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Committee Members:

Rickie Brawer, PhD, MPH

Kevin Scott, MD


The purpose of this study was to investigate the rate and causes of vitamin B12 deficiency among Bhutanese refugees in Philadelphia, as well as to gain a more complete understanding of this population’s nutritional habits. This was a mixed methods study with both qualitative and quantitative aspect. The quantitative aspect used lab values and social history stored in the Refugee Health Database. For the qualitative part of the study, 6 open ended interviews were conducted with Bhutanese Refugee’s families in their homes. We found that approximately 10% of the lab values indicated a presence of macrocytosis probably caused from an insufficient intake of foods containing vitamin B12. Secondarily to that,the high incidence and prevalencegastrointestinal ailments may have reduced their abilities to absorb the vitamin B12 they did consume. In addition, we found that the refugees’ diet contained a high amount of folate which was likely masking hemolytic effects of b12 deficiency. The study recommends that they JFMA Refugee Health Clinic no longer do vitamin B12 serum test. But, instead treat every Bhutanese Refugee for such a deficiency with a vitamin B12 oral supplement regime.