Status of vitamins A and E in schoolchildren in the centre west of Tunisia: a population-based study

Objective: The present study was undertaken to assess the status of vitamins A and E (VA and VE, respectively) and their main determinants in Tunisian children. Design: Cross-sectional population-based study. Setting: Kasserine Governorate in the centre west of Tunisia. Subjects: A total of 7407 children attending the first grade of elementary school were included. VA and VE were assessed by HPLC. Results: The prevalence of moderate VA deficiency (VAD; < 0.70 mu mol/l) was 2.3% and VE deficiency (VED; < 6.97 mu mol/l) was 5.4%. Low status in VA (0.70-1.05 mu mol/l) and VE (6.97-11.61 mu mol/l) was observed in 17% and 20.2% of children, respectively. No child exhibited severe VA or VE deficiency (< 0.35 and < 2.32 mu mol/l, respectively). The main predictors of VAD were advanced age (OR = 1.65; 95% CI 1.13, 2.41; P=0.05) and sickness within the past 2 weeks (OR = 1.51; 95% CI 1.09, 2.09; P=0.01). Predictors of VED were living in the pen-urban region (OR = 1.60; 95% CI 1.28, 2.01; P < 0001) and sickness within the past 2 weeks (OR = 0.75; 95% CI 0.60, 0.94; P=0.01). Conclusions: Moderate VAD and VED were uncommon in Tunisian children. However, low status in VA and/or VE remains frequent. A reinforcement of the national strategies for children's nutrition and health is needed, particularly in disadvantaged regions. Supplementation of VA and VE is not necessary in Tunisia, but food fortification may be beneficial.