Comparability of inflammation-adjusted vitamin A deficiency estimates and variance in retinol explained by C-reactive protein and α1-acid glycoprotein during low and high malaria transmission seasons in rural Zambian children

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cg.contributor.crpAgriculture for Nutrition and Health
cg.contributor.donorSight and Life Global Nutrition Research Instituteen
cg.contributor.donorDepartment of Foreign Affairs, Trade and Development, Canadaen
cg.contributor.donorDepartment for International Development, UK Governmenten
cg.contributor.donorCGIAR Trust Funden
cg.coverage.countryZambia
cg.coverage.iso3166-alpha2ZM
cg.coverage.regionSouthern Africa
cg.coverage.regionSub-Saharan Africa
cg.coverage.regionAfrica
cg.coverage.regionEastern Africa
cg.identifier.doihttps://doi.org/10.4269/ajtmh.17-0130en
cg.identifier.projectIFPRI - HarvestPlus
cg.isijournalISI Journalen
cg.issn1476-1645en
cg.issue1en
cg.journalAmerican Journal of Tropical Medicine and Hygieneen
cg.reviewStatusPeer Reviewen
cg.volume98en
dc.contributor.authorBarffour, Maxwellen
dc.contributor.authorSchulze, Kerry J.en
dc.contributor.authorColes, Christian L.en
dc.contributor.authorChileshe, Justinen
dc.contributor.authorKalungwana, Ng’andween
dc.date.accessioned2025-01-29T12:57:51Zen
dc.date.available2025-01-29T12:57:51Zen
dc.identifier.urihttps://hdl.handle.net/10568/171198
dc.titleComparability of inflammation-adjusted vitamin A deficiency estimates and variance in retinol explained by C-reactive protein and α1-acid glycoprotein during low and high malaria transmission seasons in rural Zambian childrenen
dcterms.abstractInflammation-induced hyporetinolemia (IIH), a reduction in serum retinol (SR) during inflammation, may bias population estimates of vitamin A deficiency (VAD). The optimal adjustment for IIH depends on the type and extent of inflammation. In rural Zambian children (4–8 years, N = 886), we compared three models for defining inflammation: α-1- acid glycoprotein (AGP) only (inflammation present if > 1 g/L or normal if otherwise), C-reactive protein (CRP) only (moderate inflammation, 5–15 mg/L; high inflammation, > 15 mg/L; or normal if otherwise) and a combined model using both AGP and CRP to delineate stages of infectious episode. Models were compared with respect to 1) the variance in SR explained and 2) comparability of inflammation-adjusted VAD estimated in low and high malaria seasons. Linear regression was used to estimate the variance in SR explained by each model and in estimating the adjustment factors used in generating adjusted VAD (retinol < 0.7 μmol/L). The variance in SR explained were 2% (AGP-only), 11% (CRP-only), and 11% (AGP–CRP) in the low malaria season; and 2% (AGP-only), 15% (CRP-only), and 12% (AGP–CRP) in the high malaria season. Adjusted VAD estimates in the low and high malaria seasons differed significantly for the AGP (8.2 versus 13.1%) and combined (5.5 versus 9.1%) models but not the CRP-only model (6.1 versus 6.3%). In the multivariate regression, a decline in SR was observed with rising CRP (but not AGP), in both malaria seasons (slope = −0.06; P < 0.001). In this malaria endemic setting, CRP alone, as opposed to CRP and AGP, emerged as the most appropriate model for quantifying IIH.en
dcterms.accessRightsOpen Access
dcterms.bibliographicCitationBarffour, Maxwell A.; Schulze, Kerry J.; Coles, Christian L.; Chileshe, Justin; and Kalungwana, Ng'andwe; et al. 2018. Comparability of inflammation-adjusted vitamin A deficiency estimates and variance in retinol explained by C-reactive protein and α1-acid glycoprotein during low and high malaria transmission seasons in rural Zambian children. American Journal of Tropical Medicine and Hygiene 98(1): 334-343. https://doi.org/10.4269/ajtmh.17-0130en
dcterms.extentpp. 334-343en
dcterms.issued2018-01-10
dcterms.languageen
dcterms.licenseOther
dcterms.publisherAmerican Society of Tropical Medicine and Hygieneen
dcterms.subjectretinolen
dcterms.subjectvitamin deficienciesen
dcterms.subjectascorbic aciden
dcterms.subjectglycoproteinsen
dcterms.subjectmalariaen
dcterms.subjectchildrenen
dcterms.subjectinflammationen
dcterms.subjecthuman diseasesen
dcterms.subjectdisease transmissionen
dcterms.subjectendemicsen
dcterms.subjecthealthen
dcterms.typeJournal Article

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