The prevalence of vitamin B12, folic acid and iron deficiency in healthy relatives of patients admitted at regional referral hospitals in Rwanda: A cross sectional study

Background: The clinical observations at teaching hospitals across Rwanda have anecdotally documented high rates of reversible megaloblastosis due to a deficiency in B complex vitamins. This study aimed to determine the prevalence of vitamin B12, folic acid and iron deficiency in a cross-section of a healthy adult Rwandan population.

Methods: This study enrolled 191 healthy participants from different regions of Rwanda. All study subjects signed informed consent, completed a pre-designed questionnaire covering their general demographics, geographical distribution and dietary habits, and underwent a neurological examination. Complete blood count, serum vitamin B12, folic acid, ferritin and C-reactive protein levels were measured. Stata MP 13 (64 bit) was used for statistical analysis. The statistically significant p-value was set to < 0.05.

Results: The point-prevalence of vitamin B12 deficiency using the standard WHO definition was 9.9%. Low or low-normal vitamin B12 levels were observed among 39/108 (36%) of subjects between 18-35 years of age. Iron deficiency was found in 7/191 (3.6%) of participants. None of the participants in this study were found to have a folic acid deficiency.

Conclusion: The proportion of low vitamin B12 was much higher than that reported in developed countries.

Recommendation: Further research is needed to elucidate the leading causes of vitamin B12 deficiency in Rwanda.

Keywords
vitamin B12; B12 deficiency; reticulocytes; micronutrient; nutrition; Rwanda