Scope and Method of Study: This cross-sectional study investigated the extent and severity of protein energy malnutrition and deficiencies of vitamin A, iron, iodine and zinc nutrition in 10 - 15 year old school girls from Tigray, Northern Ethiopia using anthropometric, biochemical and clinical indicators. A structured questionnaire was used to collect sociodemographic information. Serum retinol was analyzed by High Pressure Liquid Chromatography (HPLC); Urinary iodine (UI) concentrations were determined by chemical and spectroscopic methods; ferritin was analyzed by immunoradiometric assay (IRMA); serum zinc was analyzed using an inductively coupled plasma mass spectrometer (ICPMS); soluble transferrin receptors (sTfR) and C- Reactive Protein (hsCRP) were determined using enzyme linked immunosorbent assays (ELISA).Findings and Conclusions: Prevalence of stunting and thinness in school girls was 23% and 27%, respectively. The prevalence of anemia in the school girls was 7% after adjusting hematocrit levels for elevation. Nearly 9% had depleted and 15% had low iron stores, and 6% had clinical signs of anemia. Parasites commonly associated with anemia were rarely detected. Nearly 3% were vitamin A deficient and 26% had serum retinol levels indicative of marginal vitamin A status. Clinical assessments showed that Bitot's spots and night blindness were prevalent in 3.7% and 3.2% of the girls, respectively. Total goiter rate as assessed by palpation was 45.3%, and 67% of the girls had biochemical iodine deficiency (UI < 100 microg/L). Only 16% of the households utilized iodized salt. More than 49% of the school girls were zinc deficient on the basis of serum zinc levels. In conclusion, protein energy malnutrition and micronutrient deficiencies including iodine, iron, vitamin A and zinc were of public health significance with deficiencies of iodine and zinc being more severe than iron and vitamin A. Our results demonstrated a high level of concomitant micronutrient deficiencies in an age group which is not usually considered to be at risk for nutritional deficiencies
