scholarly journals Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

2011 ◽  
Vol 15 (4) ◽  
pp. 568-577 ◽  
Author(s):  
Avula Laxmaiah ◽  
Madhavan K Nair ◽  
Nimmathota Arlappa ◽  
Pullakhandam Raghu ◽  
Nagalla Balakrishna ◽  
...  

AbstractObjectiveTo assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.DesignA community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.SettingRural areas of eight states in India.SubjectsPre-school children and their mothers were covered.ResultsA total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8 %. The total ocular signs were significantly higher (P < 0·001) among boys (2·6 %) compared with girls (1·9 %) and in older children (3–4 years) compared (P < 0·001) with younger (1–2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95 % CI 2·9, 5·0), labourers (OR = 2·9; 95 % CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95 % CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95 % CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.ConclusionsThe study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.

2021 ◽  
Vol 8 (2) ◽  
pp. 1-4
Author(s):  
Kishor Pandurang Kadu ◽  
Smita Kishor Kadu ◽  
Santosh Yadavrao Ingle

Background: Adequate data on occurrence of ocular morbidities associated with vitamin A deficiency amongst school going children was not available. So, our study was aimed to evaluate the prevalence of vitamin A deficiency among the primary school children in relation to socio-economical status. Methods: The study was designed among school children of 5-15 years of age after taking consent form from principals of different schools in the rural areas of Amravati district in Maharashtra. A predesigned proforma was used to collect the information. Results: Total 600 school children were examined for Vitamin A deficiency, out of which 314 (52.50%) were boys and 286 (47.75%) were girls. Among the school children 106 (13.7%) students were under the age group of 5-10 years and 494 (86.3%) students were 11- 15 years. According to modified Kuppuswamy scale of Socio-economic status 96 (16%) students belongs to class III, 458 (76.33%) students from class IV and 46 (7.66%) students from class V. Prevalence of Vitamin A deficiency was observed in 34 (5.7%) students, among them 6 (17.64%) had conjunctival xerosis and 28 (82.35%) had bitot’s spot. Among 34 Vitamin A deficiency children 22 (64.70%) were girls and 12 (35.29%) were boys. Conclusion: The presence of ocular morbidity in relation to vitamin A deficiency was observed in students with low socio-economic classes. Prevention, early intervention and treatment of ocular diseases by regular screening of students and nutritional education in schools would definitely decrease the risk of ocular abnormalities. Keywords: HVitamin A deficiency, xerophthalmia.


2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getnet Kassa ◽  
Addisalem Mesfin ◽  
Samson Gebremedhin

Abstract Background In low- and middle-income countries routine vitamin A supplementation (VAS) is a key strategy for reducing vitamin A deficiency and mortality and morbidity of preschool children. However, in Ethiopia, there is paucity of evidence regarding the level and determinants of the uptake of the supplement. This study was designed to assess the coverage and predictors of VAS among preschool children in Humbo district, Southern Ethiopia. Methods A cross-sectional study was conducted in April 2016. A total of 840 mothers/caregivers having children 6–59 months of age were selected using multistage cluster sampling technique from six rural villages implementing routine VAS program. Data were collected using interviewer administered questionnaire. Possible predictors considered in the study include distance from the nearby health facility, household socio-economic status, type of the household (model vs non-model), maternal access to health education on VAS, and knowledge on vitamin A and VAS. Multivariable logistic regression analysis was performed to identify predictors of uptake of VAS. The outputs are presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI). Results The coverage of VAS was 75.0% (95% CI: 72.1–77.9). Better knowledge of mothers about the importance of the supplement (AOR: 1.49, 1.02–2.17), obtaining VAS related information from frontline community health workers (AOR: 1.51, 1.34–2.72) than health professionals and being from households in the “rich” wealth tertile (AOR: 1.80, 95% CI: 1.07–3.03) were positively associated with uptake VAS. Conclusion The VAS coverage of the area was approaching the expected national target of 80%. However, the uptake can be enhanced though awareness creation and improving socio-economic status of the community.


