Data_Sheet_1_Prevalence of micronutrient deficiencies across diverse environments in rural Madagascar.docx

It is estimated that billions of people around the world are affected by micronutrient deficiencies. Madagascar is considered to be particularly nutritionally vulnerable, with nearly half of the population stunted, and parts of the country facing emergency, near famine-like conditions (IPC4). Although Madagascar is generally considered among the most undernourished of countries, empirical data in the form of biological samples to validate these claims are extremely limited. Our research drew data from three studies conducted between 2013–2020 and provided comprehensive biomarker profile information for 4,710 individuals from 30 communities in five different ecological regions during at least one time-point. Estimated prevalences of nutrient deficiencies and inflammation across various regions of rural Madagascar were of concern for both sexes and across all ages, with 66.5% of the population estimated to be deficient in zinc, 15.6% depleted in vitamin B12 (3.6% deficient), 11.6% deficient in retinol, and lower levels of iron deficiency (as indicated by 11.7% deficient in ferritin and 2.3% deficient assessed by soluble transferrin receptors). Beyond nutrient status biomarkers, nearly one quarter of the population (24.0%) exhibited chronic inflammation based on high values of α-1-acid glycoprotein, and 12.3% exhibited acute inflammation based on high values of C-reactive protein. There is an 8-fold difference between the lowest and highest regional observed prevalence of vitamin B12 deficiency, a 10-fold difference in vitamin A deficiency (based on retinol), and a 2-fold difference in acute inflammation (CRP) and deficiencies of zinc and iron (based on ferritin), highlighting strong geographical variations in micronutrient deficiencies across Madagascar.

全球范围内，数以亿计的人口遭受微量营养素缺乏之苦。马达加斯加被视为营养脆弱地带，其近半数人口发育不良，部分地区面临紧急的、近乎饥荒般的状况（IPC4）。尽管马达加斯加通常被认为是最营养不良的国家之一，但用以验证这些说法的实证数据——以生物样本的形式——极为匮乏。本研究从2013至2020年间进行的三个研究中抽取数据，为来自五个不同生态区域的30个社区的4,710名个体在至少一个时间点的全面生物标志物信息提供了详尽分析。在马达加斯加农村的各个地区，估计的营养素缺乏和炎症的普遍率对男女两性及所有年龄段都令人担忧，其中66.5%的人口估计锌缺乏，15.6%的人维生素 B12耗竭（其中3.6%的人缺乏），11.6%的人缺乏视黄醇，以及铁缺乏的水平较低（根据11.7%的人血清铁蛋白缺乏和2.3%的人通过可溶性转铁蛋白受体评估为缺乏）。除了营养状态生物标志物之外，近四分之一的人口（24.0%）基于α-1-酸性糖蛋白的高值表现出慢性炎症，而12.3%的人基于C反应蛋白的高值表现出急性炎症。维生素 B12缺乏的地区普遍率最低与最高之间的差异达8倍，维生素A缺乏（基于视黄醇）的差异为10倍，急性炎症（CRP）以及锌和铁的缺乏（基于血清铁蛋白）的差异为2倍，这些数据突显了马达加斯加境内微量营养素缺乏的强烈地域性差异。