ten anaemic adolescent girls aged 14-18 years from eight schools participated in the study. Information on personal characteristics and food habits were collected by interview. Parents were asked about their socio-economic conditions. Anthropometric data and blood samples were collected following the interview. Results: Twenty-eight per cent of the girls had depleted iron stores (serum ferritin < 12.0 mu g/l), 25% had folic acid deficiency (red blood cell folic acid < 317 nmol/l), 89% had vitamin B-2 (erythrocyte glutathione reductase activity coefficient >= 1.4) and 7% had vitamin B-12 deficiencies (serum vitamin B12 < 150 pmol/l). Although the prevalence of vitamins A and C deficiency was very low, a significant proportion had low vitamin A (serum retinol between 0.70 and < 1.05 mu mol/l) and vitamin C status (plasma ascorbic acid between 11.4 - 23.0 mu mol/l). Frequency of consumption of meat, serum ferritin and vitamin B-2 status were found to be strongly related to Hb by multiple regression analysis. For 1 mu g/l change in serum ferritin, there was a 0.13 g/l change in Hb when adjusted for other factors. Conclusions: There is coexistence of micronutrient deficiencies among anaemic adolescent girls in rural Bangladesh, although they do not suffer from energy deficiency. Of all micronutrients, only iron and vitamin B2 concentrations were found to be related to the Hb concentration.