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Prevalence of Micronutrient Deficiencies among Preschool and School-Going Children in Flood-Hit Areas of Pakistan

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  • 1 Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan;
  • | 2 Department of Math’s, Stats and Computer Science, The University of Agriculture Peshawar, Pakistan;
  • | 3 Basic Health Unit Daiwal, Tehsil/District Khushab, District Health Authority Khushab, Punjab, Pakistan;
  • | 4 School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China;
  • | 5 Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China;
  • | 6 Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department, Khyber Pakhtunkhwa, Pakistan;
  • | 7 Institue of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan;
  • | 8 Department of Dietetics and Nutrition Sciences, University of Sialkot, Pakistan;
  • | 9 Department of Biology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan;
  • | 10 Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China

ABSTRACT.

There is minimal literature regarding micronutrient deficiencies in flood-affected regions. In our study, we aimed to find the prevalence of micronutrient deficiencies (vitamin A, calcium, zinc, iron, and iodine) among preschool and school-age children in flood-hit areas of Khyber Pakhtunkhwa, Pakistan. In this cross-sectional study, a multi-stage sampling technique was used for the selection of 656 households. Serum micronutrient status was detected in the targeted population in the affected districts. The least significant difference test was used with analysis of variance to determine significant differences in nutrient contents in different areas. Of the total respondents, 90.8% of the children were calcium deficient, 88.3% were zinc deficient, 26.7% were iron deficient, 53.5% were vitamin A deficient, and 39.5% were had an iodine deficiency in flood-affected areas. A significant difference (P < 0.05) was found in different age groups of children for zinc (5.7–42.63 μg/dL) and urinary iodine (69.6–85.4 μg/L). The 10- to 12-year-old age group had a lower serum zinc concentration (5.7 μg/dL), whereas the 1- to 3-year-old age group had a lower urinary iodine concentration (69.6 μg/L) than other groups. There was no significant difference (P > 0.05) between male and female children and various age groups for calcium and iron status. Vitamin A levels were significantly (P < 0.05) different among different age groups (high in age group 4–6 years) and districts. Vitamin A concentration was lower in the Nowshera District, whereas serum iron and zinc were lower in the Dera Ismail Khan District. All the important micronutrients in the population of children were deficient in the flood-affected areas of Pakistan. Therefore, policymakers should implement potential prevention strategies, such as food security, school health nutrition, food fortification, nutrition in the first 1,000 golden days, nutrition knowledge, and awareness of the local population, to reduce the burden of micronutrients deficiencies in flood-affected areas.

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Author Notes

Address correspondence to Yufang Xue or Xiaoshuang Chen, Clinical Nutrition Department, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, Jiangsu, China. E-mails: xyfkoala@163.com or 781651165@qq.com

Financial support: This research project was funded by the Higher Education Commission of Pakistan.

Disclaimer: The funder has no role in designing, writing, and publishing this manuscript.

Disclosure: This study was conducted according to the guidelines laid down in the Declaration of Helsinki. The ethical committee of The University of Agriculture Peshawar, Pakistan, approved all procedures involving research study participants (approval no. 002). Written informed consent was obtained from all subjects.

Authors’ addresses: Ijaz ul Haq, Ihtisham Ul Haq, and Muhammad Shahzad, Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan, E-mails: ijazbrt@outlook.com, ihtisham_aup@yahoo.com, and smohammdee@hotmail.com. Zafar Mehmood, Department of Math’s, Stats and Computer Science, The University of Agriculture Peshawar, Pakistan, E-mail: zafarjan@gmail.com. Abdul Majid Mujahid, Basic Health Unit Daiwal, Tehsil/District Khushab, District Health Authority Khushab, Punjab, Pakistan, E-mail: majid346@hotmail.com. Bilal Ahmed, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China, E-mail: drbilal_71@yahoo.com. Jahan Shah, Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China, E-mail: 111jahanshah@gmail.com. Nadar Khan, Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department, Khyber Pakhtunkhwa, Pakistan, E-mail: nadar73vet@aup.edu.pk. Ejaz Ali Khan, Institue of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan, E-mail: ejazalikhan4@gmail.com. Abbas Khan, Department of Dietetics and Nutrition Sciences, University of Sialkot, Pakistan, E-mail: abbas.khan@uskt.edu.pk. Umar Zeb, Department of Biology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan, E-mail: umar.zeb@uoh.edu.pk. Jielian Xu, Yufang Xue, and Xiaoshuang Chen, Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China, E-mails: 854455418@qq.com, xyfkoala@163.com, and 781651165@qq.com.

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