Assessment of the potential of comfrey (symphytum periginum) as a source of vitamin A for malnourished Children (8 - 16 years) : a case study of Kirigiti girls approved school in Kiambu, Kenya

Abstract

In February-September 2001, an interventional study employing the pre-test, post-test casecontrol study design was carried out among children aged 8 to 16 years in Kirigiti Girls Approved School in Kiambu District, Central Province, Kenya. The main objective of the study was to determine the potential of comfrey (Sympytum periginum) in the alleviation of vitamin A deficiency. A J3-carotene rich biscuit (J3CRB)was made using comfrey and a relatively low J3-carotenebiscuit (J3CLB)without comfrey was also made and their beta-carotene content determined. The comfrey rich biscuit had a significantly higher beta-carotene content (1060 /-lg/IOOgrams) than the comfrey free biscuit, which had (170 /-lg/100grams). Seventy-seven (77) children admitted at the school were randomly allocated to two study groups; a test group and a control group. Both groups were then subjected to an interview, physical examination and anthropometry. Pre and post-test morbidity experience was also recorded within which period stool samples were collected for examination of ova cysts and blood drawn for haemogram and biochemical estimation of serum J3-caroteneand serum retinol. Proximate composition of meals taken at the school and dietary intake were determined. The children were then dewormed and fed 95g of the respective biscuits for 31 days after which morbidity experience, anthropometry, stool and blood collection were repeated. A seven-day morbidity recall at baseline indicated that the proportion of children who had respiratorytract infection, and skin disorders were 19.5% and 16.9% respectively. At baseline, 79.2% of the children had dental caries with 39% of the children in the experimental group. The pretest clinical assessment data indicated that IS .6% of the children from the ~CRB group and 18.2 % from the ~CLB group had nyctalopia. After supplementation, nyctalopia significantly reduced in both groups (p<O.OI). No significant reduction was noted in the number of children with wrinkled cornea (p<O.OS) in both groups. Flu, coughs, fever and headaches, dermatitis, brown hair, skin disorders and parasitic infestation reduced after supplementation in both groups with significance recorded in the first six conditions (p<O.OS) but there was no significant difference observed between the two groups at pre and post-test. In the ~CRB group, the mean baseline BMI was 16.17±1.67 and in the post-test period it was 16.9± 1.67 while the ~CLB group recorded indices of 16.3±2.18 and 17.1± 1.97 respectively. There was however, no significant difference. There was no significant difference (p>O.OS) in serum ~-carotene and retinol levels at baseline but at post-test, the serum ~-c~rotene significantly increased (p<O.OS) in the cases from 0.0327 ± 0.069 to 0.096 ± 0.036 than in the control group from O.OSO ±-0.049 to 0.076 ± 0.03S. The difference in post intervention serum ~-carotene levels between the groups was highly significant (p=O.OOO). Despite the increase in the ~-carotene, the serum retinol levels did not change significantly. The data strongly indicates that comfrey (Symphytum periginum) can be a source of vitamin A But further studies are required to determine whether a higher dose of~-carotene or a longer supplementation period using ~CRB is required to observe changes in plasma retinol levels.