Overview of MRDR MRDR Dosing and Specimen Collection

Overview of MRDR: MRDR Dosing and Specimen Collection

Modified Relative Dose Response q What is Modified Relative Dose Response (MRDR)? § MRDR is used to assess vitamin A liver reserves • Reports a change in liver stores from the baseline to the follow-up survey. § Does not define vitamin A toxicity § Good indicator for vitamin A deficiency

MRDR Dosing and Specimen Collection q The Phlebotomist will be responsible for MRDR dosing and specimen collection. q Children/Women participating in MRDR dosing will be identified by the Team Supervisors.

MRDR Dosing and Specimen Collection q Doses of vitamin A 2 will be prepared (using a positive displacement pipette and tips) prior to going into the field for the day. § The vitamin A 2 stock should be stored in a refrigerator at ~4°C at the Field Laboratories while not in use or in a cold box with frozen gel packs. § Amber bottles are available to pipette the vitamin A 2 doses into and store while in the field. q Doses should be kept in a cold box with frozen gel packs until they are administered to each child/woman. q 1 m. L syringes or spoons can be used to aid in oral administration of the MRDR dose.

MRDR Dosing and Specimen Collection q Using the guidelines provided during training, administer the correct dose of vitamin A 2 to the selected children/women. § Give the dose with a ½ teaspoon olive oil (with no vitamin A) to help get the dose to the stomach and absorbed. q Fasting conditions are preferred but not required. § If the child has eaten a food that is a good source of vitamin A within the last 2 hours, then it will be necessary to wait 2 hours before administering the dose.

MRDR Dosing and Specimen Collection q The participants should also be instructed not to consume rich sources of vitamin A during the 4 hours after administering the dose of vitamin A 2 and before the second venous blood collection. q The Phlebotomist will need to return to the participant’s home to collect venous blood using a Purple Top Vacutainer 4 hours after dosing. § Collect ~3 m. L venous blood (a minimum of 2 m. L blood is needed)

MRDR Dosing and Specimen Collection q The MRDR specimens will need to be stored in a cold box with frozen gel packs until processed. § The Phlebotomist should keep all labels available for labeling the processed specimens. § Be sure to initial the transfer forms when specimens have been processed and or sign when the specimens have been transferred to someone else for processing/storage.

MRDR Dosing and Specimen Collection Return to the house 4 hrs. later to collect blood specimen Take 7 doses of vitamin A 2 into the field each day - store in cold box with frozen gel packs For selected children, administer dose using a spoon or 1 m. L syringegive vitamin A 2 with olive oil (containing no vitamin A) Store specimen in cold box with frozen gel packs Using a Purple Top Vacutainer, collect ~3 m. L venous blood and label

Questions? ?