HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Seal, A. J Articles by van den Briel, T. Search for Related Content PubMed PubMed Citation Articles by Seal, A. J Articles by van den Briel, T. Agricola Articles by Seal, A. J Articles by van den Briel, T.

Low and deficient niacin status and pellagra are endemic in postwar Angola ^1,2,3

¹ From the Centre for International Child Health, Institute of Child Health, London, United Kingdom (AJS, PIC, and FD); the World Food Programme, Luanda, Angola (EC); the MSF–Belgium, Kuito, Angola (EK); the Ministry of Health, Luanda, Angola (PS); and the World Food Programme, Rome, Italy (TvdB)

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 1 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 11 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.

Key Words: Pellagra • niacin • Angola • urine metabolites

This article has been cited by other articles:

				P. I. Creeke, F. Dibari, E. Cheung, T. van den Briel, E. Kyroussis, and A. J. Seal Whole Blood NAD and NADP Concentrations Are Not Depressed in Subjects with Clinical Pellagra J. Nutr., September 1, 2007; 137(9): 2013 - 2017. [Abstract] [Full Text] [PDF]