2014 ◽  
Vol 27 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Dixis Figueroa Pedraza ◽  
Márcia Cristina Sales

OBJECTIVE: To estimate the isolated and combined prevalence of anemia, vitamin A deficiency and zinc deficiency in pre-school children, as well as the distribution of isolated deficiencies according to gender, age and prior supplementation with vitamin A. METHODS: Cross-sectional study with pre-school children in the state of Paraíba, Brazil. Analysis of the average concentrations of hemoglobin, serum retinol and serum zinc, according to gender, age and previous vitamin A supplementation of children were carried out as well as the risk of simultaneous occurrence of micronutrient deficiencies in the presence of these deficiencies. RESULTS: The prevalence of anemia, vitamin A deficiency and zinc deficiency were 15.4%, 23.3% and 13.8%, respectively. The anemia was significantly associated with age (p<0.01). Children previously supplemented by vitamin A had higher serum retinol concentrations than children without supplements, an effect that was not observed for concentrations of hemoglobin or serum zinc. The prevalence of anemia associated with vitamin A deficiency was 5.8%, with the chance of vitamin A deficiency and anemia coexist 2.21 times (95%CI=1.03-4.84) higher in the case of vitamin A deficiency or anemia rather than in the absence of these conditions. CONCLUSION: The high prevalence of micronutrient deficiencies which are important in child growth, as well as the coexistence of nutritional deficiencies, point out the need to strengthen nutrition intervention strategies that consider this issue.


2011 ◽  
Vol 15 (4) ◽  
pp. 716-724 ◽  
Author(s):  
Martha E van Stuijvenberg ◽  
Serina E Schoeman ◽  
Carl J Lombard ◽  
Muhammad A Dhansay

AbstractObjectiveTo assess serum retinol, liver intake patterns, breast-feeding history and anthropometric status in pre-school children of a low socio-economic community where liver is regularly consumed.DesignCross-sectional study.SettingNorthern Cape Province, South Africa.SubjectsChildren aged 1–6 years (n243) who attended the local primary health-care facility and had not received a vitamin A supplement in the 6 months preceding the study. Non-pregnant female caregivers (n225), below 50 years of age, were also assessed.ResultsDespite stunting, underweight and wasting being prevalent in 40·5 %, 23·1 % and 8·4 % of the children, only 5·8 % had serum retinol concentrations < 20 μg/dl, which is in sharp contrast to the national prevalence of 63·6 %. None of the caregivers were vitamin A deficient. Liver was eaten by 89·2 % of children, with 87 % of households eating liver at least once monthly and 30 % eating it at least once weekly; liver was introduced into the diet of the children at a median age of 18 months. Ninety-three per cent of the children were being breast-fed or had been breast-fed in the past; children were breast-fed to a median age of 18 months. A significant negative correlation was found between educational level of the caregiver and frequency of liver intake (r= −0·143,P=0·032). There was no correlation between serum retinol and indicators of anthropometric or socio-economic status.ConclusionsThe blanket approach in applying the national vitamin A supplementation programme may not be appropriate for all areas in the country, even though the community may be poor and undernourished.


2003 ◽  
Vol 6 (3) ◽  
pp. 233-240 ◽  
Author(s):  
JF Schémann ◽  
A Banou ◽  
D Malvy ◽  
A Guindo ◽  
L Traore ◽  
...  

AbstractObjective:The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre–post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali.Design:Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs.Subjects and setting:We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared.Results:In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1–9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12–66-month-old children (95% CI 68.27–85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1–5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25–71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events.Conclusions:The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.


