Vitamin A deficiency, iron deficiency, and anemia among preschool children in the Republic of the Marshall Islands,

Objective We investigated the co-occurrence of vitamin A deficiency, iron deficiency, and anemia among young children in the Republic of the Marshall Islands. Methods Hemoglobin, serum retinol, and serum ferritin were assessed in the Republic of the Marshall Islands Vitamin A Deficiency Study, a community-based survey that involved 919 children ages 1 to 5 y. Results The proportion of children with vitamin A deficiency (serum retinol concentrations < 0.70 μM/L) was 59.9%. The prevalences of anemia (hemoglobin < 110 g/L), iron deficiency (serum ferritin < 12 μg/L), and iron deficiency anemia (iron deficiency and anemia) were 36.4%, 53.5%, and 23.8%, respectively. The proportion of children who had co-occurrence of vitamin A and iron deficiencies was 33.2%. The mean ages of children with and without vitamin A deficiency were 3.2 ± 1.4 and 2.9 ± 1.5 y, respectively (P = 0.01), and the mean ages of those with and without iron deficiency were 2.7 ± 1.3 and 3.5 ± 1.4 y, respectively (P < 0.0001). Conclusions Children in the Republic of the Marshall Islands, ages 1 to 5 y, are at high risk of anemia, vitamin A deficiency, and iron deficiency, and one-third of these children had the co-occurrence of vitamin A and iron deficiencies. Further investigation is needed to identify risk factors and evaluate interventions to address vitamin A and iron deficiencies among children.