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Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: a multicentre Australian study.

Benson J, Phillips C, Kay M, Webber MT, Ratcliff AJ, Correa-Velez I, Lorimer MF - PLoS ONE (2013)

Bottom Line: Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females.Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries.Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.

View Article: PubMed Central - PubMed

Affiliation: Discipline of General Practice, University of Adelaide, South Australia, Australia. jill.benson@adelaide.edu.au

ABSTRACT

Background: Vitamin B12 deficiency is prevalent in many countries of origin of refugees. Using a threshold of 5% above which a prevalence of low Vitamin B12 is indicative of a population health problem, we hypothesised that Vitamin B12 deficiency exceeds this threshold among newly-arrived refugees resettling in Australia, and is higher among women due to their increased risk of food insecurity. This paper reports Vitamin B12 levels in a large cohort of newly arrived refugees in five Australian states and territories.

Methods: In a cross-sectional descriptive study, we collected Vitamin B12, folate and haematological indices on all refugees (n = 916; response rate 94% of eligible population) who had been in Australia for less than one year, and attended one of the collaborating health services between July 2010 and July 2011.

Results: 16.5% of participants had Vitamin B12 deficiency (<150 pmol/L). One-third of participants from Iran and Bhutan, and one-quarter of participants from Afghanistan had Vitamin B12 deficiency. Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females. A higher prevalence of low Vitamin B12 was also reported in older age groups in some countries. The sensitivity of macrocytosis in detecting Vitamin B12 deficiency was only 4.6%.

Conclusion: Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries. All newly-arrived refugees should be tested for Vitamin B12 deficiency. Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.

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Related in: MedlinePlus

Age and gender distribution of newly arrived refugees who participated in the study (n = 916).
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pone-0057998-g001: Age and gender distribution of newly arrived refugees who participated in the study (n = 916).

Mentions: The study population consisted of 916 persons (427 females, 489 males). Two were excluded as there was no date of birth. Fifty-four persons declined to be screened, or did not have Vitamin B12 tested, resulting in a participation rate of 94%. The age distribution of the population by gender is presented in Figure 1. Compared to the overall population of humanitarian arrivals to Australia during the study period, there is a slight over-representation of people under 30 years of age in our sample (71%, compared to 63% in the national sample) and women (47%, compared to 42% in the national sample) [18]. Most participants were examined shortly after they arrived in Australia. Sixty-six per cent had arrived in Australia within the previous month, with only 6% having a duration of stay recorded of more than four months.


Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: a multicentre Australian study.

Benson J, Phillips C, Kay M, Webber MT, Ratcliff AJ, Correa-Velez I, Lorimer MF - PLoS ONE (2013)

Age and gender distribution of newly arrived refugees who participated in the study (n = 916).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585239&req=5

pone-0057998-g001: Age and gender distribution of newly arrived refugees who participated in the study (n = 916).
Mentions: The study population consisted of 916 persons (427 females, 489 males). Two were excluded as there was no date of birth. Fifty-four persons declined to be screened, or did not have Vitamin B12 tested, resulting in a participation rate of 94%. The age distribution of the population by gender is presented in Figure 1. Compared to the overall population of humanitarian arrivals to Australia during the study period, there is a slight over-representation of people under 30 years of age in our sample (71%, compared to 63% in the national sample) and women (47%, compared to 42% in the national sample) [18]. Most participants were examined shortly after they arrived in Australia. Sixty-six per cent had arrived in Australia within the previous month, with only 6% having a duration of stay recorded of more than four months.

Bottom Line: Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females.Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries.Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.

View Article: PubMed Central - PubMed

Affiliation: Discipline of General Practice, University of Adelaide, South Australia, Australia. jill.benson@adelaide.edu.au

ABSTRACT

Background: Vitamin B12 deficiency is prevalent in many countries of origin of refugees. Using a threshold of 5% above which a prevalence of low Vitamin B12 is indicative of a population health problem, we hypothesised that Vitamin B12 deficiency exceeds this threshold among newly-arrived refugees resettling in Australia, and is higher among women due to their increased risk of food insecurity. This paper reports Vitamin B12 levels in a large cohort of newly arrived refugees in five Australian states and territories.

Methods: In a cross-sectional descriptive study, we collected Vitamin B12, folate and haematological indices on all refugees (n = 916; response rate 94% of eligible population) who had been in Australia for less than one year, and attended one of the collaborating health services between July 2010 and July 2011.

Results: 16.5% of participants had Vitamin B12 deficiency (<150 pmol/L). One-third of participants from Iran and Bhutan, and one-quarter of participants from Afghanistan had Vitamin B12 deficiency. Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females. A higher prevalence of low Vitamin B12 was also reported in older age groups in some countries. The sensitivity of macrocytosis in detecting Vitamin B12 deficiency was only 4.6%.

Conclusion: Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries. All newly-arrived refugees should be tested for Vitamin B12 deficiency. Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.

Show MeSH
Related in: MedlinePlus