2010 ◽  
Vol 4 (6) ◽  
pp. 255 ◽  
Author(s):  
Endang Achadi ◽  
Siti Arifah ◽  
Siti Muslimatun ◽  
Trisari Anggondowati ◽  
Asih Setiarini

Di Indonesia, kekurangan Vitamin A masih menjadi masalah kesehatan masyarakat yang penting seperti terlihat pada balita penderita vitamin A defisiensi subklinis yang tinggi (50%). Hal tersebut akan berpengaruh terhadap berbagai fungsi tubuh yang antara lain meliputi sistem imun, penglihatan, sistem reproduksi dan diferensiasi sel. Tujuan dari penelitian ini adalah untuk mengetahui kontribusi konsumsi minyak yang diperkaya vitamin A dalam memperbaiki status vitamin A dan hemoglobin balita. Penelitian dengan disain studi intervensi Before-After ini dilaksanakan pada anak sehat berusia 7-10 tahun yang diberi obat cacing sebelum intervensi dilakukan. Pengukuran serum retinol dan hemoglobin dilakukan sebelum dan 3 bulan setelah intervensi . Minyak yang difortifikasi vitamin A telah disediakan di warung/ toko di sekitar tempat tinggal responden. Untuk meningkatkan demand, penelitian ini dilengkapi dengan pendekatan pemasaran sosial yang dilakukan pihak lain. Secara umum tidak terlihat perubahan status gizi, tetapi prevalensi anemia turun dari 21,8% menjadi 11,6%. Sementara, prevalens vitamin A defisiensi ditemukan lebih rendah pada anak yang mengkonsumsi ³12 minggu (26,6%) daripada yang mengkonsumsi < 12 minggu (42%) . Hasil tersebut dapat dijadikan pertimbangan untuk merekomendasikan agar minyak difortifikasi vitamin A.Kata kunci: Defisiensi vitamin A, anak sekolah, minyak fortifikasiAbstractVitamin A deficiency (VAD) remains as one of significant public health problems in Indonesia. Around 50% of under five children are suffering from subclinical VAD. Deficiency of vitamin A will affect several important role in the body, such as immune system, vision, reproductive system and cell differentiation. Therefore, guarding Indonesian children to be free from VAD is crucial for their quality as Human Resources. We assessed the impact of the consumption of vitamin A fortified cooking oil on the improvement of vitamin A and hemoglobin status among school children in urban slum area in Makassar City. The study was an intervention design Before-After. Healthy school children 7-10 years were selected from schools and de-wormed before the intervention. Serum retinol and hemoglobin was measured at baseline and at 3 months after. Fortified oil was made available through distribution at shops and accompanied with social marketing. Eventhough overall there was no change in VAD prevalence, the VAD prevalence is lower among children who consumedfortified oil ³12 weeks (26.6%) compared to those who consumed <12 weeks (42%). Prevalence of anemia decreased from 21.8% to 11.6%. We recommended that fortified oil is made mandatory.Key words: Vitamin A deficiency, school children, fortified oil


2015 ◽  
Vol 18 (14) ◽  
pp. 2511-2522 ◽  
Author(s):  
Sandjaja ◽  
Idrus Jus’at ◽  
Abas B Jahari ◽  
Ifrad ◽  
Min Kyaw Htet ◽  
...  

AbstractObjectiveTo assess oil consumption, vitamin A intake and retinol status before and a year after the fortification of unbranded palm oil with retinyl palmitate.DesignPre–post evaluation between two surveys.SettingTwenty-four villages in West Java.SubjectsPoor households were randomly sampled. Serum retinol (adjusted for subclinical infection) was analysed in cross-sectional samples of lactating mothers (baselinen324/endlinen349), their infants aged 6–11 months (n318/n335) and children aged 12–59 months (n469/477), and cohorts of children aged 5–9 years (n186) and women aged 15–29 years (n171), alongside food and oil consumption from dietary recall.ResultsFortified oil improved vitamin A intakes, contributing on average 26 %, 40 %, 38 %, 29 % and 35 % of the daily Recommended Nutrient Intake for children aged 12–23 months, 24–59 months, 5–9 years, lactating and non-lactating women, respectively. Serum retinol was 2–19 % higher at endline than baseline (P<0·001 in infants aged 6–11 months, children aged 5–9 years, lactating and non-lactating women; non-significant in children aged 12–23 months;P=0·057 in children aged 24–59 months). Retinol in breast milk averaged 20·5 μg/dl at baseline and 32·5 μg/dl at endline (P<0·01). Deficiency prevalence (serum retinol <20 μg/dl) was 6·5–18 % across groups at baseline, and 0·6–6 % at endline (P≤0·011). In multivariate regressions adjusting for socio-economic differences, vitamin A intake from fortified oil predicted improved retinol status for children aged 6–59 months (P=0·003) and 5–9 years (P=0·03).ConclusionsAlthough this evaluation without a comparison group cannot prove causality, retinyl contents in oil, Recommended Nutrient Intake contributions and relationships between vitamin intake and serum retinol provide strong plausibility of oil fortification impacting vitamin A status in Indonesian women and children.


