Vitamin A deficiency (VAD) is a significant public health problem in many
countries. While cost-effective interventions are available to control VAD,
reliable information is needed to the track progress of control programmes.
However, assessment of VAD is uncommon because current approaches are expensive
and not feasible in low-resource settings. The present study explores the
utility of retinol-binding protein (RBP), analysed by enzyme-linked
immunosorbent assay from capillary blood, as an alternative measure of serum
retinol concentrations in populations. The study collected matched panels of
venous and capillary blood from pre-school children in Chiang Mai, Thailand. Of
a total sample of 195 children, there were no differences between RBP from
venous blood, RBP from capillary blood or retinol from capillary blood relative
to retinol from venous blood. Receiver-operating characteristic curve analysis
suggested a cut-off of RBP < 0.825 μmol
l−1 had optimal screening proficiency relative to
retinol <0.70 μmol l−1. For the
purpose of population assessment, all three parameters performed well in
screening for VAD relative to retinol from venous blood. There were no
differences in the estimates of VAD between children stratified by inflammation
status. Lower RBP concentrations were found in children in the early
convalescent stage of infection than in children with no infection or in the
late convalescent stage. This study provided evidence of the biological
comparability between retinol and RBP estimated from venous blood and capillary
blood. This is a critical observation as it provides empirical evidence that RBP
from capillary blood is a surrogate measure of serum retinol concentrations.