Suspected Outbreak of Riboflavin Deficiency among Populations Reliant on Food Assistance: A Case Study of Drought-Stricken Karamoja, Uganda, 2009–2010

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Nichols, Erin K. ; Talley, Leisel E. ; Birungi, Nelly ; McClelland, Amanda ; Madraa, Elizabeth ; Chandia, Agnes B. ; Nivet, Jacqueline ; Flores-Ayala, Rafael ; Serdula, Mary K.
• Description:
  Background
  
  In 2009, a humanitarian response was launched to address a food security and livelihoods crisis in Karamoja, Uganda. During a polio immunization campaign in mid-August 2009, health workers in Nakapiripit District reported a concern about an increase in mouth sores, or angular stomatitis (AS) and gum ulcerations, among children in one village, and an investigation was launched.
  
  Objective
  
  This article describes the investigation, lessons learned, and provides guidance for monitoring micronutrient deficiencies among populations receiving food assistance.
  
  Design
  
  An investigation into a suspected outbreak of riboflavin (vitamin B2) deficiency was initiated, including a rapid assessment, mass screening, a convenience sample collection of blood specimens (n = 58 symptomatic cases and n = 18 asymptomatic individuals), and analysis of the general food ration (70% ration).
  
  Results
  
  Findings showed signs of AS in only 399 (0.2%) of 179,172 screened individuals, including adults and children. Biochemical analysis confirmed riboflavin deficiency in 84.5% of specimens from symptomatic individuals and 94.4% of specimens from asymptomatic individuals. Ration distribution data showed that 55% of distributions provided less than half the riboflavin RDA.
  
  Conclusion
  
  Evidence was insufficient to confirm an actual outbreak of riboflavin deficiency, though the present investigation adds further documentation that micronutrient deficiencies continue to persist among populations in emergency settings. This article describes challenges, lessons learned, and guidance for monitoring micronutrient deficiencies among food assistance recipients, including: ongoing nutrition monitoring and surveillance; training and sensitization about micronutrient deficiencies, sensitization of the population about locally-available food, and identifying ways to improve micronutrient interventions.
  
  
• Subjects:
  Adolescent Child Child, Preschool Disease Outbreaks Droughts Female Food Assistance Health Personnel Humans Infant Infant, Newborn Male Practice Guidelines As Topic Riboflavin Riboflavin Deficiency Young Adult

  More +
• Source:
  PLoS One. 2013; 8(5).
• Document Type:
  Journal Article
• Place as Subject:
  Uganda
• Volume:
  8
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3140d12de89eae92b003e0c050938be75021dc3e9f2ef03cb5c449f9c194d983
• Download URL:
  https://stacks.cdc.gov/view/cdc/13457/cdc_13457_DS1.pdf
• File Type:
  [PDF - 273.89 KB ]