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

Seal, AJ; Creeke, PI; Dibari, F; Cheung, E; Kyroussis, E; Semedo, P; van den Briel, T; (2007) Low and deficient niacin status and pellagra are endemic in postwar Angola. AM J CLIN NUTR , 85 (1) 218 - 224.

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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 I 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 I I 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.

Type: Article
Title: Low and deficient niacin status and pellagra are endemic in postwar Angola
Identifier: PMID: 17209199
Keywords: pellagra, niacin, Angola, urine metabolites, NICOTINIC ACID STATUS, MOZAMBICAN REFUGEES, EXCRETION, OUTBREAK, DIARRHEA
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
URI: http://discovery.ucl.ac.uk/id/eprint/7461
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