Serum zinc status is a matter of concern among children and non-pregnant women in a nationwide survey of Nepal

Abstract

AbstractNationally representative population data on zinc status in Nepal is lacking at present. This study analyzed data from the recent Nepal National Micronutrient status survey 2016 to determine the prevalence of zinc deficiency and associated risk factors among children aged 6–59 months (n = 1462) and non-pregnant women aged 15–49 years (n = 1923). Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anemia, RBP (vitamin A), and markers of inflammation. Stool samples were collected to assess soil-transmitted helminths and Helicobacter pylori infection. Socio-demographic, household, and other relevant factors were collected by a structured questionnaire. Serum zinc concentration was measured by Microwave Plasma Atomic Emission Spectrometry, and zinc deficiency was defined according to the International Zinc Nutrition Consultative Group’s guidelines. Logistic regression was used to examine the predictors of zinc deficiency among the participants. The overall zinc deficiency in children was 22.9%, while it was higher in non-pregnant women (24.7%). The prevalence of anemia among zinc-deficient children was higher (21.3%) than the zinc non-deficit children (18.7%). The prevalence of anemia was 18% among zinc-deficient non-pregnant women compared to 22% non-deficit non-pregnant women. Predictors associated with zinc deficiency among the study children were living in rural areas (AOR = 2.25, 95% CI, [1.13, 4.49]), the occurrence of diarrhea during the two weeks preceding the survey (AOR = 1.57, 95% CI, [1.07, 2.30]), lowest household wealth quintile (AOR = 0.48, 95% CI, [0.25, 0.92]) and lower vitamin A status (AOR = 0.49, 95% CI, [0.28, 0.85]. The predictors associated with zinc deficiency among non-pregnant women were: being underweight (AOR = 1.55, 95% CI, [1.12, 2.15]), fever occurrence during two weeks preceding the survey (AOR = 1.43, 95% CI, [1.04, 1.98]), H. pylori in the stool (AOR = 1.33, 95% CI, [1.04, 1.71]), lowest household wealth quintile (AOR = 0.62, 95% CI,[0.40, 0.94]) and being at risk of folate deficiency (AOR = 0.58, 95% CI,[0.36, 0.94]). We conclude that community-level intervention programs focused on rural children and women to prevent diarrhea, improve nutrition counseling, and provide economic opportunities in rural communities may help to lower zinc deficiency and other micronutrient deficiencies in the Nepalese population. We believe that intervention programs to address zinc deficiency should not be isolated. Instead, integrated approaches are beneficial to improve overall micronutrient status, such as encouraging dietary diversity, providing livelihood opportunities to the unemployed, micronutrient supplementation to vulnerable populations, and consumption of zinc-rich animal-based foods.