The Health of Newly Arrived Refugees with Vitamin B12 Deficiency

In newly arrived refugees aged 18 and over from Bhutan, Afghanistan and Iran who come to the Migrant Health Service in Adelaide, are symptoms and perception of physical, psychological and general health different in those with and without Vitamin B12 deficiency?

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12611000758909

Enrollment

139

Registered

2011-07-20

Start date

2011-10-15

Completion date

2012-10-30

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

High levels of Vitamin B12 deficiency were recently found in some refugee groups in studies in Australia and USA (Benson, 2010; CDC, 2011). The cause of the deficiency is unknown but is thought to be due to dietary deficiency in animal source foods or because of infection with helicobacter pylori. There is a well-known relationship of Vitamin B12 deficiency with depression and other problems such as fatigue, irritability, memory problems and unusual sensations in legs and feet (Oh, 2003). These symptoms are often used as indicators of Vitamin B12 deficiency however there have been no studies to date to determine if these are reliable indictors, or whether they are present in all refugees with Vitamin B12 deficiency. Many refugees have psychological problems, (Steel, 2009) as well as fatigue, irritability, dizziness and memory difficulties, but it is unknown whether these symptoms may also be linked to Vitamin B12 deficiency in this population. As refugees settle into a new country their diet and psychological health is likely to change. A control group will assist in adjusting for confounding factors. This pilot study aims to identify: 1. whether symptoms such as fatigue, irritability, memory difficulties, unusual sensations in legs and feet and psychological distress are reliable indictors of Vitamin B12 deficiency in newly arrived refugees 2. whether these symptoms change as Vitamin B12 deficiency normalises 3. whether there is a difference in symptomatology and perceptions of general health in newly arrived refugees with and without Vitamin B12 deficiency.

Interventions

A questionnaire including the K10, the general health question from the SF-36 and questions about the symptoms of Vitamin B12 deficiency will be self-administered (with the support of health staff) in their own language by newly arrived refugees from Bhutan, Afghanistan and Iran. Some participants will have Vitamin B12 deficiency (<150pmol/L), some will have borderline Vitamin B12 (150-240pmol/L) and some will have normal Vitamin B12 levels. All participants will be treated according to usual clinical protocols with Vitamin B12 injections if they have deficiency, dietary advice if they have borderline levels and no treatment if theyhave normal Vitamin B12 levels. The questionnaire will be administered to all participants again after 4 months and those with low or borderline Vitamin B12 will have their levels repeated.

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

Refugees aged 18 and over who present to the New Arrival Nursing Clinic at the Migrant Health Service in Adelaide in the first 3 months after arrival into Australia who are from Bhutan, Afghanistan or Iran.

Exclusion criteria

Aged under 18 or taking Vitamin B12 supplements at the initial presentation

Outcome results