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.