2008 ◽  
Vol 29 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Rhona Kezabu Baingana ◽  
Denis Kasozi Matovu ◽  
Dean Garrett

Background Vitamin A deficiency is a public health problem in most developing countries. The technological challenges associated with the measurement of serum retinol have limited the epidemiologic assessment of vitamin A deficiency. The combination of retinol-binding protein (RBP) enzyme immunoassay and dried blood spots offers a rapid, inexpensive, and reliable tool for the population-level assessment of vitamin A deficiency in resource-poor settings. Objective To report on the application of RBP enzyme immunoassay and dried blood spots to assess serum retinol concentrations as an indicator of vitamin A status in the Uganda Demographic and Health Survey 2006. Methods A total of 5,642 capillary blood spot samples were collected by fingerprick onto filter paper cards from women (15–49 years) and children (6–59 months) in a representative probability sample of 9,864 households between May and October 2006. The cards were dried, packed individually with desiccant, and kept at 4°C in a portable refrigerator in the field and at –20°C in the laboratory. Prior to analysis, the RBP enzyme immunoassay was optimized with the use of matched serum and dried blood spots. Results The correlation between RBP values determined by matching serum and dried blood spots was excellent ( r = 0.79, p < .00001). The prevalence of vitamin A deficiency in women (RBP < 1.24 μmol/L) and children (RBP < 0.825 μmol/L) was 19.4% and 20.4%, respectively. Conclusions The combination of RBP enzyme immunoassay and dried blood spots is a simple, reliable, and cost-effective tool for the estimation of vitamin A deficiency in population-level surveys in resource-poor settings.


Author(s):  
Jane Florida Kalumpiu ◽  
Yenny Djuardi ◽  
Taniawati Supali

Background<br />Soil-transmitted helminth (STH) infection is still a health problem in Indonesia. Vitamin A deficiency (VAD) is often found together with STH. The effect of the deworming program on the vitamin A status of primary school children is unknown. The objective of this study was to evaluate the effect of albendazole on serum retinol concentrations in primary school children.<br /><br />Methods<br />An experimental study of pre-post test design without control was carried out on 118 children from grades 3-5 at one primary school in North Jakarta, from July to September 2014. Flotac examination was used to determine STH infections and high performance liquid chromatography was performed to measure serum retinol concentration. Stool and blood samples were taken twice: before and three weeks after treatment with albendazole 400 mg single dose for three consecutive days given to all children either infected or uninfected. Paired t-test was used to analyze the data. <br /><br />Results<br />Of the 118 children, the prevalence of STH was 71.2%. The prevalence of low retinol serum (&lt;1.05 mmol/L) was 17 (17.2%) and of mild VAD was 2 (2.0%). Albendazole given in 3 consecutive days could not increase serum retinol concentrations (p=0.055). Serum retinol concentration significantly increased after albendazole treatment in children with low retinol serum at baseline (p=0.001). <br /><br />Conclusions<br />In children with low serum retinol concentration, treatment with albendazole increased retinol concentration. Integrated deworming and vitamin A supplementation strategies should be evaluated in this population.


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