Journal of Immigrant and Minority Health

, Volume 20, Issue 6, pp 1317–1323 | Cite as

Prevalence of Nutritional Deficiencies Among Populations of Newly Arriving Government Assisted Refugee Children to Kitchener/Waterloo, Ontario, Canada

  • Carolyn BeukeboomEmail author
  • Neil Arya
Original Paper


This study examined the variation among ethnic populations in prevalence of anemia, vitamin D and B12 deficiencies among refugee children. A retrospective chart review of 388 government assisted refugee children ≤ 16 years of age, seen at the Refugee Health Clinic in Kitchener, Canada from January 2009 to December 2014 was conducted. Vitamin D levels were only collected until December 1st 2010 (116 children). 15.7% were anemic (25% < 5 years, 8.7% 5–11 years, and 18.3% 12–16 years old) with Somali children having the lowest hemoglobin levels compared to those from Iraq, Afghanistan and Myanmar. 53.5% were vitamin D deficient (25(OH)D < 50 nmol/L), seen most commonly in Iraqis and Afghans. 11.2% had vitamin B12 levels < 150 pmol/L. Providers’ knowledge of prevalence of nutritional deficiencies related to region of origin, can guide appropriate screening and treatment options to promote longer term cognitive, physical and developmental health.


Refugee Children Nutrition deficiency Canada 


  1. 1.
    Canadian Pediatric Society. An overview of immigrants and refugees in Canada. 2015.
  2. 2.
    CDC. Guidelines for evaluation of the nutritional status and growth in refugee children during the domestic medical screening examination. 2012.
  3. 3.
    Government of Canada. Canada facts and figures 2014. 2014.
  4. 4.
    Government of Canada. #Welcome refugees: key figures. 2016.
  5. 5.
    Government of Canada. The refugee system in Canada. 2014.
  6. 6.
    Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health. Am J Clin Nutr. 2008;87:1080–6.CrossRefGoogle Scholar
  7. 7.
    Benson J, Skull S. Hiding from the sun—vitamin D deficiency in refugees. Aust Fam Physician. 2007;36:355–7.PubMedGoogle Scholar
  8. 8.
    Penrose K, Adams JH, Nguyen T, Cochran J, Geltman PL. Vitamin D deficiency among newly resettled refugees in Massachusetts. J Immigr Minor Health. 2012;14(6):941–8.CrossRefGoogle Scholar
  9. 9.
    Benson J. Vitamin B12 deficiency—why refugee patients are at high risk. Aust Fam Physician. 2010;39(4):.215–217.PubMedGoogle Scholar
  10. 10.
    Fabio M. Nutrition for refugee children: risks, screening, and treatment. Curr Probl Pediatr Adolesc Health Care. 2014;44(7):188–95.CrossRefGoogle Scholar
  11. 11.
    Reception House Waterloo Region. Welcome to Reception House Waterloo Region. 2014.
  12. 12.
    Ministry of Health and Long Term Care. OHIP-insured Vitamin D Testing. INFOBullitin. 2010.
  13. 13.
    Shah AY, Suchdev PS, Mitchell T, Shetty S, Warner C, Oladele A, et al. Nutritional status of refugee children entering DeKalb County, Georgia. J Immigr Minor Health. 2013;6(5):959–67.CrossRefGoogle Scholar
  14. 14.
    Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, et al. Evidence-based clinical guidelines for immigrants and refugees. CMAJ. 2011;6183(12):E824–E925.CrossRefGoogle Scholar
  15. 15.
    WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. VMNS Vitam Miner Mutr Inf Syst. 2011.
  16. 16.
    Aucoin M, Weaver R, Thomas R, Jones L. Vitamin D status of refugees arriving in Canada Findings from the Calgary Refugee Health Program Recherche État des réfugiés arrivant au Canada sur le plan des carences en vitamine D Constatations du Refugee Health Program de Calgary. Can Fam Physician. 2013;59(4):188–94.Google Scholar
  17. 17.
    Vatanparast H, Nisbet C, Gushulak B. Vitamin D insufficiency and bone mineral status in a population of newcomer children in Canada. Nutrients. 2013;5(5):1561–72.CrossRefGoogle Scholar
  18. 18.
    Paxton G, Sangster KJ, Maxwell EL, McBride CRJ, Drewe RH. Post-arrival health screening in Karen refugees in Australia. PLoS ONE. 2012;7(5):e38194.CrossRefGoogle Scholar
  19. 19.
    Eggemoen AR, Knutsen KV, Dalen I, Jenum AK. Vitamin D status in recently arrived immigrants from Africa and Asia: a cross-sectional study from Norway of children, adolescents and adults. BMJ. 2013;3(10):e003293.Google Scholar
  20. 20.
    Institute of Medicine. Dietary reference for calcium and vitamin D. Washington, DC: National Academies Press; 2011.Google Scholar
  21. 21.
    Benson J, Phillips C, Kay M, Webber MT, Ratcliff AJ, Correa-Velez I, et al. Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: a multicentre Australian study. PLoS ONE. 2013;8(2):e57998.CrossRefGoogle Scholar
  22. 22.
    De Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B 12 deficiencies. Food Nutr Bull. 2008;29(2):238–44.CrossRefGoogle Scholar
  23. 23.
    Kemmer TM, Bovill ME, Kongsomboon W, Hansch SJ, Geisler KL, Cheney C, et al. Iron deficiency is unacceptably high in refugee children from Burma. J Nutr. 2003;133:4143–9.CrossRefGoogle Scholar
  24. 24.
    Seal AJ, Creeke PI, Mirghani Z, Abdalla F, McBurney RP, Pratt LS, et al. Iron and vitamin A deficiency in long-term African refugees. J Nutr. 2005;135:808–13.CrossRefGoogle Scholar
  25. 25.
    Hassan K, Sullivan KM, Yip R, Woodruff BA. Factors associated with anemia in refugee children. J Nutr. 1997;127(11):2194–8.CrossRefGoogle Scholar
  26. 26.
    United Nations System, Standing Committee on Nutrition. Progress in Nutrition. 6th Report on World Nutrition Situation. 2010.
  27. 27.
    Statistics Canada. Iron Sufficiency of Canadians 2009–2011. 2013. Accessed 10 July 2015.
  28. 28.
    Olivares M, Walter T, Osorio M, et al. Anemia of a mild viral infection: the measles vaccine as a model. Pediatrics. 1989;84(5):851–5.PubMedGoogle Scholar
  29. 29.
    Statistics Canada. Chart1.Percentage of Canadians above and below selected vitamin D cut-off (50nmol.L) by age group. 2013. Accessed 10 July 2015.
  30. 30.
    Prentice A. Vitamin D deficiency: a global perspective. Nutr Rev. 2008. Scholar
  31. 31.
    Statistics Canada. Vitamin B12 Status of Canadians 2009–2011. 2013. Accessed 10 July 2015.
  32. 32.
    Walker P, O’Fallon A, Nelson K, Mamo B, Dicker S, Chute S, et al. Vitamin B12 deficiency in resettled Bhutanese refugees—United States, 2008–2011. MMWR Morb Mortal Wkly Rep. 2011;60:343–6.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of NursingWestern UniversityLondonCanada
  2. 2.School of NursingMcMaster UniversityHamiltonCanada
  3. 3.LondonCanada
  4. 4.Centre for Family Medicine Refugee Health ClinicWaterlooCanada
  5. 5.Family Medicine McMaster UniversityHamiltonCanada
  6. 6.Family Medicine Western UniversityLondonCanada

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