Low and deficient niacin status and pellagra are endemic in postwar Angola

Hdl Handle:
http://hdl.handle.net/10144/125625
Title:
Low and deficient niacin status and pellagra are endemic in postwar Angola
Authors:
Seal, A J; Creeke, P I; Dibari, F; Cheung, E; Kyroussis, E; Semedo, P; van den Briel, T
Journal:
American Journal of Clinical Nutrition
Abstract:
BACKGROUND: Outbreaks of pellagra were documented during the civil war in Angola, but no contemporary data on the incidence of pellagra or the prevalence of niacin deficiency were available. OBJECTIVE: The objective was to investigate the incidence of pellagra and the prevalence of niacin deficiency in postwar Angola and their relation with dietary intake, poverty, and anthropometric status. DESIGN: Admissions data from 1999 to 2004 from the pellagra treatment clinic in Kuito, Angola, were analyzed. New patients admitted over 1 wk were examined, and urine and blood samples were collected. A multistage cluster population survey collected data on anthropometric measures, household dietary intakes, socioeconomic status, and clinical signs of pellagra for women and children. Urinary excretion of 1-methylnicotinamide, 1-methyl-2-pyridone-5-carboxymide, and creatinine was measured and hemoglobin concentrations were measured with a portable photometer. RESULTS: The incidence of clinical pellagra has not decreased since the end of the civil war in 2002. Low excretion of niacin metabolites was confirmed in 10 of 11 new clinic patients. Survey data were collected for 723 women aged 15-49 y and for 690 children aged 6-59 mo. Excretion of niacin metabolites was low in 29.4% of the women and 6.0% of the children, and the creatinine-adjusted concentrations were significantly lower in the women than in the children (P < 0.001, t test). In children, niacin status was positively correlated with the household consumption of peanuts (r = 0.374, P = 0.001) and eggs (r = 0.290, P = 0.012) but negatively correlated with socioeconomic status (r = -0.228, P = 0.037). CONCLUSIONS: The expected decrease in pellagra incidence after the end of the civil war has not occurred. The identification of niacin deficiency as a public health problem should refocus attention on this nutritional deficiency in Angola and other areas of Africa where maize is the staple.
Affiliation:
Centre for International Child Health, Institute of Child Health, London, United Kingdom; World Food Programme, Luanda, Angola; MSF–Belgium, Kuito, Angola; Ministry of Health, Luanda, Angola; World Food Programme, Rome, Italy
Issue Date:
1-Jan-2007
URI:
http://hdl.handle.net/10144/125625
PubMed ID:
17209199
Additional Links:
http://www.ajcn.org/cgi/content/full/85/1/218
Type:
Article
Language:
en
ISSN:
0002-9165
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorSeal, A Jen
dc.contributor.authorCreeke, P Ien
dc.contributor.authorDibari, Fen
dc.contributor.authorCheung, Een
dc.contributor.authorKyroussis, Een
dc.contributor.authorSemedo, Pen
dc.contributor.authorvan den Briel, Ten
dc.date.accessioned2011-03-24T22:13:50Z-
dc.date.available2011-03-24T22:13:50Z-
dc.date.issued2007-01-01-
dc.identifier.citationAm. J. Clin. Nutr. 2007;85(1):218-24en
dc.identifier.issn0002-9165-
dc.identifier.pmid17209199-
dc.identifier.urihttp://hdl.handle.net/10144/125625-
dc.description.abstractBACKGROUND: Outbreaks of pellagra were documented during the civil war in Angola, but no contemporary data on the incidence of pellagra or the prevalence of niacin deficiency were available. OBJECTIVE: The objective was to investigate the incidence of pellagra and the prevalence of niacin deficiency in postwar Angola and their relation with dietary intake, poverty, and anthropometric status. DESIGN: Admissions data from 1999 to 2004 from the pellagra treatment clinic in Kuito, Angola, were analyzed. New patients admitted over 1 wk were examined, and urine and blood samples were collected. A multistage cluster population survey collected data on anthropometric measures, household dietary intakes, socioeconomic status, and clinical signs of pellagra for women and children. Urinary excretion of 1-methylnicotinamide, 1-methyl-2-pyridone-5-carboxymide, and creatinine was measured and hemoglobin concentrations were measured with a portable photometer. RESULTS: The incidence of clinical pellagra has not decreased since the end of the civil war in 2002. Low excretion of niacin metabolites was confirmed in 10 of 11 new clinic patients. Survey data were collected for 723 women aged 15-49 y and for 690 children aged 6-59 mo. Excretion of niacin metabolites was low in 29.4% of the women and 6.0% of the children, and the creatinine-adjusted concentrations were significantly lower in the women than in the children (P < 0.001, t test). In children, niacin status was positively correlated with the household consumption of peanuts (r = 0.374, P = 0.001) and eggs (r = 0.290, P = 0.012) but negatively correlated with socioeconomic status (r = -0.228, P = 0.037). CONCLUSIONS: The expected decrease in pellagra incidence after the end of the civil war has not occurred. The identification of niacin deficiency as a public health problem should refocus attention on this nutritional deficiency in Angola and other areas of Africa where maize is the staple.en
dc.language.isoenen
dc.relation.urlhttp://www.ajcn.org/cgi/content/full/85/1/218en
dc.rightsArchived with thanks to The American journal of clinical Nutritionen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAngolaen
dc.subject.meshAnthropometryen
dc.subject.meshArachis hypogaeaen
dc.subject.meshChild, Preschoolen
dc.subject.meshCluster Analysisen
dc.subject.meshDieten
dc.subject.meshDisease Outbreaksen
dc.subject.meshEggsen
dc.subject.meshFemaleen
dc.subject.meshHemoglobinsen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshNiacinen
dc.subject.meshNutritional Statusen
dc.subject.meshPellagraen
dc.subject.meshPovertyen
dc.subject.meshPrevalenceen
dc.subject.meshSocial Classen
dc.subject.meshVitamin B Complexen
dc.titleLow and deficient niacin status and pellagra are endemic in postwar Angolaen
dc.typeArticleen
dc.contributor.departmentCentre for International Child Health, Institute of Child Health, London, United Kingdom; World Food Programme, Luanda, Angola; MSF–Belgium, Kuito, Angola; Ministry of Health, Luanda, Angola; World Food Programme, Rome, Italyen
dc.identifier.journalAmerican Journal of Clinical Nutritionen

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