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    Jan 17, 2021
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    Low and deficient niacin status and pellagra are endemic in postwar Angola

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    Authors
    Seal, A J
    Creeke, P I
    Dibari, F
    Cheung, E
    Kyroussis, E
    Semedo, P
    van den Briel, T
    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
    2007-01-01
    
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    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.
    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
    Collections
    Nutrition

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